• Characteristics microbiocenosis vagina in pregnancies of 22–28 weeks complicated by preterm premature rupture of membranes

Characteristics microbiocenosis vagina in pregnancies of 22–28 weeks complicated by preterm premature rupture of membranes

HEALTH OF WOMAN. 2016.6(112):94–99 
 

Characteristics microbiocenosis vagina in pregnancies of 22–28 weeks complicated by preterm premature rupture of membranes 
 

Malanchuk O. B., Lakatosh V. P., Kostenkо O. U., Poladich I. V.

Perinatal center, Kiev

A.A. Bogomolets National Medical University, Kiev 

Premature rupture of membranes (PROM) is one of the most urgent and serious issues that must be solved practical midwives in the context of preterm birth. The cause of preterm labor is quite difficult and numerous reports of infections due to preterm birth do not distinguish – or infection directly affects the start of preterm labor or premature rupture of membranes, or both situations immediately. Due to an insufficient number of studies, we decided to analyze different approaches to antibiotic therapy, to reduce maternal morbidity and mortality reduction in newborns.


The оbjective: reduction of septic complications in childbirth and newborns during pregnancy weeks 22-28 on a background of varying duration of anhydrous period when PROM by studying features of the species composition of the vagina and the presence of microorganisms in their biotope group B Streptococcus develop schemes appointment of antibacterial therapy.


Patients and Methods. We examined 206 women with PROM in preterm labor at 22–28 weeks of gestation period. The control group included 56 pregnant women admitted to hospital with a PROM on the background of a regular labor and gave birth to a newborn. Anhydrous period in this group was 6.47±2.05 hours. Antibiotic therapy has not been evaluated. The study group consisted of women surveyed with anhydrous long period, and it was divided into 2 groups: I group – 86 patients who had a dry period of 120.30±2.06 hours, taking antibiotics for the developed scheme, after which they were delivery; II – 64 patients who had a dry period of 600.05±3.05 hours, the scheme used antibiotics according to regulatory orders and after the onset of spontaneous labor was vaginal delivery means. To confirm the diagnosis of PROM used rapid – test Actim PROM. Fence on the bacteriological examination of vaginal material in pregnant women was carried out at their admission to the clinic to the appointment of antibiotics, and birth of a child – in the mother’s vaginal and neonatal study the content of gastric aspirate. Statistical analysis of the results was carried out using standard packages of applied statistical analysis (Statistic 6.0 for Windows, Statgraphics v. 7.0).

 

Results. The premature discharge of amniotic fluid occurs against violations microecology vagina – low background lactobacilli, vaginal colonization by microbial associations (46.60%), bacterial vaginosis (37.55%), the colonization of Streptococcus agalactiae (58.93%). As the duration of the dry period is further reduced vaginal colonization by lactobacilli, increases the total number of microflora and its associative connections (64.06%), increases the degree of colonization of aerobic-anaerobic flora, increases dramatically the number of vaginal colonization and Streptococcus agalactiae (60.94%). The presence of group B streptococcus is a leading cause of morbidity and mortality in newborn infections. The factors the risk of antenatal GBS sepsis in neonates 22–28 weeks of pregnancy with PROM have to include: (CIN) (48.5%), the birth of a previous child with early symptoms of sepsis (20.8%), bakteuriyu during this pregnancy (18.9%). Neonates born to mothers treated for risk factors, 50% had fewer signs of early GBS sepsis than those who were born to mothers who did not have time to conduct screening methods and the treatment was performed.


Conclusions. During the comparative characteristics of the microflora of the vagina of pregnant women with preterm labor at 22–28 weeks against the backdrop of premature discharge of amniotic fluid with a different period of dry period proved that on the performance of septic complications of childbirth and neonatal period affects an adequate antibiotic therapy.


Key words: too early for preterm labor, premature discharge of amniotic fluid, babies with extremely low body weight, vaginal flora of the mother and the gastric aspirate of the newborn, clinical manifestations of streptococcal infection in the newborn, antibiotic therapy.


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