Treatment for mixed non-specific vulvovaginitis in pregnant women using combined topical preparations

Aim: to assess clinical laboratory efficacy of a combined medication (metronidazole 10 mg + clotrimazole 20 mg in 1 g of gel, M + C) for mixed non-specific vulvovaginitis in the 3rd trimester of pregnancy. Patients and Methods: this study enrolled 105 pregnant women admitted to the Obstetrical Department of Pregnancy Diseases. The study group included 53 women who received M + C (5 g, one full applicator) twice daily for five days. The comparison group included 52 women who received a vaginal suppository (metronidazole 500 mg + sodium miconazole 100 mg) twice daily for seven days. In addition, all women received peroral probiotic strains of lyophilized Lactobacilli (one capsule twice daily for seven days). Primary endpoints were changes in complaints, speculum exam findings, vaginal pH-metry, and vaginal smears. Secondary endpoints were the type of delivery beginning, overall duration and specificity of the delivery process, signs of chorioamnionitis, intraamniotic fetal infection, birth injury, Apgar score, and specificity of the postnatal period. Results: 50 women of the study group (94.3%) and 47 women of the comparison group (90.4%) presented with no complaints after the treatment course (р=0.45). Local discomfort at the time of drug administration was reported in three women of the study group (5.7%) and four women of the comparison group (7.7%) (р=0.68). Forty-seven women of the study group (88.7%) reported being highly satisfied with M + C. Normalization of WBC counts was seen in 49 women of the study group (92.4%) and 49 women of the comparison group (94.2%) (p<0.05 compared to baseline in both groups). The number of women with moderate and high gram-positive rod counts increased in the study group (n=29, 54.7%; p<0.05). No differences in delivery type, mean delivery time, and Apgar score were reported. No postnatal purulent septic complications were revealed in either group. Conclusions: combined vaginal gel containing metronidazole 10 mg and clotrimazole 20 mg is highly effective for mixed non-specific vulvovaginitis in the 3rd trimester of pregnancy. KEYWORDS: pregnancy, non-specific vulvovaginitis, topical treatment, vulvovaginitis, clotrimazole. FOR CITATION: Shaposhnikova E.V., Bazina M.I., Mentsik M.M. et al. Treatment for mixed non-specific vulvovaginitis in pregnant women using combined topical preparations. Russian Journal of Woman and Child Health. 2021;4(3):201–208 (in Russ.). DOI: 10.32364/2618-8430- 2021-4-3-201-208.

Download Full-text

Postpartum endometritis prevention in abdominal delivery planning in pregnant with severe anaerobic vaginal dysbiosis

Kazan medical journal ◽

10.17750/kmj2015-005 ◽

2015 ◽

Vol 96 (1) ◽

pp. 5-9 ◽

Cited By ~ 1

Author(s):

K V Voronin ◽

A M Alale ◽

I I Alale ◽

R M Banakhevich

Keyword(s):

Cesarean Section ◽

Pregnant Women ◽

Vaginal Discharge ◽

Bacterial Flora ◽

Uterine Cavity ◽

Test System ◽

Control Group ◽

Study Group ◽

Septic Complications ◽

Ascending Infection

Aim. Prevention of purulent and septic complications in females after planned caesarean section.Methods. Out of 60 pregnant women, who underwent comprehensive examination during the trial, 35 (58.3%) were included in the study group and were delivered off by planned cesarean section; 25 (41.7%) pregnant women, included in the control group, were delivered off by urgent cesarean section. Considering the goal of the study, bacteriology of vaginal discharge, amniotic fluid and placental tissues, DNA detection of vaginal discharge bacterial flora before and after treatment (using «Femoflor-16» test system) according to classification by M.N. Boldyreva (2010), uterine cavity aspirate cytology according to classification by M.A. Kupert (2003), sonography of the uterus and uterine adnexa on the 4-5 day after the surgery according to classification of A.P. Milovanov were added to the training program for pregnant women. In the study group, pregnant patients with severe anaerobic vaginal dysbiosis at the 36-38 weeks of gestation were administered causal treatment of severe anaerobic vaginal dysbiosis, pregnant patients of the control group were not treated if severe anaerobic vaginal dysbiosis was diagnosed.Results. Performed correction of vaginal microbiota in the study group has significantly improved the course of postoperative period, reduced the incidence of uterine subinvolution, signs of chorioamnionitis as a manifestation of ascending infection compared to the control group. Postpartum endometritis has developed in 1 (2.8%) patient of the study group and in 5 (20.0%) cases in the control group. Offered method for preparing the patients with vaginal dysbiosis to cesarean section reduced the risk for postpartum endometritis by 6.8 times.Conclusion. Strategy of preparation for planned Caesarean section should include vaginal discharge bacteriology and treatment of severe anaerobic vaginal dysbiosis, which reduces the risk for postpartum endometritis by 6.8 times.

