HEALTH OF WOMAN. 2019.7(143): 74–79; doi 10.15574/HW.2019.143.74

L.M. Vygivska, I.V. Maidannyk, V.F. Oleshko
Bogomolets National Medical University, Kiev

The article presents the results of a prospective clinical examination of women with a history of burdened infertility, whose pregnancy occurred as the result of assisted reproductive technologies application.

The objective: to study the peculiarities of vaginal biocenosis condition in the dynamics of pregnancy in pregnant women after ART application in order to improve the tactics of antenatal observation and prevention of obstetric and perinatal complications.

Materials and methods. In order to achieve the aim comprehensive examination of 299 pregnant was conducted. Women were divided into two groups: the main group included 249 women whose pregnancy occurred as a result of ART application. The control group consisted of 50 pregnant women with spontaneous onset of pregnancy and its physiological course, which have been taken to the antenatal supervision in the period of 6-8 weeks of pregnancy.

Pregnant women of the examined groups was carried out to determine the pH of the vaginal content, amine test, bacterial screening of the vaginal contents, examination for the presence of sexually transmitted infections and TORCH infections.

Results. Bacterial vaginosis manifestations in 28.7% (27 cases) of I group women and in 19.5% (17 cases) of II group women and were significantly different from those of control group pregnant (p<0.05). Aerobic vaginitis associated with the active proliferation of conditionally pathogenic aerobic microflora which was detected in 39.4% of pregnant women.

Bacteriological examination of I group pregnant women revealed that in the spectrum of isolated microflora microaerophils – Gardnerela vaginalis and Atopobium vaginae were most often in association with Mobiluncus and some representatives of aerobic microflora (S. faecalis, E. coli, Klebsiella spp).

It should be noted that the state of microecology of the genital tract in the pregnant of the main groups was characterized by a significant increase in the composition of the aerobic microflora of seeding indicators of aerobic conditionally pathogenic microorganisms with pathogenic properties (hemolysis, plasma coagulation, lycitin activity). In particular, these women experience an increase in the incidence and concentration of staphylococci, streptococci and Escherichia with hemolytic properties.

Conclusions. For women who have become pregnant as a result of ART application, it is advisable to use routinely test strips to determine vaginal pH as a screening method for selecting pregnant women for an in-depth cultural examination of the vaginal biotope. At pH > 4.4, in addition to microscopy of vaginal smears to determine the degree of activation of the leukocyte reaction, it is advisable to carry out an amine test, bacteriological examination with the obligatory quantification of the concentration of the detected agents, as well as sowing to determine the anaerobic microflora.

Key words: pregnancy, infertility, assisted reproductive technologies, vaginal biocenosis.

REFERENCES

1. Baragnovskaya EI, Lashkevich EL. 2009. Osobennosti biotsenoza polovyih putey i reproduktivnaya funktsiya zhenschin. Immunopatologiya, allergologiya, infektologiya 4: 82–90.

2. Ventskivska IB, Zahorodnia OS. 2012. Protyzapalni preparaty v likuvanni zahrozy peredchasnykh polohiv. Aktual. pytannia pediatrii, akusherstva ta ginekologii 1: 145–147.

3. Veropotvelyan PN, Koshevaya EV, Veropotvelyan NP, Zhuravleva SA. 2015. Rol molochnoy kisloty v mikrobnom peyzazhe vlagalischa: sovremennyiy vzglyad na problemu. Med. aspekty zdorovya zhenschiny 4: 48–55.

4. Kvitka NV, Peremot SD, Smilianska MV. 2009. Infektsii pry zapalnykh zakhvoriuvanniakh zhinochykh statevykh orhaniv. Medytsyna transportu Ukrainy 3: 35–37.

5. Malanchuk OB, Lakatosh VP, Kostenko OIu, Paladych IV. 2016. Osoblyvosti mikrobiotsenokhu pikhvy u vahitnykh u termini 22–28 tyzhniv vahitnosti, uskladnenoi peredchasnym rozryvom plodovykh obolonok. Zdorove zhenshchyny 6: 94–99.

6. Markin LB, Shakhova OV, Popovych AI. 2012. Kompleksna terapiia retsydyvuiuchoho khronichnoho henitalnoho khlamidiozu. Aktual. pytannia pediatrii, akusherstva ta ginekologii 2: 1–6.

7. Nagornaya VF, Moskalenko TYa, Gritsenko AA. 2015. rN vlagalischnogo sekreta v otsenke vlagalischnoy mikrobiotyi vo vremya beremennosti. Zdorove zhenschiny 6: 90–93.

8. Osipova LS, Kononenko IYa, Yurchuk ZhN. 2012. Genitalnyiy gerpes. Osobennosti techeniya i lecheniya v sovremennyih usloviyah. Ukr. zhurn. dermatologIYi, venerologii, kosmetologii 3: 5–10.

9. Panchenko LA. 2014. Gerpes. Rol v patologii cheloveka. Protivovirusnyie preparatyi. Harkov, Planeta-Print. 204.

10. Podolskyi VV, Kahramanian AL. 2015. Likuvalno-profilaktychni zakhody, spriamovani na korektsiiu mikrobiotsenozu urohenitalnykh orhaniv u zhinok fertylnoho viku, meshkanok silskohospodarskoho raionu Ukrainy. Neonatologiia, khirurhiia ta perynatalna medytsyna 5 (2): 66–71.

11. Seythanova BT, Shapambaev ZZ, Olzhaeva RR, Kalmenova PE. 2014. Mikrobiotsenoz vlagalischa i kishechnika beremennyih zhenschin. Nauka i zdravoohranenie 1:70–71.

12. Hryanin AA, Reshetnikov OV. 2012. Hlamidiynaya infektsiya: ot nauki k praktike. Kiev, OOO Tetris-print: 180.