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Abstract
Objective – to assess the morphological features of the structure of the placenta and the state of the microflora of the vagina and placenta in women with preterm birth.
Materials and methods. Study design: retrospective, case-control. The study included 150 women. Group I consisted of 50 women with premature vaginal birth; Group II consisted of 100 women with term vaginal birth.
Results. The results of the study showed that in patients with preterm birth (PB), an ascending infection of the placenta is realized with a predominance of choriodeciduitis (40 %) and intervillusitis (32 %), as well as a higher rate of placental insufficiency (54 %). In these women in the early stages of pregnancy, a higher incidence of vaginal biocenosis was recorded. The relationship between the vaginal biocenosis in early pregnancy, the frequency of infection of the surface of the placenta and the realization of infection of the placenta has not been established. In patients with PB in the early stages of pregnancy, statistically significantly more often microorganisms were isolated from the vagina such as Staphylococcus haemolyticus – 30.6 %, Staphylococcus epidermidis – 30.6 %, Corynbacterium spp. – 19.4 %, Enterococcus faecalis, E. coli. No statistically significant differences were found between the frequency of excretion of various microorganisms from the surface of the placenta in women with preterm and term births.
Conclusion. Patients with PB were characterized by a higher incidence of ascending infection of the placenta and disorders of vaginal biocenosis.
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Premature birth. Clinical recommendations (treatment protocol). M., 2013. 35 p. (Letter of the Ministry of Health of the Russian Federation N 15-4/10/2-9480of December 17, 2013). Russian (Преждевременные роды. Клинические рекомендации (протокол лечения). М., 2013. 35 с. (Письмо Минздрава России № 15-4/10/2-9480 от 17.12.2013)
Dudenhausen JW. Primary prevention of preterm birth. J Perinat Med. 2014; 42: 431-433
Been JV, Nurmatov UB, Cox B, Nawrot TS, van Schayck CP, Sheikh A. Effect of smoke-free legislation on perinatal and child health: a systematic review and meta-analysis. Lancet. 2014; 383: 1549-1560
Diez-Izquierdo A, Balaguer A, Lidon-Moyano C, Martín-Sánchez JC, Galán I, Fernández E, Martínez-Sánchez JM. Correlation between tobacco control policies, preterm births, and low birth weight in Europe. Environ Res. 2018; 160: 547-553
Kyvernitakis I, Maul H, Bahlmann F. Controversies about the Secondary Prevention of Spontaneous Preterm Birth. Geburtsh Frauenheilk. 2018; 78: 585-59
Shor S, Zimerman A, Maymon R, Kovo M, Wolf M, Wiener I et al. Combined therapy with vaginal progesterone, Arabin cervical pessary and cervical cerclage to prevent preterm delivery in high-risk women. J Matern Fetal Neonatal Med. 2019. (2): 1-5
Sentilhes L, Sénat MV, Ancel PY et al. Prevention of spontaneous preterm birth: Guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF). Eur J Obstet Gynecol Reprod Biol. 2017; 210: 217-224
Kindinger LM, Bennett PR, Lee YS, Marchesi JR, Smith A, Cacciatore S et al. The interaction between vaginal microbiota, cervical length, and vaginal progesterone treatment for preterm birth risk. Microbiome. 2017; 5(1): 6
Artymuk NV, Elizarova NN, Kolesnikova NB, Pavlovskaya DV, Chernyaeva VI. Features of pregnancy, childbirth and the condition of newborns with premature rupture of the membranes and premature pregnancy. Ginecologia. 2016; 18(1): 64-67. Russian (Артымук Н.В., Елизарова Н.Н., Колесникова Н.Б., Павловская Д.В., Черняева В.И. Особенности беременности, родов и состояния новорожденных при преждевременном разрыве плодных оболочек и недоношенной беременности. Гинекология. 2016. Т. 18, № 1. С. 64-67)
Elizarova NN, Artymuk NV, Turieva MV, Kolesnikova NB, Pavlovskaya DV, Grishkevich EV. Infection peculiarities of placenta in women with premature rupture of membranes at 22+0-36+6 weeks depend on latency. Mother and Baby in Kuzbass. 2017; 2(69): 17-22. Russian (Елизарова Н.Н., Артымук Н.В., Туриёва М.В., Колесникова Н.Б., Павловская Д.В., Гришкевич Е.В. Инфекционные особенности последа при преждевременном разрыве плодных оболочек в 22+0-36+6 недель в зависимости от продолжительности безводного периода //Мать и Дитя в Кузбассе. 2017. № 2(69). С. 17-22)
Kanninen TT, Quist-Nelson J, Sisti G, Berghella V. Chlamydia trachomatis screening in preterm labor: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2019; 240: 242-247
Artymuk NV, Belokrinitskaya TE. Clinical Norms. Obstetrics and gynecology. M.: GEOTAR-Media, 2018. 352 p. Russian (Артымук Н.В., Белокриницкая Т.Е. Клинические нормы. Акушерство и гинекология. М.: ГЭОТАР-Медиа, 2018. 352 с.)
Aagaard K, Ma J, Antony KM, Ganu R, Petrosino J, Versalovic J. The placenta harbors a unique microbiome. Sci Transl Med. 2014; 6(237): 237ra65
Feist H, von Kaisenberg C, Hussein K. Pathoanatomical and clinical aspects of the placenta in preterm birth. Pathologe. 2017; 38(4): 248-259
Malyshkina AI, Nazarova AO, Kulida LV, Kozyrina AA, Zholobov YuN, Nazarov SB. Pathomorphology of placenta in women with preterm births at different age of gestation. Obstetrics, gynecology and reproduction. 2017; 11(4): 23-29. Russian (Малышкина А.И., Назарова А.О., Кулида Л.В., Козырина А.А., Жолобов Ю.Н., Назаров С.Б. Патоморфологические особенности плацент у женщин с преждевременными родами в зависимости от срока гестации //Акушерство, гинекология и репродукция. 2017; 11(4): 23-29)
Perez-Muñoz ME, Arrieta MC, Ramer-Tait AE, Walter J. А critical assessment of the «sterile womb» and «in utero colonization» hypotheses: implications for research on the pioneer infant microbiome. Microbiome. 2017; 5(1): 48
Kamińska D, Gajecka M. Is the role of human female reproductive tract microbiota underestimated? Benef Microbes. 2017; 8(3): 327-343
Marochko TYu, Levanova LA, Artymuk DA. Microbiological and morphological parallels with infection of the placenta. Materials of the scientific-practical conference of the Trans-Baikal Territory «Proven and controversial in obstetrics and gynecology». Chita, 2019. P. 39-41. Russian (Марочко Т.Ю., Леванова Л.А., Артымук Д.А. Микробиологические и морфологические параллели при инфицировании плаценты //Матер. науч.-практ. конф. Забайкальского края «Доказанное и спорное в акушерстве и гинекологии». Чита, 2019. С. 39-41)