Novikova N. Prognosis and prevention of intrauterine infection in women with prematurity and urogenital infections.

The aim of the study was to decrease the rate of prematurity, adverse pregnancy outcome, perinatal morbidity and mortality by means of the prognosis and the prevention of intrauterine infections. One hundred twenty women with prematurity and urogenital infections as well as 20 abortive fetuses and 90 healthy pregnant women were examined. The correlation between maternal and fetal infections was found. The rate of urogenital infections in women with prematurity and urogenital infections and in healthy pregnant women was C.trachomatis - 58% and 3%, U.urealyticum 49% and 28%, M.hominis 34.5% and 3%, streptococci group B 13% and 7%, Candida 27.5% and 7%, respectively. Among women with prematurity and urogenital infections 40% were seropositive to CMV, 19.5% to HSV, and 19% T.gondii. Bacterial vaginosis was diagnosed in 57.5% of women with prematurity and in 11% of healthy pregnant. The perinatal transmission rate of С.trachomatis was 41%, U.urealyticum - 37.5%, М.hominis -40%, group B Streptococci - 100%,Саndida albicans - 60%. The frequency of histological chorioamnionitis was 93% in women with prematurity and urogenital infection. Immunosupression was detected in women with prematurity and urogenital infection in compare to healthy pregnant women. The recommended antimicrobial therapy of women with prematurity and urogenital infection resulted in a decrease of the rate of pregnancy, labor and postpartum complications as well as in the decrease of the rate of perinatal morbidity and the prevention of intrauterine infections. The efficacy of recommended therapy with azythromycin, engystol and metronidazol was in relation to C.trachomatis 88%, U.urealyticum 74%, M.hominis 81%, streptococci group B 87%, bacterial vaginosis 49%, Candida 73%, CMV 84%, and HSV 73%. The rate of the premature rupture of membrane has been decreased by 43%, the rate of the late spontaneous abortions - by 25%, the rate of the premature birth - by 7% in treated women in compare to those that were not treated.