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- Title
Запальний статус пологових шляхів вагітних з істміко-цервікальною недостатністю при використанні цервікального шва, акушерського песарію та прогестеронової терапії.
- Authors
Біла, В. В.; Чернега, В. О.
- Abstract
Preterm birth is a major global health problem. Every year about 15 million babies are born prematurely in the world, of which 1 million newborns die. Spontaneous preterm birth (SPB) accounts for 40–45% of all preterm births. Cervical insufficiency (CI) is a significant risk factor for SPB. The studies have established the influence of the vaginal microbiome on cervical length during pregnancy and the importance of the bacterial composition of the vagina as a factor determining the risk of preterm birth. The objective: to study the vaginal microbiome of pregnant women with CI and various treatment methods (progesterone therapy, cervical suture or obstetric pessary). Materials and methods. During 2020–2023, an observational longitudinal study was conducted in the municipal non-profit enterprise “Perinatal Center of Kyiv”, in which 94 pregnant women participated. Among them 64 women were diagnosed CI (progesterone therapy group – n=22, cervical suture group – n=23 and obstetric pessary group – n=19). The control group included 30 pregnant women without CI. Results. Vaginal progesterone therapy and the use of a cervical suture have less effect on the microbiome than the use of a pessary. Conditionally pathogenic and pathogenic microflora was detected in 27.27% of patients in the progesterone group, 47.82% of patients in the cervical suture group, and 57.89% – in the pessary group. Inflammatory smear grade 3–4 was found in 31.81% of patients in the progesterone group, 47.82% – the cervical suture group, and 57.89% – the pessary group; complaints of discomfort and discharge – in 22.72%, 39.13% and 57.89% of patients, respectively. Compared with the control group, the use of a pessary is associated with an increase in the frequency of identification of opportunistic pathogenic microflora (16.67% vs. 52.63%; p<0.05), unsatisfactory results of bacterioscopic examination (20.00% vs. 57.89%; p<0.05), as well as an increase in complaints of discomfort and significant vaginal discharge (16.67% vs. 57.89%; p<0.05). Conclusions. It has been established that regardless of the type of therapy, inflammatory changes (presence of opportunistic pathogenic and pathogenic microflora, inflammatory type of smear, complaints of discharge and discomfort) of the birth canal are observed in pregnant women with CI. There is a connection between different methods of treatment and unsatisfactory results: bacteriological analysis – the presence of opportunistic pathogenic and pathogenic microflora (p<0.05), bacterioscopic analysis – inflammatory type of smear of the 3-4 grade of purity (p<0.05) and anamnestic analysis – the presence of complaints in female patients (p<0.05).
- Subjects
PROGESTERONE; SCIENTIFIC observation; NONPROFIT organizations; VAGINAL discharge; UTERINE cervix incompetence; LOCAL government; PREGNANT women; VAGINA; PESSARIES; COMPARATIVE studies; HUMAN microbiota; DESCRIPTIVE statistics; CERVICAL cerclage; LONGITUDINAL method
- Publication
Reproductive Health of Woman, 2023, Vol 70, Issue 7, p55
- ISSN
2708-8723
- Publication type
Article
- DOI
10.30841/2708-8731.7.2023.292601