Sadovnychaya E. Optimization of the pregnancy management tactics in women with iron-deficiency anemia associated with chronic urogenital infection

Thesis is devoted to the problem of improvement obstetric outcomes in pregnant women with iron-deficiency anemia associated with chronic urogenital infection, developing complex of diagnostic and treatment measures and their introduction to the medical practice. There was found the main risk factors of iron-deficiency anemia in women with chronic urogenital infection. Pregnancy in patients with iron deficiency anemia with chronic urogenital infections is accompanied by an increase in the frequency of threatened abortion (53,3%), preterm delivery (26,7%), placental dysfunction and fetal distress (18, 3%). Chronic urogenital infection represented by viral and bacterial associations with prevalence of pathogenic microorganisms (E.coli, Enterococcus. Staphylococcus spp., chlamydias, urea- and mycoplasms, HSV1-2, CMV and HPV-16.18 infections. Availability of chronic urogenital infection leads to iron deficit to (8,8 ± 1,7) mmol/1 at decreasing of ferritin contents at the level of (7.2 ± 0,2) mg/1, that significantly below that control group data (p <0,05). In pregnant women activation of chronic urogenital infection and iron-deficiency anemia here are metabolic acidosis, activation mechanisms of antioxidant protection, immunodeficiency. In 10% of pregnant women with comorbidity of anemia and chronic urogenital infection there was determined immaturity of placenta, prominent hemodynamic disorders and involutive-dystrophic processes. Compensatory reaction were detected as a compensatory hyperplasia of terminal villous vessels with syncitio-capillares meembranes formation/ The proposed scheme of treatment allowed to improve maternal and perinatal outcomes and decrease the occurrence of intrapartum complications (RRR=0,19).