INFECTIOUS PATHOLOGY OF THE REPRODUCTIVE TRACT IN PREGNANT WOMEN
Abstract
Aim. To evaluate the incidence and structure of infectious diseases of the reproductive tract of pregnant women and its effect on the course and outcome of pregnancy. Materials and Methods. 327 pregnant women were selected by continuous sampling method. The research involved clinical laboratory, instrumental, microbiological, and pathomorphological methods of study. After delivery, depending on the pathological study follow-up results all women were divided into two groups: I (basic) – 130 women with morphologically verified intrauterine infection (IUI), II (comparison) – 197 women without inflammatory changes in the afterbirth. There was conducted a comparative analysis of clinical and anamnestic data, of additional survey results, as well as perinatal outcomes of women in both groups. Results. In 80% of pregnant women infectious diseases of the lower reproductive tract were found, the most common form of which was cervicitis (54 %). The inflammatory process in the cervix can be seen as one of the markers of a possible implementation of IUI in pregnant women. Morphologically confirmed IUI was established in 39.8% of cases of all sorts and in 77.8 % – among premature delivery cases. In premature delivery IUI was presented by histological forms, reflecting the inflammatory process in the tissue of the placenta, which has more substantial length and depth. Only 40 % of IUI during pregnancy was accompanied by a systemic inflammatory response. Conclusion. Along with cervicitis, significant markers indicating a high risk of having IUI during pregnancy include burdened obstetric and gynecological anamnesis, persistent threat of pregnancy termination, changes in the structure of the fetoplacental complex at ultrasound violation utero-fetal blood flow, and prothrombotic state of homeostasis. Accounting for these markers will allow the justification of approaches to pathogenetic treatment of this complication.References
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15. Perepelitsa S.A., Golubev A.M., Moroz V.V. [Inflammatory Changes in the Placenta and Bacterial Infection in Preterm Infants with Respiratory Failure]. Obshchaya reanimatologiya [General Resuscitation], 2012, vol. 8, no. 3, pp. 18–24. (in Russ.)
16. Posiseeva L.V., Panova I.A., Sotnikova N.Yu. [Early Predictors of the Nature of Pregnancy in Women with Urogenital Infection Markers]. Akusherstvo i ginekologiya [Obstetrics and Gynecology], 2009, no. 2, pp. 23–27. (in Russ.)
17. Savel'eva G.M., Shalina R.I., Kurtser M.A. [Preterm Birth is the Most Important Problem of Modern Obstetrics]. Akusherstvo i ginekologiya [Obstetrics and Gynecology], 2012, no. 8/2, pp. 4–12. (in Russ.)
18. Tyutyunnik V.L., Kan N.E., Karapetyan T.E. [The Role of the Opportunistic Infections and Vaginal Factors of Innate Immunity in Pregnant Women to Intrauterine Infection]. Problemy reproduktsii [Problems of Reproduction], 2013, no. 4, pp. 95–98. (in Russ.)
19. Selikhova M.S., Kuznetsova O.A., Vdovin S.V. [The Role of Endotoxemia and Innate Immune Mechanisms in the Pathogenesis of Developing Pregnancy]. Vestnik VolgGMU [Bulletin Volgmu], 2012, iss. 1 (41), pp. 17–20. (in Russ.)
20. Skryabina V.V. [Features of Clinical Manifestations of Infectious-Inflammatory Process in Women with Uncomplicated and Complicated Pregnancy]. Ginekologiya [Gynecology], 2013, vol. 15, no. 1, pp. 8–12. (in Russ.)
21. Sukhikh G.T., Van'ko L.V. [Immune Factors in the Etiology and Pathogenesis of Complications of Pregnancy]. Akusherstvo i ginekologiya [Obstetrics and Gynecology], 2012, no. 1, pp. 128–136. (in Russ.)
22. Khashukoeva A.Z., Vodyanik N.D., Khlynova S.A. [Chronic Endometritis – Problems and Solutions]. Lechashchiy vrach [The Attending Physician], 2012, no. 3, pp. 42–45. (in Russ.)