Download Full-text

"PROM"

The Professional Medical Journal ◽

10.29309/tpmj/2009.16.03.2877 ◽

2009 ◽

Vol 16 (03) ◽

pp. 438-444

Author(s):

SHAKILA YASMIN ◽

NAHEED FATIMA ◽

SHAZIA SAEED

Keyword(s):

Pregnant Women ◽

Sample Size ◽

Comparison Group ◽

Active Management ◽

Study Group ◽

Oral Misoprostol ◽

Active Labour ◽

Number Of Patients ◽

Significant Difference ◽

Fetal Complications

Objective: To assess and compare the number of subjects in both groups (Study and comparison), who went into active labourwithin 24 hours and to compare the various complications (maternal & fetal) in both groups. Study Design: Quasi experimental. Sampling Technique: Convenience sampling. Sample Size & Setting: A total of 100 pregnant women presenting with history of leaking amniotic fluid at term (>37 wks) to labour ward of obstetrics and Gynaecology unit, Bahawal Victoria Hospital, Bahawalpur were included in the study. Material & Method: The pregnant women fulfilling the inclusion criteria were enrolled as our study subjects. Rupture of membranes was confirmed by nitrazine test.Thepatients were randomized into two groups (50 women in study and 50 in comparison group). In study group, 50 (Ligm of misoprostol was givenorally after initial assessment of mother and fetus. The dose was repeated 4 hourly, if there was no uterine activity. The number of patients going into active labour and delivering within 24 hours were noted. Different complications (maternal & fetal) faced during all procedure were also recorded and managed. In comparison group, patients were managed were also recorded and managed. In comparison group, patients were managed conservatively for 24 hours. Like in study group, number of patients gong into active labour and delivering with in 24 hours were noted. Different maternal & fetal complications occurring in this group were also recorded and managed. Results: A total of 100 Pregnant women were included in the study. The sample size (100 patients with PROM at term) was completed in 5 months. During that period over all 1105 deliveries were conducted, so the incidence of PROM at term in the study was 9.4%. It was observed in the study group, that all the patients (100%) went into active labour and 96% were delivered within 24 hours of PROM. While in comparison group 72% patients went into active labour and only 62% were delivered within 24 hours of PROM. The results showed that in study group 36 patients went into active labour with only one dose of oral misoprostol, 9 patients required 2 doses and 5 patients required 3 doses of oral misoprostol for going into active labour. When maternal complications were compared in both groups, 92% patients in study group had no complication while only 8% patients had to face different complications. In comparison group 86% had no complication and in 14% patients different complications occurred. Regarding fetal complications 4% fetus/neonates had to face different complications in each group. In current study there was no significant difference in the mode of delivery between the two groups. Conclusion: It was concluded that active management of pre labour rupture of membrances at term with oral misoprostol is a better option than the expectant management. Oral misoprostol in dose of 50 jugm is an effective agent for cervical ripening and induction of labour in PROM at term as significantly high percentage of patients delivered within 24 hours with no increase in maternal and fetal complications.

Download Full-text

Diagnostic Value of Different Noninvasive Criteria of Latent Myocarditis in Comparison with Myocardial Biopsy

Cardiology ◽

10.1159/000499865 ◽

2019 ◽

Vol 142 (3) ◽

pp. 167-174

Author(s):

Olga Blagova ◽

Yuliya Osipova ◽

Alexander Nedostup ◽

Evgeniya Kogan ◽

Alexander Zaitsev ◽

...

Keyword(s):

