Urinary infections and perinatal losses
DOI:
https://doi.org/10.15574/HW.2024.4(173).3339Keywords:
perinatal losses, urogenital tract, pregnancy complications, group B streptococcus, infectionAbstract
Today, one of the leading factors contributing to perinatal losses are infections, especially of the urogenital tract.
Aim - to assess the presence of infection, especially of the urogenital tract, in women with perinatal losses and establish their role in the genesis of stillbirth.
Materials and methods. A prospective examination of 45 patients with miscarriage after 12 weeks was conducted - the main group, divided into the subgroup I (n=24) - women with miscarriage in the period from 12 to 21 weeks 6 days; the subgroup II (n=21) – women with antenatal fetal death. The control group - 30 patients with advanced pregnancy. We determined the microbiocenosis of vaginal secretions, the group B streptococcus. The reliability of the research results was assessed using Student's and Fisher's criteria. A statistically significant difference was considered at p<0.05.
Results. The average age of pregnant women in the main group was 26±2.1 years. Every third patient of the main group had a history of otorhinolaryngology pathology. Pathology of the urinary system was noted by 44.4% of patients in the main group. The course of this pregnancy was complicated by nausea and vomiting of pregnancy, threat of abortion, asymptomatic bacteriuria; polyhydramnios. Pathological degrees of microbiocenosis in the main group were diagnosed twice as often as in the control group (p<0.05). Gram-positive microflora prevailed. The concentration of Lactobacillus spp. in the main group was 4.2±1.8 CFU/ml. The growth of the group B streptococcus in vaginal secretions in the main group occurred 3.5 times more often than in the control group.
Conclusions. Among women with miscarriage after 12 weeks, an important role of infection of the urogenital tract (Ureaplasma urealyticum, Gardnerella vaginalis, Streptococcus spp.) has been assigned, which has a direct impact on the course of pregnancy. Somatic pathology was also noted in the examined women: inflammatory diseases of the genital organs (37.8%), gestational pyelonephritis (28.6%), threatened miscarriage (29.2%); polyhydramnios (20.9%). An association of opportunistic vaginal microflora at a concentration of 106 CFU/ml and a decrease in Lactobacillus spp.
The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was adopted by the Local Moral Committee of the institution indicated in the work. Informed consent was obtained from the women for the study.
The authors declare no conflict of interest.
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