scholarly journals The efficiency of treatment of vaginal infections in women with a history of miscarriage

2019 ◽  
Vol 68 (5) ◽  
pp. 63-74
Author(s):  
Anna A. Siniakova ◽  
Elena V. Shipitsyna ◽  
Olga V. Budilovskaya ◽  
Vyacheslav M. Bolotskikh ◽  
Alevtina M. Savicheva

Hypothesis/aims of study. The problem of vaginal infections during pregnancy is of high importance in obstetric practice. To predict the risks and reduce the frequency of pregnancy and childbirth complications, it is necessary to dynamically assess the vaginal microflora and treat its disorders. The aim of the study was to investigate the vaginal microflora and evaluate the effectiveness of treating vaginal infections in pregnant women with a history of miscarriage. Study design, materials and methods. The study included 153 pregnant women in the first trimester. The main group (group I) consisted of 99 women with a history of miscarriage, 35 of whom had signs of threatened abortion (subgroup IA) and 64 did not (subgroup IB). The control group (group II) comprised 54 women without a history of miscarriage and signs of threatened abortion. The vaginal microflora was examined using microscopic, bacteriological and quantitative real-time PCR methods. All patients with an established vaginal infection (bacterial vaginosis, aerobic vaginitis, and vulvovaginal candidiasis) received etiotropic therapy, depending on the microorganisms identified and their sensitivity to antimicrobial drugs. After treatment, in order to assess the effectiveness of the therapy, the vaginal microflora was examined in the second trimester and the outcomes and complications of present pregnancy were evaluated. Results. In women of subgroup IA, vulvovaginitis and bacterial vaginosis were detected 3.5 times more often compared to the control group, and 1.6 times more often compared to subgroup IB (66% and 19%, respectively, p 0.001; 66% and 42%, respectively, p 0.05). Aerobic vaginitis was the most frequent vaginal infection in the first trimester of pregnancy in women of the main group (p 0.05). After treatment, the frequency of the vaginal infections in the second trimester in women of the main group significantly decreased: by 1.9 times in subgroup IA and by 1.5 times in subgroup IB (p 0.05). There were no significant differences in the frequency of adverse pregnancy outcomes in women with bacterial vaginosis or vulvovaginitis as compared to women with normal vaginal microflora. Nevertheless, pregnancy and childbirth complications were diagnosed 4 times more frequently in the main group (23% and 6%, respectively, p 0.05), with the complications occurring significantly more often in the cases of vulvovaginitis or bacterial vaginosis and signs of threatened abortion in the first trimester (p 0.05). Conclusion. Etiotropic therapy of vaginal infections diagnosed in the first trimester of pregnancy in women with a history of miscarriage was highly effective. In 40% of women, vaginal microbiocenosis normalized, and the clinical symptoms of vaginosis/vaginitis disappeared. Differences in the frequency of adverse pregnancy outcomes in women with vulvovaginitis or bacterial vaginosis in the first trimester and in women with normal vaginal microbiocenosis were not significant. However, the treatment of vaginal infections in the group of pregnant women with a history of miscarriage did not significantly affect the frequency of pregnancy and childbirth complications.

2021 ◽  
Vol 6 (2) ◽  
pp. 41-50
Author(s):  
E. N. Kravchenko ◽  
A. A. Goncharova

Aim. To study the features of gestation in women with a combination of antiphospholipid and TORCH syndromes in relation to preconception care.Materials and Methods. We analyzed 137 medical records of women with a past medical history of pregnancy loss and antiphospholipid syndrome (APS), focusing on the presence or absence of plasmapheresis in the preconception period, and further ranking the patients into 2 subgroups (with and without TORCH syndrome). As a control group, we included 28 pregnant women without both syndromes.Results. Gestation in women with combined APS and TORCH syndromes was accompanied by a 10-fold higher risk of threatened abortion in the first trimester and 3-fold higher risk of placental insufficiency as compared to those without both syndromes. Notably, the combination of the syndromes doubled the risk of placental insufficiency in comparison with APS alone. The lack of plasmapheresis in patients with APS and TORCH syndrome was associated with > 2-fold higher risk of threatened abortion. Further, in patients with APS and TORCH syndrome, lack of plasmapheresis increased the likelihood of developing fetal hypoxia by a factor of 2 and 3 in comparison with those diagnosed with APS alone or control patients.Conclusions. TORCH syndrome is a major risk factor of adverse outcome in pregnant women with APS. Inclusion of plasmapheresis into the preconception care in women with APS and TORCH syndrome significantly reduced the development of pregnancy complications. 


