- Modern principles of treatment of perinatal infections
Modern principles of treatment of perinatal infections
HEALTH OF WOMAN. 2019.10(146): 62–68; doi 10.15574/HW.2019.146.62
Grishchenko O. V.1, Bobrytska V. V.2
1Kharkov Medical Academy of Postgraduate Education
2Kharkiv National University named after V.N. Karazin
The objective: was to optimize the treatment of perinatal infections and improve perinatal outcomes by using macrolide with a wide spectrum of action of Doramycin (spiramycin).
Materials and methods. A retrospective analysis of data and dynamic observation of 130 pregnant women with positive results of infectological studies was carried out. I (main) group of 50 patients receiving Doramycin 3 mln 3 times a day for 10 days; II (comparison group) 40 patients receiving pulse therapy with azithromycin 1 g per day on the 1st, 7th, 14th day, III (control group) 40 patients who did not receive antibiotic therapy. The selection criteria for pregnant women for this observation were the positive results of ELISA, PCR, bacteriological studies in combination with the pathological course of the perinatal period, clinical and ultrasonographic data.
Results. Elimination of chlamydial infection, toxoplasma, pathogenic flora sensitive to macrolides was observed mainly in patients of group I treated with Doramycin. Perinatal outcomes were also significantly better among patients in the main group. In group III, which did not receive antibiotic therapy, there was a high percentage of small children, premature birth and neonatal morbidity.
Conclusion. Doramycin is an effective and safe drug, the use of which can be recommended during pregnancy, complicated by perinatal infections. The use of Doramycin significantly improves the outcome of labor for the mother and fetus.
Key words: doramycin, spiramycin, perinatal infections, treatment.
REFERENCES
1. Vovk LM. 2011. Rol osnovnykh predstavnykiv TORCH-kompleksu v rozvytku perynatalnoi patolohii. Klinichna imunolohiia. Alerholohiia. Infektologiia 2(41): 25-29.
2. Mavrov HY, Chynov HP. 2005. Lechenye khlamydyoza (podkhodы k antybakteryalnoi terapyy). Ukrainskyj zhurnal dermatologii, venerologii, kosmetologii (3):82-91.
3. Mitsoda RM, Sadyhov YuM, Potokii NI. 2015. Analiz chastoty perynatalnykh infektsii u zhinok iz zavmerloiu vahitnistiu v anamnezi. Zdorove zhenshchyny 9 (105): 57-58.
4. Nakaz MOZ Ukrainy vid 15.07.2011 №417 «Metodychni rekomendatsii shchodo orhanizatsii nadannia ambulatornoi akushersko-hinekolohichnoi dopomohy».
5. Nakaz MOZ Ukrainy №906 vid 27.12.2006 «Pro zatverdzhennia klinichnoho protokolu z akusherskoi ta hinekolohichnoi dopomohy «Perynatalni infektsii».
6. Pasiieshvili NM. 2016. Analiz perynatalnoi zakhvoriuvanosti ta smertnosti v umovakh perynatalnoho tsentru ta shliakhy yii znyzhennia. ScienceRise. Medical Science. 1/3(18): 37-43.
7. Pirogova ZI, Ryabchuk FN. 2011. Kliniko-laboratornaya harakteristika persistiruyuschih infektsiy hlamidiynoy i mikoplazmennoy etiologii u detey. Lechaschij vrach 1(24):13.
8. Turianytsia SM, Fedko YuR, Korchynska OO, Fedko RM, Khudanych OV. 2013. Suchasni napriamky vedennia vahitnykh iz toksoplazmovoiu infektsiieiu. Problemy klinichnoi pediatrii 2 (20): 36-43.
9. Fedorich PV, Mavrov GI, Podolskiy VlV. 2019. Obosnovanie primeneniya Doramitsina dlya eradikatsii mikrofloryi, assotsiirovannoy s bakterialnyim vaginozom. Zdorove zhenschinyi 1(137):55–59.
