• Vaginal microbiomes in women with infertility that was surgical treatment on the uterine appendages

Vaginal microbiomes in women with infertility that was surgical treatment on the uterine appendages

HEALTH OF WOMAN. 2018.8(134):98–102; doi 10.15574/HW.2018.134.98

Dubchak A. E. , Milevsky A. V. , Obeid N. N.
SI «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanovaya NAMS of Ukraine», Kyiv
Shupyk National Medical Academy of Postgraduate Education, Kiev
PI CCH № 1, Zhytomyr

The objective: of the study was to study the microbial vaginal tract in women with infertility, who had undergone surgical treatment on the uterine appendages.

Materials and methods. An examination of vaginal discharge on flora and STIs was conducted in 120 women of reproductive age with infertility and benign ovarian formations, ectopic pregnancy, which was organ-retained surgical intervention on the appendages of the uterus. Of these, 76 (1 group) patients were surgically treated in a planned manner, 44 (in 2 groups) – in urgent cases.

Results. Inflammatory diseases of the genital area were more common in women with infertility, who had surgical treatment in an urgent manner than in women of group 1 (p<0.05), especially inflammatory diseases of the cervix – almost twice as likely as in group 1. The vaginal microbial examination of women with infertility who were hospitalized for surgical treatment in an urgent manner indicates a significant imbalance between the parameters of contamination of the genital tract by conditionally pathogenic and normal microflora. This, above all, was manifested by the high frequency of determination in women of the 2nd group of representatives of optional aerobes and anaerobes (p<0.05). The concentration of facultative-aerobic and anaerobic microorganisms was in patients of the 2nd group, mostly of high degree of microbial dissemination, and in women of the 1 group, medium and low. STIs were found mainly in association with anaerobic and aerobic microorganisms in patients who were operated in an urgent manner.

Conclusion. It is necessary to correct the vaginal biotope in women with infertility before surgical treatment – to promptly influence pathogenic microorganisms with antimicrobial agents and restore physiological vaginal microbial vagina.

Key words: women, infertility, vaginal microbial, appendages of the uterus, surgical treatment.

REFERENCES

1. Taylor-Robinson D et al. (2012). Difficulties experienced in defining the microbial cause of pelvic inflammatory disease. Int. J. STD AIDS. 23;1:18–24. https://doi.org/10.1258/ijsa.2011.011066; PMid:22362682

2. Antibakterialnaya terapiya vospalitelnyih zabolevaniy organov malogo taza bez oshibok i eksperimentov: metodicheskoe rukovodstvo dlya vrachey. (2013). Pod. red. Radzinskogo VE, Kozlova RS, Duhina AO. M, Redaktsiya zhurnala Status Praesens:16. ISBN 978-5-905796-21-0).

3. RCOG Green Top Guidelines-Management of Pelvic Inflammatory Disease (2003, 2009) (www.rcog.org.uk).  URL: http:// www.bashh.org/documents/3572.pdf.)

4. CDC. Sexually Transmitted Disease Treatment Guidelines. Pelvic InflammatoryDisease. MMWR. (2010). 59:RR-12.

5. Workowski KA, Berman S. (2010). Sexually transmitted diseases treatment guidelines. Morbidity and Mortality Weekly Report. 59;12 RR:63–67.

6. Bebneva TN, Dobretsova TA. (2016). Smeshannyie vaginalnyie infektsii: novaya ideologiya. Nespetsificheskie vaginalnyie infektsii v praktike akushera-ginekologa. Informatsionnyiy byuleten. Pod redaktsiey Radzinskogo VE, Savichevoy AM.

7. Dubchak AE, Milevskiy AV, Dovgan EN. (2013). Nespetsificheskie vospalitelnyie zabolevaniya organov malogo taza u zhenschin. Zdorove zhenschinyi 2(78):51–55.

8. Dubchak AE, Milevskiy AV. (2018, Mar). Sovremennyie metody lecheniya vospalitelnyih zabolevaniy sheyki matki u zhenschin reproduktivnogo vozrasta (obzor literatury). Reproduktivna endokrinologiya 1(39):2–6.

9. Smetnik VP, Marchenko LA. (2005). Sovremennaya antibakterialnaya terapiya vospalitelnyih zabolevaniy organov malogo taza u zhenschin. Lechaschiy vrach 2:32–37.

10. Dewitt J. et al. (2010). Tubo-ovarian abscesses: is size associated with duration of hospitalization & complications? Obstet Gynecol Int. 2010: 5. Article ID 847041.

11. Crittle K.N., Peipert J.F. (2014, May). Diagnosis and Treatment of Pelvic Inflammatory Disease: A Quality Assessment Study MD, MPH, MHA. Obstetrics & Gynecology. doi: 10.1097/01.AOG.0000447288.15647.

12. Ricardo F Savaris, Daniele G Fuhrich, Rui V Duarte, Sebastian Franik, Jonathan Ross. (2017, Apr 24). Antibiotic therapy for pelvic inflammatory disease. Cochrane Systematic Review. Intervention Version published.

13. Dubossarskaya ZM, Dubossarskaya YuA, Grek LP, Ushakova TB. (2017). Sovremennyiy vzglyad na problemu vospalitelnyih zabolevaniy organov malogo taza u zhenschin. Zdorove zhenschiny 6(122):57–64.

14. Sheshukova NA, Makarov IO, Ovsyannikova TV. (2011). Giperplasticheskie protsessyi endometriya: osobennosti proliferativnoy aktivnosti pri sochetanii s hronicheskim endometritom. Akusherstvo, ginekologiya i reproduktsiya 3:10–15.