2019 ◽  
Vol 72 (2) ◽  
pp. 175-180
Author(s):  
Viacheslav M. Husiev ◽  
Daria S. Khapchenkova

Introduction: The article presents information about the peculiarities of the course of pregnancy and childbirth in women with a syphilitic infection in the anamnesis. The peculiarities of the state of newborn babies born from mothers who have suffered syphilis are described. To date, the incidence of syphilis in Ukraine has a clear tendency to decline, but still remains quite high. The maximum incidence of syphilis is observed in women aged 15-20 years. The combination of pregnancy and syphilitic infection in an anamnesis is an unfavorable factor in regard to high risk of perinatal complications, the frequency of which does not tend to decrease. The aim - study the features of the course of pregnancy and childbirth in women with a syphilitic infection in the anamnesis, the evaluation of the state of newborns. Materials and methods: A prospective examination of 57 healthy women and their newborns (control group) and 60 pregnant women with a history of syphilitic infection (the main group) had been conducted. All pregnant women had undergone ultrasound examination, including feto- and placentometry, an estimate of the amount of amniotic fluid. The effect of the transferred syphilis on the state of the newborn had been assessed in accordance with the results of the clinical examination of an anthropometric data, including an Apgar score. Results: It is stated that the incidence of latent (41,66%) and forms with a prolonged course (20,00%) of syphilitic infection. The threat of premature childbirth was almost 3,5 times higher than in women with syphilis, cases of an anemia in pregnant women – 2 times, hypertensive disorders of pregnant women were 2,4 times more common in women of the main group, fetal development retardation syndrome 6,4 times, while a greater percentage of this disorder was recorded among women in the main group who were ill with latent forms and suffered secondary recurrent syphilis (35%). In 20% of the cases, pregnancy in women with syphilis has been completed by the cesarean section, an abnormality of the contractile capacity of the uterus was significantly higher – 23,33%. The adaptive capacity of the newborns in the main group has been significantly lower, compared to the control group. Conclusions: Syphilitic infection in the anamnesis complicates the course of pregnancy with numerous pathological conditions. Syphilitic infection, borne before pregnancy, affects not only the course of pregnancy, but also the course of childbirth and the postpartum period. The pathological conditions in infants are due to a decrease in resistance to birth stress, early depletion of adaptive resources of newborns under the influence of a syphilitic infection of the mother. In children who have experienced chronic intrauterine hypoxia, the risk of hemorrhagic syndrome is significantly higher due to increased permeability of the vascular wall. Such children have a tendency to develop neurological disorders and respiratory system lesions.


2020 ◽  
Vol 5 ◽  
pp. 5-10
Author(s):  
T. P. Andriichuk ◽  
A. Ya. Senchuk ◽  
V. I. Chermak

The objective: to study the features of pregnancy, childbirth, postpartum period, fetal status and newborns in patients with a history of chronic salpingo-оophoritis.Materials and methods. Conducted a retrospective study of 150 birth histories and neonatal development maps. All patients were divided into two groups. The main group includes 100 patients with chronic salpingo-оophoritis, for which they received anti-inflammatory treatment from 1 to 3 times before pregnancy. The control group included 50 pregnant women who did not suffer from chronic salpingo-оophoritis.Results. Our analysis of pregnancy, childbirth, fetal and neonatal status in women with chronic salpingo-оophoritis indicates that such patients have a complicated obstetric and gynecological and somatic history, which forms an unfavorable basic condition of organs and systems, imperfect adaptation to pregnancy, high risk of failure of adaptive reactions. The result is a violation of the formation and development of the mother-placenta-fetus system and, as a consequence, a high level of complications during pregnancy, childbirth and perinatal pathology.Conclusion. Patients suffering from chronic salpingo-oophoritis should be considered at high risk of possible complications during pregnancy and childbirth. This category of women needs quality preconception training and careful monitoring during pregnancy.


