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"Emergency medicine" 5(52) 2013

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Optimization of treatment of urinary tract infections in pregnantn women

Authors: M.Pasiyeshvili - Kharkiv Regional Clinical Perinatal Centre

Categories: Medicine of emergency

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Urinary tract infections in pregnant women (UTIPW) belong to the most common infectious pathology in modern obstetric practice, its frequency among hospital infections reaches 45-50%, it is characterized by recurrence and does not tend to decrease [4,8]. Antibacterial therapy plays the leading role among existing treatment methods for gestational pyelonephritis, but this antibacterial therapy can also contribute to the development of several complications in pregnant woman and affect the fetus negatively. In view of the above, the search of new treatment methods of UTIPW and prevention of obstetric complications belong to important tasks of modern obstetrics.

Aim of the work was to develop a comprehensive treatment method for UTIPW, which would effectively affect the bacterial flora of the urinary tract in pregnant women and promote prevention of obstetric complications development.

Materials and methods. To achieve the stated objective it was conducted the complex clinical and laboratory examination of 58 pregnant women with asymptomatic bacteriuria, who formed the main group. 20 pregnant women without symptoms of urinary tract infection, with physiological pregnancy formed the control group. After antibacterial therapy women of the main group were divided into two clinical groups depending on the method of comprehensive treatment. The first clinical group included 28 pregnant women, who were treated with Canephron (2 pills 3 times a day for 3 weeks) a herbal medicine used for treatment and prevention of inflammatory diseases of the urinary tract [6]. The second clinical group included 30 pregnant women who received 200 ml of ozonized saline solution intravenously once a day for 10 days. Ozonetherapy was used because of its scientifically proven ability to stimulate the immune system, to accomplish its detoxifying and antimicrobial activity [1,3]. By examination of pregnant women the immunological, bacteriological investigation of urine with determination of pathogenic germs and their sensibility to antibiotics was conducted besides the conventional clinic and laboratory tests, after getting two positive results of bacteria (≥ 100000 CFU/ml), the appropriate therapy was prescribed.

Discussion of the results of own research. It can be concluded that the UTIPW leads to an imbalance of immune system, which can be explained by the disturbance of cellular and humoral immunity, autonomous changes in cytokine levels, activation of lipid peroxidation, reducing of total antioxidant activity of plasma, tension of antioxidant systems of the organism of pregnant women. Timely comprehensive therapy of asymptomatic bacteriuria in pregnant women using medical ozone leads to normalization of immune and oxidative and antioxidant homeostasis, which allows us to recommend the use of medical ozone as an antioxidant, immunomodulator and antimicrobial factor for treatment UTIPW. The use of ozone in pregnant women significantly reduces the number of pregnancy complications, improves the condition of feto-placental complex, improves pregnancy results for both mother and newborn. Thus, the use of ozone therapy in the treatment of asymptomatic bacteriuria can be widely used in obstetric practice because of its efficiency, accessibility and absence of complications for both the mother and the fetus.

Conclusion. Using of complex pathogenesis-based therapy aimed at optimization of efficacy of treatment UTIPW has no side effects and can improve the results of treatment of pregnant women with asymptomatic bacteriuria and prevent recurrence of urinary tract infections, what will significantly reduce the number of obstetric complications and improve perinatal indicators.

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