Grytsenko A. Optimization of screening, diagnosis, control of the effectiveness of treatment of vaginal infections during pregnancy

The research is dedicated to the reduction of the frequency of obstetric and perinatal pathology by optimizing screening, diagnosis and correction of disoders of the vaginal biotope in pregnant women. The work is based on a prospective randomized trial of 148 pregnant women, 40 non-pregnant women and a retrospective analysis of 173 pregnant women with intrauterine infection. As a result of the studies, the possibility of using the pH of the vaginal secretion as an informative, integral, accessible method for diagnosing the microbiota of the vagina has been proven. The method of correcting violations of vaginal microbiota, where the basic position is the creation of a medium with a pH of 4,0-4,4 in the vagina (normocenosis), is developed. The pH, qualitative and quantitative bacteriological characteristics for 5 types of microbiota are established. It is established that the number of complications of gestation and foci of other locus of infection grows with an increase in the pH of the vagina. A high correlation between pH, lactobacilli concentration in the vagina and the level of sexual and gonadotropic hormones has been established. The application of the developed method for correction of vaginal biocenosis has made it possible to reduce the incidence of gestational complications in pregnant women with vaginal infection: placenta dysfunction from 79,9 % to 51,3 %, threat of interruption of pregnancy from 22,2 % to 15,0 %, pre-eclampsia from 25,9 % to 13,2 %, intranatal distress from 9,3 % to 3,2 %, discharge for 7 days from 45,9 % to 11,8 %.