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0THE INFLUENCE OF INTRAUTERINE INFECTION ON THE COURSE OF PREGNANCY AND CHILDBIRTH
Djurabekova S.T.
Tashkent Pediatric Medical Institute https://doi.org/10.5281/zenodo.11410447
Abstract. The study analyzed women who had experienced intrauterine infection and the impact of the infection on the course ofpregnancy and childbirth. In addition to collecting medical history, the research included morphological data of postpartum women within the first twenty-four hours after delivery. Pregnant women who had experienced intrauterine infection were found to have a high risk of complications during pregnancy and childbirth.
Keywords: intrauterine infections, pregnant women, postpartum.
Relevance: Despite significant progress made in recent decades in the fight against infectious diseases, intrauterine infections remain a serious unresolved social issue in society. This is due to a persistent trend of deteriorating population health and an increase in the number of infectious diseases. Researchers note the widespread occurrence of perinatal infection, including among clinically healthy newborns. It is known that intrauterine infections, including those affecting the nervous system, are more likely to develop in mothers with chronic somatic diseases, inflammatory diseases of the urogenital tract, a complicated obstetric-gynecological history, pathological pregnancy, and childbirth. Recently, there has been an increase in information about the role of maternal infection as a cause of fetal damage. Obstetricians, neonatologists, and other specialists (including neuropathologists) continue to focus on issues such as determining the role of adverse factors in the pathogenesis of perinatal CNS damage, assessing the risk for pregnant women and fetuses, and finding reliable criteria for the short-term and long-term prognosis of child development. Identifying reliable markers of perinatal CNS damage development will allow for the timely identification of a high-risk group of pregnant women for individual therapeutic and preventive measures. This approach, utilizing forecasting systems, is likely to significantly reduce the frequency of neurological diseases in young children.
Research aim: To investigate the influence of pre-existing conditions and sexually transmitted infections on the course of pregnancy and childbirth.
Materials and methods: The pre-existing conditions, obstetric and gynecological history, and the course of pregnancy and childbirth in 78 women were analyzed. Pathology was detected in 40 women, accounting for 51% of the total number of participants.
Health assessment of expectant mothers during pregnancy utilized a clinical and anamnestic approach, evaluating somatic and obstetric-gynecological history, urogenital infection structure, and analyzing the course of pregnancy and childbirth.
Morphological examination of the placenta was conducted within the first day postpartum in the pathology department of SamMI clinic using an accelerated histological processing technique.
Research findings: Assessment of obstetric and gynecological history revealed vulvovaginitis (25%) and spontaneous abortions (14%) as the most common pathologies. Every second woman had a history of abortions (55%). It is noteworthy that pathological conditions were observed in almost half of the participants (45%), indicating a burdened pre-existing condition
among pregnant women. Screening at women's health clinics identified sexually transmitted infections (STIs) in 25.3% of cases.
Table 1. Structure of STIs detected in pregnant women (n=40)
STIs Obs. %
Chlamydia 21 51,2
Ureaplasma 15 36,6
Cytomegalovirus 9 22
Herpes 2 4,9
Rubella 6 14,6
Based on the data presented in Table 1, the highest proportion is attributed to chlamydia (21 cases, 51.2%), Ureaplasma (15 cases, 36.6%), cytomegalovirus (9 cases, 22%).
Among 12 pregnant women (29.3%), two STIs were detected, the frequency of mixed sexually transmitted infections is shown in Table 2.
Table 2. Frequency of sexually transmitted mixed infections in pregnant women (n=12).
Infections Chlamydia Ureaplasma Cytomegalovir us Herpes Rubella
Ureaplasma 2 - 3 - -
Rubella 3 - - - -
Cytomegalovirus 4 3 - - -
Chlamydia - 2 4 - 3
Chlamydial infection was most commonly associated with cytomegalovirus infection (4 cases) or rubella (3 cases). Chlamydiosis was detected in 3/4 cases of mixed infections transmitted sexually (9 cases out of 12).
