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"Child`s Health" 3 (63) 2015

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State of the system placenta-fetus-newborn at the pregnant with disorder of microbiocoenosis of sex ways

Authors: Aussi Marvan, Matsynin A.N. — Obstetrics and Gynecology Department № 2 Donetsk National Medical University named after M. Gorky

Categories: Pediatrics/Neonatology

Sections: Clinical researches

print version

In the structure of maternal morbidity, 13-15% falls to the share of infectious pathology. Infectious diseases take one of the first places in the structure of perinatal morbidity, causing from 11 to 45 % of fetus loss lately. Still-births as the result of such pathology reach 14, 9-16, 08%. According to results of some researchers, the normocoenosis of vagina was established only at 35-40 % of pregnant women.
The purpose of the research was the study of the system placenta-fetus-newborn at the pregnant women with disorders of microbiocoenosis of sex ways.

Research methods.

Under observation there were kept hundred and eighty four (184) pregnant women with perinatal losses between the ages of 19 and 34. The control group made up thirty (30) presumptively healthy pregnant women, the main group consisted of hundred and ten (110) patients that were examined and treated according to proposed scheme and seventy four (74) according to generally used scheme. Among them, there was the first group of thirty five (35) patients that were treated for perinatal losses at the stage of family planning; forty five (45) patients of the second group were treated since the first day of their pregnancy; and thirty (30) patients of the third group were treated in the second and third term of their pregnancy.
Antenatal research of fetus state and fetoplacental complex (FPC) was conducted with help of studying cardiocotography, ultrasonic, biophysical profile of the fetus – by Vintzilcos method. With the aim of dynamic estimation of FPC there was conducted the research of placenta in afterbirth period.

Results and discussion.

Antenatal examination of fetus state and fetoplacental complex with the help of studying cardiocotography, ultrasonic, biophysical profile of the fetus state revealed that chronic intrauterine hypoxia of fetus with decline of adaptation possibilities of fetoplacental complex was recorded at 2 healthy women (6,67 %), at 3 (8, 57%) and at 2 (4,44 %) patients from sub-group I and subgroup II which was remarkably lower than 8 (26,67 %, p<0,05) cases in sub-group III and 12 (16,22 %) – in the comparison group (p<0,05).
Estimation of biophysical profile of a fetus, which was carried out by Vintzilcos method, revealed that normal condition of the fetus, that is 10-12 points, was recorded at 17 (48,57 %) patients of subgroup I, at 21 (46,67 %, p>0,05) – II and at 9 (30,00 %) – III (p<0,05). 
Satisfactory state of fetuses to which is corresponded 8-9 points, was registered at 10 (28,57 %) patients in subgroup I, at 12 (26,67 %, р>0,05) – in subgroup II, and at 10 (33,33 %) – in subgroup III.
Questionable state of fetuses, that is 6-7 points, was observed at every fifth woman out of the first and second subgroup (accordingly 8 (22,86 %) and 12 (26,67 %) cases, р>0,05) and at every third woman out of the third subgroup (9 (30.00 %) cases, р>0,05). At 2 patients (6,67 %) out of the third subgroup there was observed pathological state of the fetus. In the comparison group in 37 cases (50 %) the state of the fetus was normal, in 10 (13,51 %) – satisfactory, in 27 (36,49 %) – questionable. In the control group it was corresponding 17 (56,67 %), 12 (40,00 %) and 1 (3,33 %) case.
At the women of all compared groups there occurred premature effusion of pericarpial waters, that is, at 2 freshly confined women (5,71 %) in the first group, at 3 (6,67 %) – in the second group, at 5 (16,67 %) – in the third group, and at 18 (24,32 %) in the comparison group. 
We should underline that the indices of the third group and of the comparison group, probably, differed from the indices of the first and the second subgroups (р<0,05). At 3 (8,57 %) cases in the first subgroup, 2 (4,44 %) in the second one, at 9 (30,00 %) – in the third one and at 13 (17,57 %) – in the comparison group there occurred premature childbirth at women (р<0,05).
So, in case of phetoplacental deficiency morphological peculiarities of placenta were characterized by pathological immaturity in the form of dissociate development of fibre сhorion, general changes, involutedly dystrophic processes and circulatory disorders. The extent of manifestation of placental pathological changes was influenced both by the duration of infectious process and timeliness of medico-prophylactic measures. 

Conclusions.

Thus, what concerns the patients of the first and second subgroups is that their placental pathological changes took about 10 % of the area and were totally compensated thank to manifested adaptive processes and fiery character of inflammatory infiltrate. So, in the first subgroup, the treatment during the whole gestation period with the preliminary stage and prolongation of pregnancy exercised its positive influence. And as to the second subgroup, unfortunately, it (воно -?) did not allow to escape the development of subcompensated forms of placental deficiency (till 11.11 %). In the comparison group with the incomplete course of medico-prophylactic measures, there was observed 12.16 % of cases with compensated and 16.22 % with subcompensated form of placental deficiency.

Bibliography

1. CaoB  , StoutM J  , LeeI. , Mysorekar I.U. Placental Microbiome and Its Role in Preterm Birth / // Neoreviews, 2014, Vol.15, N12: e537-e545.
2. Bulska M., Szcześniak P., Pięta-Dolińska A. The placental transfer of erythromycin in human pregnancies with group B streptococcal infection / [Ginekol. Pol.]. 2015. Vol. 86, N 1: 33-39.
3. Chastota razvitija infekcionno-vospalitel'nyh zabolevanij novorozhdennyh priplacentarnoj nedostatochnosti / V. V. Zubkov, I. I. Rjumina, O. I. Mihajlova, V. L. Tjutjunnik // Akusherstvo i ginekologija. - 2012. - N 3. - Р. 65-70 
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