Author(s):  
Инна Довжикова ◽  
Inna Dovzhikova ◽  
Михаил Луценко ◽  
Mikhail Lutsenko ◽  
Ксения Петрова ◽  
...  

The aim of the work is to assess the effects of cytomegalovirus infection on the 20α-hydroxysteroid dehydrogenase activity in the villous chorion syncytiotrophoblast in the first trimester of pregnancy. The materials for the study included 48 villous chorions samples taken during spontaneous abortions at 8th–10th weeks of gestation from women with reactivation of cytomegalovirus infection (the main group). The control group included 35 villous chorions samples from pregnant women with chronic cytomegalovirus infection in the latent stage taken at medical abortions at the same stage of gestation. The results of women’s examination were studied taken into account the activity of cytomegalovirus infection by immunoassay by detection of IgM antibodies or by 4 times and more increase of IgG antibody titers in the paired serums in dynamics in 10 days. The activity of 20α-hydroxysteroid dehydrogenase was assessed by the histochemical method. Quantitative evaluation of the reaction products was carried out on sections under the microscope MT (Japan) connected to software-hardware complex «SCION Corporation» (USA). At histochemical specimen of villous chorion of pregnant women who had a reactivation of cytomegalovirus infection during pregnancy (main group), there was a decrease of cytophotometric parameter of 20α-hydroxysteroid dehydrogenase activity till 30.1±2.12 pixels/μm2 (p<0.001) compared with the control group. The decrease in the reaction activity in syncytiotrophoblast indicated a decrease in the contents of 20α-dihydroprogesterone in placenta, which contributed, in our opinion, to spontaneous abortion.


2017 ◽  
pp. 10-15
Author(s):  
I.A. Usevych ◽  
◽  
V.L. Kolesnik ◽  

Psychological problems during pregnancy and childbirth for today is a little studied subject of modern obstetrics. The possibilities for solving psychological problems that arise in cases of emergency obstetric situations are almost not used by Ukrainian specialists through the marriage of knowledge and skills to provide crisis psychological help to obstetric patients. The objective: to determine the level of psychoemotional load in pregnant and parturient women, depending on the category of urgency of cesarean section. Material and methods. The main group of the study was presented: 1 group - pregnant women, who had planned a cesarean section operation according to the ІV category of urgency and who had already had a caesarean section in the anamnesis; ІІ group – pregnant women who planned an operation according to the IV category of urgency and who had no previous caesarean section in their history; ІІІ group – pregnant and parturient women who underwent surgery, respectively, in the I–III category of urgency; Control group – 30 pregnant women in the period of 37–41 weeks of pregnancy. A survey was conducted using the questionnaires of J.Teylor, Ch.Spielberger and SAN-test. Results. On the eve of labor in pregnant women there is an increase in the psychoemotional load, which can be determined using the above questionnaires. There is a direct dependence on the category of urgency of cesarean section and the level of psychoemotional load. Also revealed the correlation dependence of the voltage of the adaptation reserves of the pregnant woman on the presence of a history of caesarean section. Conclusion. Almost 50 percent of pregnant women, in cases of cesarean section, respectively, 1–3 categories of urgency in the preoperative period have the maximum level of psychoemotional load according to the questionnaires used. Pregnant women who have undergone a caesarean section in anamnesis are more adapted and have less psycho-emotional stress than women who have a cesarean section for the first time. Key words: cesarean section, psychoemotional state, pregnancy, childbirth, scale J. Teylor, scale Ch. Spielberger, SAN-test.


2021 ◽  
Vol 66 (8) ◽  
pp. 485-488
Author(s):  
A. V. Kust ◽  
N. Y. Sotnikova ◽  
A. I. Malyshkina ◽  
D. N. Voronin

