Incidence and character of inflammatory diseases in pregnant women

Abstract

Actuality: Inflammatory diseases in pregnant women complicate pregnancy, triggering adverse outcomes of labor and deteriorating postpartum period. The aim of the study was to analyze the incidence and character of inflammatory diseases in pregnant women. Materials and methods. The study involved examination of 60 pregnant women at the age of 20-35 years at 25-38 weeks of gestation. All the pregnant women underwent clinical examination in accordance with the order issued by the Ministry of Health of Ukraine No. 582 (of 15.12.2003). Results.The study implied retrospective analysis of obstetric and labor records at the Department of Pathologic Pregnancy in Kharkiv Maternity Hospital No.1 during the years 2014-2015.The study showed that prior to the present pregnancy 67% of women had inflammatory diseases of the reproductive organs (vaginitis,colpitis, endocervicitis, salpingooophoritis, etc.). Sexually transmitted infections were detected in 15.5% of women. Extragenital diseases in remission were found in 12.2% of pregnant. The most frequently observed disorders were chronic pyelonephritis (25.0%), chronic gastritis (15.0%) and vegetative-vascular dystonia (10.0%).The study of the reproductive function showed that the present pregnancy was the first for 30.5% of women, 20.5% of pregnant women had more than two abortions, 8.4% and 5.4%, respectively, had pathologic and premature birth in history, 15.6% of patients had ectopic pregnancy, infertility I was observed in10.6% and infertility II in 9.0%. Clinically pregnant patients presented with itching and burning in the vagina, frequent urination and vaginal discharge (leukorrhea).Bacteriologic study of vaginal contents showed fungus mycelium and spores in 28 pregnant women (46.6%),indicating vaginal candidiasis. Bacterial vaginosis was identified in 32 pregnant women (53.4%): increased white blood cells count from 15 to 45 within sight, clue cells and much mucus, secondary to a decrease in lactic acid bacteria, presence of Gardnerella vaginalis.Ultrasound examination revealed oligohydramnios in 20 pregnant (33.3%) and polyhydramnios in 18 (30%), increased echogenicity of the endothelium of the internal organs in 5 (8.3%), placental dysfunction in 17 (28.4%) patients.Labor history: vaginal labor in 34 (56.6%), cesarean section in 17 cases, including: scheduled in 12 (20.0%),urgent in 5 (3.4%), premature rupture of membranes in 9 pregnant women (15.0%). Conclusion:Bacteriologic study of vaginal content has a high diagnostic value in prognosis of pregnancy and childbirth. It allows timely, non-invasively prevention of abnormal changes in the mother-placenta-fetus system.