Therefore, the health status analysis of the examined pregnant women showed that extragenital pathology was observed in almost every fourth woman (24.7%), dominated by inflammatory diseases of the urinary tract. Sexually transmitted infections were detected during pregnancy with the same frequency (25.3%), with chlamydial infection (isolated or as part of a mixed infection) present in half of the cases. Nearly half of the examined individuals (45%) had a complicated obstetric-gynecological history, with the frequency of chronic inflammatory gynecological diseases (adnexitis, colpitis) reaching 26.5%.
Table 3. Frequency of comorbidity of extragenital pathology, obstetric and gynecological
pathology in women, and STIs.
Extragenital Pathologies STIs (n=40 ) No STIs (n=38 ) P
Total % Total %
Chronic pyelonephritis 5 12.5 1 2,6 >0,05
Cystitis 2 5 3 7,8 >0,05
Colpitis 20 50 8 21 <0,001
Thus, the analysis of the combination of extragenital pathology, obstetric and gynecological pathology in women, and sexually transmitted infections (Table 3) showed a
significant association between chronic inflammatory diseases of the gynecological sphere in women (colpitis) and STIs (50%, p<0.001).
These findings suggest a high risk of pathological pregnancy and childbirth, which may contribute to an increase in the frequency of pathology in children, including affecting the nervous system.
Table 4. Characteristics of pathology during pregnancy and childbirth (n=78).
Pregnancy and childbirth complications STIs (n=40 ) No STIs (n=38 )
Total % Total %
Threat of abortion 15 12.5 10 2,6
Gestosis 5 5 3 7,8
Perinatal CNS damage 20 50 8 21
Hemolytic disease 8 20 5 13
Hypoxia, asphyxia during childbirth 13 32,5 7 18,4
Anemia 17 42,5 11 28,9
Preterm childbirth 16 40 10 2,6
Intrauterine fetal growth restriction 26 65 8 21
Fetal hypoxia 15 12,5 6 15,7
From Table 4, it can be seen that the most common pathologies during pregnancy among the surveyed women were threatened abortion (25 cases, 32%), gestosis (8 cases, 10.2%), preterm labor (26 cases, 33.3%), and anemia (28 cases, 35.9%). A low frequency of antenatal diagnosis of polyhydramnios and fetoplacental insufficiency was noted.
When studying the afterbirth, morphological signs of infection were identified in (18%), placental insufficiency in (26%), their combination in (19%). There were no statistically significant differences in the lesions of different parts of the afterbirth in the studied groups (p>0.05), allowing the assessment of (37%) afterbirths as afterbirths with morphological signs of infection. Evaluation of the lesions in different parts of the afterbirth revealed that afterbirths with signs of infection most commonly presented with choriodecidual inflammation (71.19%), chorioamnionitis (38.98%), phlebitis (33.9%), and arteritis (20.34%). The more inflammatory changes in the afterbirth, the higher the likelihood of fetal infection. Assessment of placental insufficiency revealed that chronic insufficiency accounted for 68.1%, acute insufficiency for 19.4%, and combined for 12.5%.
Conclusion: The examination of pregnant women showed a high frequency of unfavorable pre-morbid background, complicated by obstetric-gynecological history, infections transmitted sexually during pregnancy, combined with a high frequency of complicated pregnancy and childbirth. Morphological examination of the placenta is an additional method; based on the morphological examination of the afterbirth, it is possible to predict the risk of intrauterine infections in newborns.
REFERENCES
1. S.Yu. Lavrik, S.V. Domitrak, V.V. Shprakh // Clinical neurophysiology and neurorehabilitation: Signs of delayed formation of electrocortical rhythms in children with consequences of perinatal damage to the central nervous system / collection. materials II scientific-practical. Conf. From international Participation. - St. Petersburg, 2014.
2. Tusupkaliev B.T., Zhumalina A.K., Zhekeeva B.A. Modern aspects treatment of congenital herpetic infections in newborns with small birth weight // Medical Journal of Western Kazakhstan 3(51) 2016.P.75-77.
3. Емельянова, А. И., Красильникова, А. Я., & Курбанов, Д. Д. (1989). Особенности течения гестационного периода при единственной почке. Акушерство и гинекология, (9), 36-39.
4. Курбанов, Д. Д., Филатов, В. И., Красильникова, А. Я., & Ермоленко, Н. И. (1987). Значение ренально-кортикального индекса в оценке состояния почек при хроническом пиелонефрите у беременных. Мед. журнал Узбекистана, (7-С), 33-36.