Heart Surgery ◽

Comparison Group ◽

Clinical Laboratory ◽

Heart Diseases ◽

Open Heart Surgery ◽

Diagnostic Value ◽

Study Group ◽

Predictive Values ◽

Morphological Studies ◽

Noninvasive Markers

Purpose: The aim of this study was to quantify the value of various clinical, laboratory, and instrumental signs in the diagnosis of myocarditis in comparison with morphological studies of the myocardium. Methods: In 100 patients (65 men, 44.7 ± 12.5 years old) with “idiopathic” arrhythmias (n = 20) and dilated cardiomyopathy (DCM; n = 80), we performed the following: 71 endomyocardial biopsies (EMB), 13 intraoperative biopsies, 5 studies of explanted hearts, and 11 autopsies with virus investigation (real-time PCR) of the blood and myocardium. Antiheart antibodies (AHA) were also measured as well as cardiac CT (n = 45), MRI (n = 25), and coronary angiography (n = 47). The comparison group included 50 patients (25 men, 53.7 ± 11.7 years old) with noninflammatory heart diseases who underwent open heart surgery. Results: Active/borderline myocarditis was diagnosed in 76.0% of the study group and in 21.6% of patients in the comparison group (p < 0.001). The myocardial viral genome was observed more frequently in patients in the comparison group than in the study group (65.0 and 40.2%; p < 0.01). We evaluated the diagnostic value of noninvasive markers of myocarditis. The panel of AHA had the greatest importance in the identification of myocarditis: sensitivity was 81.5%, and the positive and negative predictive values were 75.0 and 60.5%. This defined the diagnostic value of noninvasive markers of myocarditis and established a diagnostic algorithm providing an individual assessment of the likelihood of myocarditis development. Conclusion: AHA have the greatest significance in the diagnosis of latent myocarditis in patients with “idiopathic” arrhythmias and DCM. The use of a complex of noninvasive criteria allows the probability of myocarditis to be estimated and the indications for EMB to be determined.

Download Full-text

Clinical, laboratory and instrumental criteria for myocarditis, established in comparison with myocardial biopsy: A non-invasive diagnostic algorithm

Terapevticheskii arkhiv ◽

10.17116/terarkh201789930-40 ◽

2017 ◽

Vol 89 (9) ◽

pp. 30-40 ◽

Cited By ~ 3

Author(s):

O V Blagova ◽

Yu V Osipova ◽

A V Nedostup ◽

E A Kogan ◽

V A Sulimov

Keyword(s):

Heart Surgery ◽

Comparison Group ◽

Clinical Laboratory ◽

Inflammatory Diseases ◽

Open Heart Surgery ◽

Diagnostic Algorithm ◽

Diagnostic Value ◽

Left Ventricular ◽

Study Group ◽

Morphological Examination

Aim. To determine the diagnostic value of different clinical, laboratory, and instrumental signs in the diagnosis of myocarditis in patients with the picture of idiopathic arrhythmias, dilated cardiomyopathy (DCM) and in a comparison group when comparing with myocardial morphological examination. Subjects and methods. A study group included 100 patients (35 women; mean age, 44.7±12.5 years) with idiopathic arrhythmias (n=20) and DCM as a syndrome (n=100). All underwent myocardial morphological examination: endomyocardial biopsy (EMB) (n=71), intraoperative biopsy (n=13), study of the explanted heart (n=6), and autopsy (n=11). A comparison group consisted of 50 patients (25 women; mean age, 53.7±11.7 years) with non-inflammatory diseases of the heart (left ventricular end-diastolic dimension 50%) who underwent open-heart surgery (n=47), EMB (n=2), or autopsy (n=1). The investigators also performed polymerase chain reaction for cardiotropic viral DNA in the blood and myocardium, anticardiac antibody (ACA) identification, myocardial scintigraphy (n=26), coronary angiography (n=47), magnetic resonance imaging (MRI) (n=25), and multislice computed tomography of the heart (n=45). The diagnostic value of the extended spectrum of clinical, laboratory, and instrumental markers for myocarditis was estimated. Results. Active/borderline myocarditis was diagnosed in 76% of the patients in the study group (75.5% in the arrhythmia subgroup and 76.3% in the DCM one) and in 24.3% of those in the comparison group (p

Download Full-text

Coagulation way of hemostasis in pregnant women and puerperae with pre-eclampsia in whom caesarean section was performed

Kazan medical journal ◽

10.17750/kmj2016-873 ◽

2016 ◽

Vol 97 (6) ◽

pp. 873-881 ◽

Cited By ~ 1

Author(s):

T E Kurmanbaev ◽

N V Yakovlev ◽

A A Khasanov ◽

I G Mustafin ◽

R M Nabiullina

Keyword(s):