To determine the level of CD20 + IL-10 + B-lymphocytes in pregnant women with the threat of termination of pregnancy at 5-12 weeks and recurrent miscarriage in history and compare the data obtained with the end of gestation. A survey of 65 women at a gestational age of 5-12 weeks was carried out. The main group consisted of 33 women with a threatening recurrent miscarriage at the time of the examination, the comparison group consisted of 10 pre-pregnant women with a threatening sporadic miscarriage at the time of the examination, the control group consisted of 22 pregnant women without signs of a threatening miscarriage. The main group, depending on the outcomes of pregnancy, is divided into 2 subgroups: subgroup A - pregnancy ended in undeveloped pregnancy or miscarriage (9 women), subgroup B - pregnancy ended in childbirth (24 women). The relative content of CD20 + IL-10 + B-lymphocytes was determined by flow cytometry on FACSCanto II (Becton Dickinson, USA). Women in the main group had a significantly lower level of CD20 + IL-10 + B-lymphocytes in comparison with the rest of the surveyed. A retrospective analysis revealed that among women of subgroup A there was a sharp decrease in CD20 + IL-10 + cells compared with subgroup B. Prediction of a non-developing pregnancy and spontaneous miscarriage up to 22 weeks of gestation in pregnant women with threatened spontaneous miscarriage and a history of recurrent miscarriage is possible with the relative content of CD20 + IL-10 + equal to or less than 4.5% (sensitivity 100%, specificity 82.6%, accuracy 87.9%).


2021 ◽  
pp. 56-60
Author(s):  
Р.Н. ЕСПАЕВА

В статье показаны результаты лечение бактериального вагиноза у 40 беременных в I триместре. 25 беременным проводилось комплексное лечение, включающее применение вагинальных свечей с действущим веществом хлоргексидин, по 1 свече на ночь во влагалище в течение 10 дней в сочетании с пероральным применением Флориум по 1 капсуле х 2 раза в день за 30 минут до еды в течение 14 дней. Остальные 15 беременных получали только свечи с действующим веществом хлоргексидин местно по 1 свече на ночь во влагалище в течение 10 дней. Сравнительный анализ результатов лечения показал, что в группе лечения с применением комплекса лактобактерий у 100% беременных «ключевые клетки» в контрольном мазке после лечения не определялись, в то время как у 16% женщин контрольной группы в мазке после лечения всё ещё определялись «ключевые клетки». А также, беременные основной группы отмечали прекращение жидких выделений с неприятным запахом в 100% случаев, в то время как у 23% беременных контрольной группы продолжались такие выделения, причиняющие дискомфорт. The article shows the results of treatment of bacterial vaginosis in 40 pregnant women in the first trimester. 25 pregnant women underwent complex treatment, including the use of vaginal candles with the active substance chlorhexidine, 1 candle per night in the vagina for 10 days in combination with oral administration of Florium 1 capsule x 2 times a day 30 minutes before meals for 14 days. The remaining 15 pregnant women received only candles with the active substance chlorhexidine locally, 1 candle per night in the vagina for 10 days. A comparative analysis of the results of treatment showed that in the group of treatment with the use of lactobacilli complex in 100% of pregnant women, " key cells "were not determined in the control smear after treatment, while in 16% of women of the control group,"key cells" were still determined in the smear after treatment. And also, pregnant women of the main group noted the cessation of liquid secretions with an unpleasant smell in 100% of cases, while 23% of pregnant women of the control group continued such secretions causing discomfort.


2021 ◽  
Vol 70 (4) ◽  
pp. 73-79
Author(s):  
Anna I. Malyshkina ◽  
Natalia Y. Sotnikova ◽  
Dmitriy N. Voronin ◽  
Alena V. Kust

BACKGROUND:The frequency of recurrent miscarriage is up to 5 % of all desired pregnancies and is mainly due to immunological disorders. Dysfunction in the regulation of the functional activity of B lymphocytes is the pathogenetic link in multiple obstetric complications, including habitual miscarriage. AIM:The aim of this study was to characterize the regulation of the functional activity of peripheral B lymphocytes in pregnant women with threatened spontaneous miscarriage and a history of habitual miscarriage. MATERIALS AND METHODS:We examined 88 women aged 18-40 years at a gestation period of 5-12 weeks. The main group consisted of 36 patients with threatened spontaneous miscarriage at the time of examination and a history of habitual miscarriage. The control group included 28 women with uncomplicated pregnancy. The comparison group consisted of 24 primary pregnant patients with threatened spontaneous abortion at the time of examination. BAFF and APRIL levels in the blood serum were determined by enzyme immunoassay. The content of CD19+BAFFR+B lymphocytes in the lymphocyte gate was evaluated in the peripheral blood by flow cytometry using monoclonal antibodies. Akt mRNA expression was assessed using real-time reverse-transcription quantitative polymerase chain reaction. CD19+В lymphocytes were isolated by direct magnetic separation. RESULTS:In the main group, there was an increase in expression of BAFF receptors on peripheral CD19+B lymphocytes and a decrease in the serum BAFF concentration compared to the parameters in the other study groups. We also found a pronounced trend towards a decrease in the serum APRIL level in the main and comparison groups of patients compared to healthy pregnant women. Besides, Akt mRNA expression in peripheral CD19+B lymphocytes was increased in the main group. CONCLUSIONS:Threatened habitual abortion is associated with the deficit of the regulatory influence of BAFF and APRIL, which is expressed in the disruption of B cell homeostasis and the weakening of humoral effector mechanisms.


