1ST CITY CLINICAL HOSPITAL

The progress of modern perinatology has led to the need to solve new problems associated with the gestational process and antenatal care of the fetus. The incidence of urogenital infections remains consistently high on all continents of the world. The problem of improving obstetric and gynecological care for women suffering from genital infections has become one of the most important medical problems and is due to the high level and constant increase in morbidity and the chronic course of the process.

It has been proven that all genital infections cause very large changes in the metabolism of cells in the host body: they disrupt the metabolism of amino acids, the synthesis of proteins, nucleic acids, and introduce new genetic information. They increase the amount of free arachidonic acid, leading to activation of prostaglandin synthesis, which in turn can cause spontaneous abortions, premature births, stillbirths, and pathologies of pregnancy and childbirth.

When analyzing the structure of urogenital infections, the most common occurrence of the following microorganisms was revealed: Escherichia coli in 22%, Streptococcus agalactiae in 21%, Staphylococcus epidermidis in 13%, Staphylococcus aureus in 11%, fecal enterococcus in 10%, candida in 8%, mycoplasma in 6 %, ureaplasma in 5%, trichomonas and chlamydia in 2%. (Table 1).

When analyzing births in women with urogenital infections, the following complications were identified: the frequency of premature births is 24%, cesarean sections are 53%, which may be due to the initial unfavorable background and the highest frequency of complications of the gestational period in these patients.

When analyzing the outcome of birth for newborns, it was found that in 37% of cases intrauterine infection was observed, in 27% of cases children were born premature, in 14% there was fetal malnutrition, in 3% there was antenatal fetal death.

When studying the characteristics of the course of pregnancy in women with urogenital infections using functional research methods, the following was revealed (Table 2):

The presence of infections of the urogenital tract is accompanied by a high incidence of complications during pregnancy, childbirth and the postpartum period. Among the causative agents of urogenital infections, Escherichia coli and Streptococcus agalactiae occupy the first place. The most common urogenital infections observed are: colpitis in 32% of cases, exacerbation of chronic pyelonephritis in 25% of cases, gestational pyelonephritis in 22% of cases. The presence of infections of the urogenital tract is accompanied by a high frequency of pregnancy complications; the most common are: decreased feto- and uterine-placental blood flow in 63% of cases, intrauterine fetal suffering in 42% of cases. Infections of the urogenital tract aggravate the gestational process and increase the risk of disease in newborns. The most common complications: pneumonia occurred in 21%, associated with Streptococcus agalactiae, inflammatory changes in the BC were observed in 19% of cases, babies were born prematurely in 17%, asphyxia was observed in 8% of cases.

Thus, early diagnosis and initiation of effective treatment of urogenital infections in pregnant women can serve as a significant reserve for reducing both complications of the gestational process and the frequency of intrauterine infection of the fetus and perinatal morbidity.