Molecular Weight ◽

Caesarean Section ◽

Pregnant Women ◽

Low Molecular Weight Heparin ◽

Comparison Group ◽

Low Molecular Weight ◽

Study Group ◽

Clinical Value ◽

Blood Samples ◽

Kinetics Of

Aim. To evaluate clinical value of trombodynamics in diagnosing the state of coagulation way of hemostasis in patients with pre-eclampsia in whom caesarean section was performed.Methods. The study included 66 pregnant women. The study group included 34 of them with moderate to severe pre-eclampsia. During the postoperative period all puerperae received low molecular weight heparin (Dalteparin 2500 IU subcutaneously once a day for 7 days). The comparison group consisted of 32 pregnant women. All of them had scheduled Caesarean section. LMWH was not administered in this group. Thrombodynamics assay was performed in both groups. Blood samples were taken 1-2 hours before cesarean section, 6-12 hours after the surgery before the first injection of anticoagulant if administered, and on day 5 after delivery not less than 24 hours after the injection of anticoagulant.Results. In the group of patients with pre-eclampsia changes in trombodynamics characteristic for hypercoagulation were revealed: increase of clot growth velocity (V), clot size (CS), its relative density (D) and development of spontaneous clots (Tsp). These numbers become normal slower than in pregnant women and puerperae without pre-eclampsia and with delivery performed surgically.Conclusion. According to trombodynamics assay, in pregnant women and puerperae with pre-eclampsia, severe hypercoagulation with increased reaction kinetics of clot formation and its physical characteristics were revealed, as well as increase of blood procoagulant potential.

Download Full-text

Features of obstetric and perinatal pathology at women with an undifferentiated dysplasia of connecting tissue

HEALTH OF WOMAN ◽

10.15574/hw.2017.123.96 ◽

2017 ◽

pp. 96-98

Author(s):

A.L. Kostiuk ◽

Keyword(s):

Pregnant Women ◽

Key Words ◽

High Frequency ◽

Clinical Laboratory ◽

Perinatal Pathology

The objective: to study features of obstetric and perinitalny pathology at women with undifferentiated dysplasia of a connecting tissue. Patients and methods. 100 patients with clinical-laboratory signs of an undifferentiated dysplasia of connecting tissue are surveyed. On the basis of the received results of the patient were divided into two groups: the main – 50 women (expression of і6 points) whom regarded as patients with the expressed undifferentiated dysplasia of connecting tissue, and group of comparison – 50 women (expression <6 points) whom regarded as patients without the expressed undifferentiated dysplasia of connecting tissue. Results. Results of the conducted researches testify to the high frequency of obstetric and perinatal pathology at pregnant women with clinical-laboratory and functional signs of an undifferentiated dysplasia of connecting tissue. Conclusion. The received results are the basis for algorithm improvement the diagnostical and treatment-and-prophylactic actions at women with an undifferentiated dysplasia of connecting tissue. Key words: undifferentiated dysplasia of connecting tissue, obstetric and perinatal pathology.

Download Full-text

New possibilities of the use of surgical lasers in obstetrics

Kazan medical journal ◽

10.17816/kazmj83652 ◽

1997 ◽

Vol 78 (6) ◽

pp. 434-438

Author(s):

I. F. Fatkullin

Keyword(s):

Surgical Treatment ◽

High Risk ◽

Postoperative Complications ◽

Cesarean Section ◽

Laser Welding ◽

Comparison Group ◽

Obstetrics And Gynecology ◽

Septic Complications ◽

Basic Group ◽

Section Operation

The laser welding suture of peritoneum in pregnants and in women in labor with high risk of pyo-septic complications is used in cesarean section operation. In the basic group the postoperative complications are three times as little than in the comparison group. The promise of the use of the biological laser @welding@ in obstetrics and gynecology to improve technology and results of surgical treatment especially in delivery of women with high risk of pyo-septic complications is noted.

Download Full-text

Features of the genesial and somatic anamnesis at pregnant women with an undifferentiated dysplasia of connecting tissue

HEALTH OF WOMAN ◽

10.15574/hw.2017.120.83 ◽

2017 ◽

pp. 83-85

Author(s):

A.L. Kostiuk ◽

Keyword(s):

Pregnant Women ◽

Key Words ◽

Clinical Laboratory ◽

Perinatal Complications ◽

Early Diagnostics

The objective: to study features of the somatic and genesial anamnesis at pregnant women with an undifferentiated dysplasia of connecting tissue for possibility of early diagnostics of the subsequent obstetric and perinatal complications. Patients and methods. 100 patients with clinical-laboratory signs an undifferentiated dysplasia of connecting tissue are surveyed. On the basis of the received results of the patient were divided into two groups: the main – 50 women (expression і6 points) regarded as patients with the expressed undifferentiated dysplasia of connecting tissue and group of comparison – 50 women (expression <6 points), regarded as patients without the connecting tissue expressed by an undifferentiated dysplasia. Results. Results of the conducted researches testify to an important role of the established features of the somatic and genesial anamnesis at pregnant women with clinical-laboratory and functional signs of an undifferentiated dysplasia of a connecting tissue. Conclusion. The received results need to be used for carrying out pregravidarny preparation and forecasting of possible obstetric and perinatal complications at pregnancy. Key words: undifferentiated dysplasia of connecting tissue, genesial and somatic anamnesis.

