Особенности влагалищного биотопа беременных с несостоятельностью обтурационной функции шейки матки и возможности их коррекции

Abstract

The article presents the investigation results of the vaginal biotope of pregnant women with incompetence of cervix obstructive function. The frequency growth of this complication in nulliparous women, the absence of significant differences in pregnancy outcomes without regard to the correction methods, the increase of number of obstructed and pathological labors among these women, were the basis for the factors analysis that deteriorate the prognosis for the mother and fetus. The vaginal microbiocenosis pathology plays one of the leading roles in the premature birth development) in women with incompetence of cervix obstructive function. The objective: to study the vaginal biotope in pregnants with incompetence of cervix obstructive function in order to improve the antenatal care tactics and increase the effectiveness of non-surgical treatment modality of this pathology. Patients and methods. 63 pregnants at term 22–32 weeks who had been treated at the department of pathology of pregnancy and childbirth of SE «IPAH NAMS of Ukraine» with the verified incompetence of cervix obstructive function (main group) were examined. The control group was formed by 34 pregnants with physiological state of cervix obstructive function. Results. The predominance of alkaline or slightly alkaline vaginal biotope’s reaction expressed leukocyte reaction, high desquamated epithelium content and a sharp decline in the numbers of Lactobacillus spp. at the background of mostly associated coccal microflora, Gram-negative microorganisms and Candida albicans fungi is typical for the main group of pregnants. The association of anaerobic microorganisms from bacterial-viral and bacterial-chlamydial urogenetal infections is typical for every third main group of pregnant women. Conclusion. The pathogenetically justified antibiotic therapy with a long-term correction of vaginal microbiocenosis dysbiotic disorders before the introduction of the perforated silicone cervical pessary provides the absence of discomfort which is associated with vaginal secret overproduction and allows stabilizing the leukocyte vagina microbiocenosis reaction within the physiological one and reducing the risk of preterm labor in these pregnants. Key words: the incompetence of cervix obstructive function, cervix, microbiocenosis, pregnancy, miscarriage.