10. Adams Waldorf KM, McAdams RM. 2013. Influence of infection during pregnancy on fetal development. Reproduction 146 (5): R151-62. https://doi.org/10.1530/REP-13-0232; PMid:23884862 PMCid:PMC4060827
11. Adamyan LV, Kuzmin VV, Arslanyan KN, Kharchenko EI. 2015. Spread of nosocomial infection in obstetric hospitals. Ter. Arkh. 87(11):109-112. https://doi.org/10.17116/terarkh20158711109-112; PMid:26821427
12. Wizman S, Lamarre V, Coic L et al. 2016. Awareness of cytomegalovirus and risk factors for susceptibility among pregnant women, in Montreal, Canada. BMC Pregnancy Childbirth 16 (1): 54. https://doi.org/10.1186/s12884-016-0844-9; PMid:26979058 PMCid:PMC4793542
13. Baud D, Greub G. 2011. Intracellular bacteria and adverse pregnancy outcomes. Clin Microbiol Infect. 17 (9): 1312-22. https://doi.org/10.1111/j.1469-0691.2011.03604.x; PMid:21884294
14. Baud D, Regan L, Greub G. 2008. Emerging role of Chlamydia and Chlamydia-like organisms in adverse pregnancy outcomes. Curr Opin Infect Dis. 21 (1): 70-6. https://doi.org/10.1097/QCO.0b013e3282f3e6a5; PMid:18192789
15. Borborema-Alfaria AP, Freitas NS, Astolfi Filho S, Borborema-Santos CM. 2013. Chlamydia trachomatis infection in a sample of northern Brazilian pregnant women: prevalence and prenatal importance. Braz. J. Infect. Dis. 17(5):545-50. https://doi.org/10.1016/j.bjid.2013.01.014; PMid:23831212
16. Honkila M, Renko M, Pokka T, Wikström E, Uhari M, Tapiainen T. 2018, Sep. Symptoms, Signs and Long-term Prognosis of Vertically Transmitted Chlamydia trachomatis Infections. Pediatr.Infect. 37(9):930-933. https://doi.org/10.1097/INF.0000000000001925; PMid:29389825
17. Honkila M, Wikström E, Renko M, Surcel HM, Pokka T, Ikäheimo I, Uhari M, Tapiainen T. 2017. Probability of vertical transmission of Chlamydia trachomatis estimated from national registry data. Sex Transm Infect. 93(6):416-420. https://doi.org/10.1136/sextrans-2016-052884; PMid:28228485
18. Inkaya AÇ, Örgül G, Halis N et al. 2019, Sep 30. Perinatal outcomes of 25 hiv-infected pregnant women: hacettepe university experience. J. Turk. Ger. Gynecol. Assoc. https://doi.org/10.4274/jtgga.galenos.2019.2019.0033; PMid:31564083
19. Kristina Adachi, Rarine Nielsen-Saines, Jeffry d.Klausner. Chlamydia trachomatis Infection in Pregnancy: The Global Challenge of Preventing Adverse Pregnancy and Infant Outcomes in Sub-Saharan Africa and Asia.Biomed.Res.Int. 2016: 9315757, 21p. https://doi.org/10.1155/2016/9315757; PMid:27144177 PMCid:PMC4837252
20. Mariya Angelova, Emil Kovachev, Veselina Tsankova, Iliana Koleva, Silvia Mangarova. 2016. Role and Importance of Chlamydia Trachomatis in Pregnant Patients. Open Access Maced J Med. Sci. 4(3): 410–412. https://doi.org/10.3889/oamjms.2016.077; PMid:27703564 PMCid:PMC5042624
21. Mestas E. 2016. Congenital cytomegalovirus. Adv Neonatal Care. 16 (1): 60-5. https://doi.org/10.1097/ANC.0000000000000242; PMid:26752783
22. Sweeney EL, Kallapur SG, Gisslen T et al. 2016. Placental infection with ureaplasma species is associated with histologic chorioamnionitis and adverseoutcomes in moderately preterm and late-preterm infants. J. Infect Dis. 213 (8): 1340-7. https://doi.org/10.1093/infdis/jiv587; PMid:26671889 PMCid:PMC4799668
23. Wong YP, Tan GC, Wong KK, Anushia S, Cheah FC. 2018. Gardnerella vaginalis in perinatology: An overview of the clinicopathological correlation. Malays. J. Pathol. 40(3):267-286.