Download Full-text

Evaluation of Coronavirus Anxiety in Pregnant Women on Apgar Score and Birth Weight After One Year of Coronavirus Outbreak (Case Study: Zabol, Iran)

Journal of Obstetrics Gynecology and Cancer Research ◽

10.30699/jogcr.7.2.89 ◽

2022 ◽

Vol 7 (2) ◽

pp. 89-98

Author(s):

Fatemeh Mirzaie ◽

Khadije Rezaie Keikhaie ◽

Mahin Badakhsh ◽

Bahareh Khajehpourbahareh ◽

Samira Ghofrani ◽

...

Keyword(s):

Birth Weight ◽

Pregnant Women ◽

Apgar Score ◽

One Year ◽

Outbreak Case

Download Full-text

Optimization of prevention measures of septic complications in women with high infectious risk

HEALTH OF WOMAN ◽

10.15574/hw.2018.129.108 ◽

2018 ◽

pp. 108-113

Author(s):

Yu.R. Feyta ◽

◽

V.I. Pyrohova ◽

Keyword(s):

High Risk ◽

Postpartum Period ◽

Comparison Group ◽

Infectious Complications ◽

Main Group ◽

Septic Complications ◽

Effective Prevention ◽

Vaginal Gel ◽

Infectious Risk ◽

Treatment Techniques

Despite the introduction of modern diagnostic technologies, prophylaxis and treatment techniques in obstetrical practice, the incidence of postpartum purulent-septic complications (PPSC) remains rather high and is an important medical and social problem, as they take one of the leading places in the structure of maternal morbidity and mortality. The objective: to improve the management of parturient womenwith a perineal birth injury in anamnesis, as part of an effective prevention of purulent-septic complications of puerperium. Materials and methods. The study included 77parturient women. Main and comparative groups were formed by women with a violation of the integrity of the perineum in the previous labor and with a high risk of developing infectious complications in puerperium. Women of the main group (n = 24) during each vaginal examination in labor (and an additional injection in 15-30 minutes after the rupture of the membranes) and twice a dayat a dose of 5 ml for 5 days postpartum, an antiseptic agent in the form of a vaginal gel, which consists of: 0.02% decamethoxin (antiseptic component), 0.5% hyaluronic acid (regenerating component) and lactate buffer (regulatory component). The comparison group included 27 women, without using vaginal gel in laborand using traditional wound treatment techniques in the postpartum period. The control group consisted of 26 women with uncomplicated somatic status, physiological course of pregnancy and labor. The evaluation of the effectiveness of the prescribed treatment was based on subjective symptoms (pain, discomfort, burning in the region of the perineal sutures), clinical data (swelling, hyperemia, nature of suturing healing), generally accepted indicators in dynamics (bacterioscopy of vaginal contents, pH-metry of the vaginal environment). Results. At the background of the use of three-component vaginal gel in the main group, the level of injury of soft tissues of the birth canal in these deliveries was lower by 19.9% than in the comparison group, prevalence of the 1st degreeperineumruptures, decreased the need for repeated episio- and perineotomy, which reduced the duration stay at hospital and improved postpartum rehabilitation in relation to the comparison group. On the third day of puerperium, hyperemia and edema of the wound area in women of the main group were observed almost three times less compared with the comparison group. On the fifth day of the puerperium in the main group the complaints were insignificant and appeared on the average 5 times less often, the healing was by the primary tension without infectious complications. The use of vaginal gel reduced the number of leukocytes in wound secretions by shortening the time of wound epithelization (1.5 times faster than in the parous from the comparison group). On the fifth day of using vaginal gel, 2/3 of the patients observed normalization of the vaginal microflora, the restoration of pH was observed. The results indicate the benefits of early onset of prophylactic measures and high effectiveness of topical antiseptic therapy in women with high infectious risk. Conclusions.In order to prevent antibiotic resistance tactics of prevention of PPSC in the group of high-risk septic complications provides one of the elements of anintegrated approach to use local antiseptics. Inclusion of the latter into a complex of prophylactic and treatment measures in the management of a high-riskwomen in puerperium contributes to the reduction of traumatic and infectious complications and provides more favorable course of labor and the postpartum period. Key words: labor traumatism, postpartum purulent-septic complications, local antiseptic.

Download Full-text