23. Behnia F., Sheller S., Menon R. Mechanistic Differences Leading to Infectious and Sterile Inflammation. Am. J. Reprod. Immunol., 2016, vol. 75, no. 5, pp. 505–518. DOI: 10.1111/aji.12496
24. Bersani I., Thomas W., Speer C.P. Chorioamnionitis – the Good or the Evil for Neonatal Outcome? J. of Maternal and Neonatal Medicine, 2012, vol. 25, pp. 12–16. DOI: 10.3109/14767058.2012.663161
25. Hulthen Varli I., Petersson K., Kublickas M. Both Acute and Chronic Placental Inflammation Are Overrepresented in Term Stillbirths. A Case-Control Study. Infectious Diseases in Obstetrics and Gynecology, 2012, Article ID 293867.
26. Higgins R.D., Saade G., Polin R.A. Evaluation and Management of Women and Newborns With a Maternal Diagnosis of Chorioamnionitis. Obstet. Gynecol., 2016, vol. 127, no. 3, pp. 426–436. DOI: 10.1097/AOG.0000000000001246
27. Gulati S., Bhatnagar S., Raghunandan C. Interleukin-6 as a Predictor of Subclinical Chorioamnionitis in Preterm Premature Rupture of Membranes. American Journal of Reproductive Immunology, 2012, vol. 67, pp. 235–240. DOI: 10.1111/j.1600-0897.2011.01084.x
28. Le S.Y.R., Leung C.W. Histological Chorioamnionitis for Bacterial Colonization, Laboratory Markers of Infection, and Early Onset Sepsis in Very-Low-Birth-Weight Neonates. J. of Maternal and Neonatal Medicine, 2012, vol. 25, no. 4, pp. 364–368. DOI: 10.3109/14767058.2011.579208
29. Menard J.P., Bretelle F. Bacterial Vaginosis and Preterm Delivery. Gynecol. Obstet. Fertil., 2012, vol. 40, no. 1, pp. 48–54. DOI: 10.1016/j.gyobfe.2011.11.004
30. Du H., Han X., Zhang L. Pathological Change of Histologic Chorioamnionitis and its Association with Neonatal Inflammation. Zhonghua Bing Li Xue Za Zhi, 2015, vol. 44, no. 12, pp. 864–867.
31. Castro-Leyva V., Espejel-Nun ez A., Barroso G. Preserved Ex Vivo Inflammatory Status in Decidual Cells from Women with Preterm Labor and Subclinical Intrauterine Infection. Decidual Inflammation during Subclinical Infection, 2012, vol. 7, no. 8, pp. e43605.
32. Conti N., Torricelli M., Voltolini C. Term Histologic Chorioamnionitis. A Heterogeneous Condition. Eur. J. Obstet. Gynecol. Reprod. Biol., 2015, vol. 188, pp. 34–38. DOI: 10.1016/j.ejogrb.2015.02.034
2. Nikonov A.P., Belova A.V., Astsaturova O.R. [Genital Mycoplasmas in the Structure of the Opportunist Infections of the Vagina and Cervix in Pregnant]. Voprosy ginekologii, akusherstva i perinatologii [Questions of Gynecology, Obstetrics and Perinatology], 2010, vol. 9, no. 5, pp. 5–9. (in Russ.)
3. Glukhovets B.I., Glukhovets N.G. Patologiya posleda [Pathology of Placenta]. St. Petersburg, GRAIL Publ., 2002. 448 p.
4. Kostyuchek D.F., Gaykovskaya L.B., Rustanovich Yu.G. [The Change of the Immune Status in Women with Non–Progressive Pregnancy]. Meditsinskaya immunologiya [Medical Immunology], 2012, vol. 14, no. 1–2, pp. 157–162. (in Russ.)
5. Tyutyunnik V.L., Karapetyan T.E., Donnikov A.E. [Changes in Local and Systemic Immunity of Opportunistic Infections of the Vagina in Pregnant]. Akusherstvo i ginekologiya [Obstetrics and Gynecology], 2013, no. 8, pp. 25–29. (in Russ.)
6. Kovalenko A.E., Kalinina N.I., Alekseenkova M.V. [Biochemical Markers of Threatening Preterm]. Akusherstvo i ginekologiya [Obstetrics and Gynecology], 2013, no. 3, pp. 43–47. (in Russ.)
