Opportunities for treating opportunistic vaginal infections during pregnancy

Abstract

The aim of the study was to evaluate the effectiveness of treatment of women with opportunistic vaginal infections during pregnancy. Materials and methods. A prospective cohort study included 330 pregnant women, of whom 151 were diagnosed with bacterial vaginosis (BV), 37 had aerobic vaginitis (AB), 109 had vulvovaginal candidiasis (VC), 20 had a combination of VC + BV. When carrying out antibiotic therapy in the early stages of pregnancy, the principle of local treatment was observed. Results. Most often (46.0%), vaginal infections were detected when women were treated early in pregnancy. In the treatment of BV in the early stages of pregnancy with antiseptic chlorhexidine, a positive result of therapy was noted in 97.6% of women. Therapy with metronidazole or clindamycin BV in women who applied in the II and III trimesters, gave a positive result, respectively, in 90.0% and 89.5% of cases. The course of therapy with chlorhexidine pregnant women with AB was effective in 91.7% of cases with treatment in the first trimester and 92.0% in treatment in the II and III trimesters. In the treatment of VC in early pregnancy, natamycin was effective in 95.0% of women. In the II and III trimesters, econazole treatment was successful in 88.2% and 88.6%, respectively. In the treatment of combination of BV + VC in early gestation, the complex course of chlorhexidine + natamycin was effective in 76.5% of women, in II and III trimesters Neo-Penotran Forte was effective in 93.8% of pregnant women. Relapses of vaginal infections were observed in 34 pregnant women (10.3%). Superinfection with fungi was noted in 9.3% of cases of BV treatment and in 8.1% of pregnant women with AB. Among women observed from early pregnancy, there were no cases of premature birth, manifestations of intrauterine infections were noted in 5.3% of newborns. At treatment in the II and III trimesters, premature birth was in 6.5% and 13.5% of women, and manifestations of intrauterine infections - in 15.3% of newborns. Thus, microbiological monitoring of timely detection and treatment of opportunistic vaginal infections in pregnant at-risk groups showed the advisability of treating these infections in early gestation.