5. Курбанов, Д. Д., Алиева, Т. М., & Кадырова, Н. С. (2007). Взаимосвязь некоторых эссенциальных микроэлементов и гормонов крови у женщин репродуктивного возраста с постовариоэктомическим синдромом. Бюллетень ассоциации врачей Узбекистана, 4, 21-23.
6. Курбанов, Д., Ахмедова, Д., Ищенко, И., & Тиллашайхова, М. (2015). Причина железодефицитной анемии у девочек-подростков проживающих в караулбазарском районе бухарской области. Журнал вестник врача, 1(3), 25-27.
7. Эшмаматова, Д. Б., Таджиева, М. А., & Ганиходжаев, Р. Н. (2023). ДИНАМИКА ПОВЕДЕНИЯ ТРАЕКТОРИЙ ОТОБРАЖЕНИЙ ЛОТКИ-ВОЛЬТЕРРЫ В СЛУЧАЕ ОДНОРОДНЫХ ТУРНИРОВ. In Труды Математического центра имени НИ Лобачевского. Т. 66 XVI Международная Казанская школа-конференция" Теория функций, ее приложения и смежные вопросы", Сборник трудов.-Казань: КФУ, 2023.Т. 66.-291 с. (p. 285).
8. Эшмаматова, Д. Б., Таджиева, М. А., & Юсупов, Ф. А. (2022). Асимптотическое поведение траекторий некоторых отображений Лотки-Вольтерра, действующих в двумерном симплексе с транзитивными турнирами. Bulletin of the Institute of Mathematics, 5(6), 1-7.
9. Akhmedova, D. R., Ishchenko, I. V., Tillashaykhova, M. K., Navruzova, R. S., & Yuldashev, A. O. (2021). FEATURES OF FOOD, CONTENT OF MICROELEMENTS IN FOOD AND ENVIRONMENT IN FAMILIES LIVING IN UZBEKISTAN. Annals of the Romanian Society for Cell Biology, 13120-13123.
10. Курбанбаева, Г., & Ищенко, И. (2021). Послеродовые кровотечения как причина материнской смертност. Перспективы развития медицины, 1(1), 120-121.
11. Турсункулова, Х., & Ищенко, И. В. (2021). Течение послеоперационного периода у женщин с консервативной миомэктомией после родоразрешения путем кесарево сечения. Перспективы развития медицины, 1(1), 274-274.
12. Тиллашайхова, М. Х. (2018). ПЕРВИЧНАЯ ГИПОФУНКЦИЯ ЯИЧНИКОВ. Интернаука, 38, 10.
13. Тиллашайхова, М. Х., Мухамедханова, Ш. Т., Юлдашева, Д. С., Ищенко, И. В., & Ахмедова, Д. Р. (2015). Роль вирусной и микоплазменной инфекции в генезе синдрома истощенных яичников. Актуальная инфектология, (3 (8)), 59-61.
14. Расуль-Заде, Ю. Г., & Климашкин, А. А. (2013). Применение L-аргинина у беременных при легкой преэклампсии. Украгнський хгмютерапевтичний журнал, (3-4), 68-68.
15. Расуль-Заде, Ю. Г., Дусчанова, З. А., & Климашкин, А. А. (2012). Оценка клинической эффективности ингибиторов обратного захвата серотонина в комплексном лечении тяжелых форм предменструального синдрома. Врач-аспирант, 57(2.4), 544-554.
16. Rasoul-Zadeh, Y. G., & Klimashkin, A. A. (2022). Doppler indices in monitoring fetuses with late onset of intrauterine fetal growth restriction. Bulletin of Medical Science, 2(26), 12-18.
17. Расуль-Заде, Ю. Г., Дусчанова, З. А., & Климашкин, А. А. (2011). Способ оценки состояния женщин с предменструальными расстройствами с помощью ведения ежедневных записей. Вестник ТМА, (4), 116.
18. Камилов, А., Асадов, Д., Расуль-Заде, Ю., Ядгарова, К., Климашкин, А., Карабаева, Н., & Абдусалямов, А. (2011). Концепция непрерывного повышения качества перинатальной помощи. Журнал вестник врача, 1(2), 3-9.