7. Kolomeets T.D., Kolomeets E.V. [Cervical Pathology and Pregnancy. Frequency, Maternal and Perinatal Outcomes]. Vestnik Rossiyskogo Gosudarstvennogo meditsinskogo universiteta [Herald of the Russian State Medical University], 2011, no. 2, 157 p. (in Russ.)
8. Kukharchik Yu.V., Gutikova L.V. [Status of Prooxidant–Antioxidant System in Women with a First Episode of Miscarriage]. Rossiyskiy vestnik akushera-ginekologa [Russian Gazette Obstetrician-Gynecologist], 2013, no. 2, pp. 8–11. (in Russ.)
9. Lazareva G.A., Vedoshchenko T.V. [Pedigree Infection as a Cause of Preterm Birth]. Nauchnye vedomosti Belgorodskogo gosudarstvennogo universiteta. Ser. Meditsina. Farmatsiya [Scientific Statements of the Belgorod State University, Series Medicine. Pharmacy], 2013, vol. 24, no. 25, pp. 132–136. (in Russ.)
10. Lomova N.A., Ordzhonikidze N.V., Van'ko L.V. [The Syndrome of the Systemic Inflammatory Response and Pregnancy (Review)]. Akusherstvo i ginekologiya [Obstetrics and Gynecology], 2012, no. 1, pp. 23–27. (in Russ.)
11. Makarov O.V., Koval'chuk L.V., Gankovskaya L.V. Nevynashivanie beremennosti, infektsiya, vrozhdennyy immunitet [Miscarriage, Infection, Innate Immunity]. Moscow, GEOTAR Media Publ., 2007. 175 p.
12. Ovsyannikova N.I., Kryukovskiy S.B., Smirnova T.I. [Perinatal Outcomes in Pregnant Women with a High Risk of Fetal Infection]. Vestnik novykh meditsinskikh tekhnologiy [Herald of New Medical Technologies], 2010, vol. 17, no. 4, pp. 39–41. (in Russ.)
13. Makarkov A.I., Buyanova S.N., Ivanova O.G. [Features of the T–Cell Immune Regulation for Miscarriage. The Evolution of Paradigms]. Rossiyskiy vestnik akushera-ginekologa [Russian Gazette Obstetrician-Gynecologist], 2012, no. 5, pp. 10–15. (in Russ.)
14. Strizhakov A.N., Tezikov Yu.V., Lipatov I.S. [Pathogenetic Substantiation of Diagnosis and Prevention Dogestatsionnoy Embrioplatsentarnoy Dysfunction]. Voprosy ginekologii, akusherstva i perinatologii [Questions of Gynecology, Obstetrics and Perinatology], 2012, vol. 11, no. 1, pp. 5–10. (in Russ.)
15. Perepelitsa S.A., Golubev A.M., Moroz V.V. [Inflammatory Changes in the Placenta and Bacterial Infection in Preterm Infants with Respiratory Failure]. Obshchaya reanimatologiya [General Resuscitation], 2012, vol. 8, no. 3, pp. 18–24. (in Russ.)
16. Posiseeva L.V., Panova I.A., Sotnikova N.Yu. [Early Predictors of the Nature of Pregnancy in Women with Urogenital Infection Markers]. Akusherstvo i ginekologiya [Obstetrics and Gynecology], 2009, no. 2, pp. 23–27. (in Russ.)
17. Savel'eva G.M., Shalina R.I., Kurtser M.A. [Preterm Birth is the Most Important Problem of Modern Obstetrics]. Akusherstvo i ginekologiya [Obstetrics and Gynecology], 2012, no. 8/2, pp. 4–12. (in Russ.)
18. Tyutyunnik V.L., Kan N.E., Karapetyan T.E. [The Role of the Opportunistic Infections and Vaginal Factors of Innate Immunity in Pregnant Women to Intrauterine Infection]. Problemy reproduktsii [Problems of Reproduction], 2013, no. 4, pp. 95–98. (in Russ.)
19. Selikhova M.S., Kuznetsova O.A., Vdovin S.V. [The Role of Endotoxemia and Innate Immune Mechanisms in the Pathogenesis of Developing Pregnancy]. Vestnik VolgGMU [Bulletin Volgmu], 2012, iss. 1 (41), pp. 17–20. (in Russ.)
