Skorbach Y. Improvement of prophylaxis of purulent-septic complications of puerperium depending on microbiocenosis of vagina.

. Object of the study: Vaginitis in the 3rd trimester of pregnancy. Purpose of the study: To reduce the number of purulent septic complications of puerperium by means of prognosis and develop-ment of immune correction based on determining apoptosis in the immune-competent cells and its association with microbiocenosis of the sex organs in the pregnant. Methods of the study: Clinical observation, clinical laboratory in-vestigation, investigation of microbiological and immunological status of the pregnant, the study of the characteristic markers of apoptosis process, statistical analysis. Practical significance: The performed study proved an important etiopathogenetic role of apoptosis in pregnant with vaginitis. It was shown that the level of apoptosis in the immunocompetent cells could be used as a marker of infection process in the organism. To correct the disorders of the immune system in pregnant with vaginitis it was recommended to administer an immune-modulating drug in addition to a complex treatment, which can allow to reduce the incidence of purulent-septic complications of the puerperium. Novelty of the obtained results: For the first time, apoptosis markers in the immunocompetent cells of pregnant with normal pregnancy were investigated using the study of receptor structures CD95 with determining monoclonal antibodies and morphological peculiarities at staining with acridine-orange and Hehst 3342, concentration of diluted sFasL ELISA and caspase3 activity in the lymphocytes of the blood serum. Considerable increase of apoptosis activity in the immune system of the pregnant with vaginitis was revealed. Dependense of increase in the apoptosis activity parameters on the pathological state of microbiocenosis of the vagina and their significance in determining the risk of purulent-septic complications was proven. The necessity of immune correcting therapy in treatment of vaginitis and prevention of purulent-septic complications of the puerperium was proven and substantiated based on the study of caspase-3 apoptosis activity. Introduction: The developed method of immune correction was introduced into the clinical practice of clinical specialized maternity hospital No. 5, maternity hospital No. 1 (Kharkiv), maternity department of Regional Clinical Hospital (Kharkiv), Balakleya Central District Hospital, therapeutic-preventive center Sana. Theoretical ideas and practical recommendations of the work are used in the teaching process at obstetrics and gynecology departments No. 1 and 2 of Kharkiv State Medical University. Sphere of application: medicine, obstetrics and gynecology.