Pasiyeshvili N. Pathways for reduction of perinatal morbidity and mortality in the case of infectious inflammatory fetal impairment.

The main concern of this study is to improve quality of the perinatal care in the case of fetomaternal infection in order to reduce the rate of perinatal mortality and maternal morbidity, by means of recognition of the truly infection-related mechanism affecting fetus adversely and causing inflammatory fetal impairments (IFI) usually in the form of fetal inflammatory response syndrome, and then on the ground of obtained information prudent amendments of the approach to treatment and prevention of this complication of pregnancy. In order to achieve this goal the study comprised several tasks: 1) all cases history of 14276 women hospitalized for delivery in Kharkov Regional Clinical Perinatal Center throughout 2011-2015 underwent retrospective analyses for reevaluation and final clarifica- tion of causative factors that had led to perinatal morbidity and mortality; 2) comprehensive examination with testing for bacterial-viral-agent panel and follow-up of 1043 pregnant women recognized as harboring IFI and then their neonates; 3) comprehensive examination of 50 pregnant women with antenatal fetal demise; 4) 423 pregnant women with IFI were enrolled into the study which should have ascertained infectious agent, hormonal profile, state of coagulation and immune balance, endothelial function and apoptosis, oxidative burst; 5) pursuing the goal to work out proper approach to management cases of IFI experimental model with immunocorrection therapy chosen with regard to infectious agent was validated by the study on 104 laboratory rats; 6) morphological and immuno- histochemical examination of placenta after the delivery from women with IFI. Complex treatment and prevention of IFI progression by immunocorrection and medical ozone prescription making immune and endothelial homeostasis recover leads to decline of the number of bacterial inflammatory complications in neonates, allows limiting amount of antibiotics, to reduce its possible adverse effect on the patient's organism. Such approach appears to have no side effects, improve efficiency of treatment for IFI, premature membrane rupture, asymptomatic bacteriuria, prevent relapse of urinary tract infection, that finally reduces rate of obstetric complications and improves perinatal indexes.