20. Skryabina V.V. [Features of Clinical Manifestations of Infectious-Inflammatory Process in Women with Uncomplicated and Complicated Pregnancy]. Ginekologiya [Gynecology], 2013, vol. 15, no. 1, pp. 8–12. (in Russ.)
21. Sukhikh G.T., Van'ko L.V. [Immune Factors in the Etiology and Pathogenesis of Complications of Pregnancy]. Akusherstvo i ginekologiya [Obstetrics and Gynecology], 2012, no. 1, pp. 128–136. (in Russ.)
22. Khashukoeva A.Z., Vodyanik N.D., Khlynova S.A. [Chronic Endometritis – Problems and Solutions]. Lechashchiy vrach [The Attending Physician], 2012, no. 3, pp. 42–45. (in Russ.)
23. Behnia F., Sheller S., Menon R. Mechanistic Differences Leading to Infectious and Sterile Inflammation. Am. J. Reprod. Immunol., 2016, vol. 75, no. 5, pp. 505–518. DOI: 10.1111/aji.12496
24. Bersani I., Thomas W., Speer C.P. Chorioamnionitis – the Good or the Evil for Neonatal Outcome? J. of Maternal and Neonatal Medicine, 2012, vol. 25, pp. 12–16. DOI: 10.3109/14767058.2012.663161
25. Hulthen Varli I., Petersson K., Kublickas M. Both Acute and Chronic Placental Inflammation Are Overrepresented in Term Stillbirths. A Case-Control Study. Infectious Diseases in Obstetrics and Gynecology, 2012, Article ID 293867.
26. Higgins R.D., Saade G., Polin R.A. Evaluation and Management of Women and Newborns With a Maternal Diagnosis of Chorioamnionitis. Obstet. Gynecol., 2016, vol. 127, no. 3, pp. 426–436. DOI: 10.1097/AOG.0000000000001246
27. Gulati S., Bhatnagar S., Raghunandan C. Interleukin-6 as a Predictor of Subclinical Chorioamnionitis in Preterm Premature Rupture of Membranes. American Journal of Reproductive Immunology, 2012, vol. 67, pp. 235–240. DOI: 10.1111/j.1600-0897.2011.01084.x
28. Le S.Y.R., Leung C.W. Histological Chorioamnionitis for Bacterial Colonization, Laboratory Markers of Infection, and Early Onset Sepsis in Very-Low-Birth-Weight Neonates. J. of Maternal and Neonatal Medicine, 2012, vol. 25, no. 4, pp. 364–368. DOI: 10.3109/14767058.2011.579208
29. Menard J.P., Bretelle F. Bacterial Vaginosis and Preterm Delivery. Gynecol. Obstet. Fertil., 2012, vol. 40, no. 1, pp. 48–54. DOI: 10.1016/j.gyobfe.2011.11.004
30. Du H., Han X., Zhang L. Pathological Change of Histologic Chorioamnionitis and its Association with Neonatal Inflammation. Zhonghua Bing Li Xue Za Zhi, 2015, vol. 44, no. 12, pp. 864–867.
31. Castro-Leyva V., Espejel-Nun ez A., Barroso G. Preserved Ex Vivo Inflammatory Status in Decidual Cells from Women with Preterm Labor and Subclinical Intrauterine Infection. Decidual Inflammation during Subclinical Infection, 2012, vol. 7, no. 8, pp. e43605.
32. Conti N., Torricelli M., Voltolini C. Term Histologic Chorioamnionitis. A Heterogeneous Condition. Eur. J. Obstet. Gynecol. Reprod. Biol., 2015, vol. 188, pp. 34–38. DOI: 10.1016/j.ejogrb.2015.02.034
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Published
2017-02-01
How to Cite
Kurnosenko, I., Dolgushina, V., & Sandakova, E. (2017). INFECTIOUS PATHOLOGY OF THE REPRODUCTIVE TRACT IN PREGNANT WOMEN. Human. Sport. Medicine, 17(1), 46-56. https://doi.org/10.14529/hsm170105
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Clinical and Experimental Medicine
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