Характеристика течения гестации и микробиоценоза цервикального канала у беременных с угрозой прерывания гестации во II триместре

Abstract

Була обстежена 101 вагітна жінка із загрозою переривання вагітності у II триместрі. Вік жінок ко- ливався від 22 до 35 років, середній вік – 28,7 ± 4,06 років. Контрольну групу склали 25 жінок з неускладненим перебігом вагітності у віці від 21 до 35 років, середній вік – 27,8 ± 2,11 років. За отриманими даними було виявлено, що мікрофлора цервікального каналу жінок із загрозою втрати вагітності у II триместрі відрізнялася високою частотою зустрічальності паличкової флори, великою кількістю епітелію і лейкоцитів, III ступенем чистоти, що вказувало на запалення ендоцервікса. Виражений запальний процес виявлений у 21 (20,8%) жінок. Слід зазначити, що дослідження біоценозу цервікального каналу дозволило виявити 37,6% випадків запалення ендоцервікса з прихованими ознаками цього процесу.

Было обследовано 101 беременная женщина с угрозой прерывания беременности во II триме- стре. Возраст женщин колебался от 22 до 35 лет, средний возраст – 28,7±4,06 лет. Контрольную группу составили 25 женщин с неосложненным течением беременности в возрасте от 21 до 35 лет, средний возраст – 27,8±2,11 лет. По полученным данным было выявлено, что микрофлора цервикального канала женщин с угрозой потери беременности во II триместре отличалась высокой частотой встречаемости палочковой флоры, большим количеством эпителия и лейкоцитов, III степенью чистоты, что указывало на воспаление эндоцервикса. Выраженный воспалительный процесс выявлен у 21 (20,8%) женщин. Следует отметить, что исследование биоценоза цервикального канала позволило выявить 37,6% случаев воспаления эндоцервикса со скрытыми признаками этого процесса.

The aim was to study the course of gestation in women with the threat of termination of pregnancy and microbiocenosis of the cervical canal in pregnant women with the threat of termination of gestation in the II trimester. Methods. 101 pregnant women with the threat of termination of pregnancy in the II trimester were examined. The age of women ranged from 22 to 35 years, the average age – 28.7±4.06 years. The control group consisted of 25 women with uncomplicated pregnancy at the age of 21 to 35 years, the average age – 27.8±2.11 years. According to the social composition of the surveyed women in the main and control groups were as follows: employees – 55 (54.4%) and 13 (52.0%); Housewives – 40 (39.6%) and 10 (40.0%), students – 6 (5.9%) and 2 (8.0%), respectively. The distribution of the women surveyed by parity was as follows: the first – born in the main group were 37 (36.6%), in the control group – 9 (36.0%), re – pregnant, respectively – 64 (63.4%) and 16 (64.0%); first-born-63 (62.4%) and 14 (56.0%), re-producing-38 (37.6%) and 11 (44.0%), respectively. In all pregnant women, anamnestic data were collected, extragenital diseases were studied. All patients underwent General clinical examination, ultrasound scanning. Ultrasound was performed on the device “Flex Focus 1202” (firm “B-K Medical ApS”, Denmark). Results. The history data showed that the age of menarche onset in women of the main and control groups averaged 12.6±0.33 and 12.4±0.2 years, respectively, i.e. there were no practically differences between the groups. At the same time, in the main group, the menstrual cycle was irregular in 13.9% of cases. Among somatic diseases, the frequency of occurrence of chronic gastritis should be noted – in 20 (19.8%, control – 4.0%), neurocirculatory dystonia – in 32 (31.7%), chronic tonsillitis – in 33 (32.7%, control – 4.0%). Among gynecological diseases, chronic inflammatory diseases of the genitals, chronic adnexitis, erosion of the cervix, for which women were treated, were often encountered. The frequency of medical abortions was also higher in the main group – 66.3% of cases (p<0.01) versus 24.0% in the control group. Spontaneous miscarriages were observed in 21 (20.8%, p<0.01) women of the main group, while in the control group spontaneous miscarriages were observed in 2 (8.0%) women who suffered stress during this period. In 22 (21.8 percent) of the 64 re-pregnant women in history indicated preterm birth. The study revealed that the majority of patients with threatened abortion in the II trimester had obstetric complications-98 (97.0%) women. Placental insufficiency was the most frequent in 49 (48.5%), 27 (26.7%) of which were accompanied by fetal development delay, exacerbation of genital infections – in 40, gestational pyelonephritis – in 21 patients of the main group. Conclusion. The study of the cervical canal biocenosis helps to identify pregnant women with a high risk of inflammatory complications and, taking these data into account in the management of such pregnant women, it is possible to reduce the incidence of complications.