2017 ◽  
pp. 22-24
Author(s):  
E.V. Kravchenko ◽  

The objective: the study of the status of the embryo and extraembryonic structures for bleeding that is not associated with the detachment of the chorion in the first trimester of gestation. Patients and methods. Were examined 34 patients in the gestational age 6-9 weeks (main group) with bleeding from the genital tract, in which, at the primary ultrasonic inspection revealed no detachment of the chorion. The control group included 30 women with uncomplicated course And trimester of gestation. The average age of the pregnant women of the main group was 25.3±3.1 years in the control group 26.4±4.3 years. All women underwent standard clinical and laboratory examination. Results. Studies have shown that prognostic markers of unfavorable development of the embryo in the early stages of pregnancy bleeding not related to chorion detachment was not detected. For the purpose of hemostasis in pregnant of the main group of prescribed drugs traneksamic acid 0.25 mg 3-4 times a day for 3 days. Traneksam – antifbrinolytic tool is able to block not only plasminogen, and plasmin that has already formed. It also stimulates the synthesis of collagen, through which increases the elasticity of the fibrin clot. Pregnant women in both groups received vitamin E 1 capsule per day magnesium products, Magnicum 1 tablet 3 times a day, folic acid 400 micrograms per day. Assessing clinical signs of disease in dynamics of treatment, it should be noted that the hemostasis in the main group was achieved in an average of 2.3±0.7 days. Conclusion. Bleeding in early gestation, not connected with the detachment of the chorion, the use of Traneksam provides fast absolute hemostasis, which in turn contributes to the normalization of tone of the uterus and the physiological course of placentation. Key words: bleeding in early pregnancy, the chorion detachment, hemostasis, hemostatic therapy, Traneksam.


2018 ◽  
pp. 104
Author(s):  
N.Y. Skripchenko ◽  
◽  
O.M. Pavlova ◽  
T.M. Mazur ◽  
◽  
...  

The objective: to study the features of the endocrinological status and the fetoplacental complex in pregnant women with adenomyosis, the course of pregnancy and childbirth in these women, to develop new, systematize and improve the existing methods of diagnosis, treatment and prevention of complications and reproductive losses. Materials and methods. We examined 90 pregnant women who were divided into groups: 30 healthy women – control group, a comparison group of 30 women with adenomyosis receiving classic progesterone therapy and the main group of 30 women with adenomatosis who received advanced preserving, metabolic therapy and diet therapy. The condition of the feto-placental complex, the frequency of IUGR, hemodynamic disturbances on the part of the fetus, and the level of estriol, progesterone, cortisol, chronic gonadotropin (CGL), placental lactogen were evaluated. Results. The main complication in pregnant women with adenomyosis was placental dysfunction (the comparison group was 60.0% and the main group was 33.3%), whose structure was performed by compensated (58.2%) and subcompensated forms (35.8%). The frequency of preterm labor threat was 20.0% in comparison group and 13.3% in main one, while in the control group – 1 case, which is 3.3%. Frequency of SCR was in the comparison group – 20.0% and in the main – 3.3%. Low levels of estriol, progesterone, HHG, placental lactogen, increased cortisol levels in comparison and main groups were determined, and after treatment the indicators of the main group significantly improved. Conclusions. With timely correction of violations, prevention of fetoplacental insufficiency and complex treatment with the use of advanced classical progesterone therapy in combination with metabolic and diet therapy we can significantly reduce the frequency of various complications in pregnant women with adenomyosis. Key words: adenomyosis, pregnancy, non-pregnancy, diet therapy, metabolic therapy, preservation therapy, preventive care.


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