The method of rehabilitation of the urogenital system of pregnant women

 

(57) Abstract:

The invention to medicine, in particular to a method of rehabilitation of the urogenital system, pregnant women, and is intended for obstetricians and gynecologists. The basis of the method is antibacterial therapy, carried out against the background immunomodulation, which is achieved by intramuscular injection of the drug NEOVIR 250 mg with an interval between the introduction of 48 h (treatment 5 injections). Upon completion of the course of antibiotic and immunomodulatory therapy proceed to the stage of rehabilitation of the microflora of the gastrointestinal tract and vagina introduction of bifidobacteria and intravaginal instillation of Lactobacterin. The method can reduce the cases of chlamydial infection with 50 to 2.9%, and Ureaplasma from 19.4% to 0%. It was also noted significant reduction in the incidence of viral infection. This leads to the prevention of a wide range of perinatal complications.

The present invention relates to medicine, namely to obstetrics, and can be used for the treatment of infectious pathology of the urogenital tract against the backdrop of ongoing immunomodulation and subsequent rehabilitation of the microflora of the gastrointestinal tract and vagina.

The act is spruce feminine genital organs, which are dominated by bacterial vaginosis, urogenital candidiasis and chronic intrauterine infection chlamydial and mycoplasmal etiology. Exposure to urogenital infections, their ability to influence the formation of the complications of gestational process and the effectiveness of ongoing treatment efforts are determined by the immune status and microbiocenosis of pregnant women [1].

Similar to the proposed method is described in the literature as the method of activation of the local immune system and restore local protection systems, involving local application of complex immunoglobulin preparation (CMP) containing immunologically active fractions of serum proteins [2] . The effectiveness of this method is insufficient in the absence of the impact of the TRC on the state of cellular and humoral immunity in General.

In recent years in the practice of dermatovenerologists and gynecologists are specific drugs that selectively affect certain parts of cellular immunity (timolin, T-activin, timogen, etc.), however, their use in pregnant women is limited or is contraindicated. The presence of beremennosti systemic immunomodulation.

Prototypes of this invention are:

1. The way colonization of the gastrointestinal tract and vagina representatives of normal microflora through enteral and topical application of eubiotics in the form of lyophilised preparations, and in the form of fermented food products containing bifidobacteria and lactobacilli[2, 3, 4, 5, 6, 7].

2. Activation of endogenous interferon through enteral application of herbal remedies (drugs, Chinese Magnolia vine, eleuterokocca, ginseng) on the background of improvement of cellular metabolism and liver function [8].

The purpose of the invention: an improved treatment of chronic urogenital infections in pregnant women, reduce the frequency of formation of pregnancy complications associated with the presence of infection and side effects of antibiotic therapy (dysbiosis, candidiasis, immunosuppression).

Description of method: begin treatment with intramuscular injection of the drug NEOVIR 250 mg every 48 hours (treatment 5 injections). NEOVIR - immunomodulating and immunostimulating drug that has the ability to stimulate endogenous interferon in high titers. From the 2nd injection Noratom choice active against a broad spectrum of pathogens, including Ch. Trachomatis and Ur. Urealyticem was non-toxic 16-membered macrolide - ROVAMYCIN. Daily dose of 9 million IU the course of treatment is 10 days. Upon completion of antibiotic and immunomodulatory therapy proceed to the stage of rehabilitation of the microflora of the gastrointestinal tract and vagina, achieved enteral intake of fermented milk bifidobacteria 200 ml daily on an empty stomach (treatment 4 weeks) and the intravaginal instillation of an aqueous solution lyophilized Lactobacterin (N 10 - 14). To prevent reinfection conduct a parallel investigation and treatment of sexual partners.

The claimed method were treated with 50 pregnant women with identified they urogenital infection, thus reducing the incidence of chlamydial infection with 50% in the 1st trimester to 2.9% in the period of full-term pregnancy. The most significant effect from the proposed comprehensive treatment made against Ureaplasma infection, the frequency of its detection in the 1st trimester of 19.4% and in the 3rd - 0%. It is significant dynamics in the incidence of viral infections (HSV, CMV), in the 1st trimester - 13.9 per cent; in the 3rd - 2,9%.

Declared SPO is camping spontaneous miscarriage in the period of 13 weeks with subsequent secondary infertility (3 years). The survey, conducted in the 1st trimester spontaneous pregnancy, revealed the presence of women associative urogenital infections, presents chlamydial cervicitis, bacterial vaginosis (BV) and herpes simplex virus (HSV) of the 2nd type. The woman received the full course of the proposed method of treatment at 16 weeks of pregnancy. Monitoring the effectiveness of therapy, conducted in 28 weeks, revealed the state of normanize, the results of clinical-laboratory examination of a pregnant testified about the lack of signs of an infectious lesion of fetoplacental complex. The pregnancy ended urgent spontaneous childbirth, newborn with no signs of intrauterine infection.

Example 2. Somov N. In. 29. From the anamnesis: the first pregnancy ended in a premature birth in the period of 32 weeks of gestation, delivery was preceded by premature rupture of membranes and prolonged rupture of membranes. Further parity women indicates habitual miscarriage (3 pregnancy terminated spontaneously in the period from 13 to 18 weeks of gestation).

Clinical and laboratory examination in the 1st trimester of this pregnancy has revealed the presence of x is and the full course of the proposed method of treatment, and then underwent surgical correction of istituzionale failure. Monitoring the effectiveness of treatment testified sufficient effect in relation to previously identified infection. In the 3rd trimester has been a recurrent yeast infection, treated with antimycotic drugs for local application on the background of repeated treatment NEOVIA. Women odoratissimus the term full-term pregnancy, the child has no signs of intrauterine infection.

Sources of information

1. Kosheleva N. G. Modern tactics of treatment and prevention of miscarriage taking into account the etiopathogenesis // Herald of the Russian Association of obstetricians and gynecologists. - 1996. - N 3. - S. 45 - 49.

2. Tsvetaeva T. Y. Complex immunoglobulin preparation instrumentation and forms of its use in the treatment of inflammatory diseases in gynecology // Disbacteriosis and eubiotics: proc. Dokl. All-Russian scientific-practical conference (26 - 28 March 1996, Moscow). - M., 1996. - S. 38.

3. Lenzner A. A., Lentzner H. P. Protective function follow vagina and her ability to gain // Dysbiosis and eubiotics: proc. Dokl. All-Russian scientific-practical conference (26 - 28 March 1996, Moscow). - M., 1996. - S. 22.

5. Mirzabaev A. K., Antonov A. A. Application of eubiotics in the treatment of genital candidiasis in women // Disbacteriosis and eubiotics: proc. Dokl. All-Russian scientific-practical conference (26 - 28 March, 2996, Moscow). - M., 1996. - S. 25.

6. Tarasevich, A. C. Flora of the vagina and intestines pregnant first trimester // Disbacteriosis and eubiotics: proc. Dokl. All-Russian scientific-practical conference (26 - 28 March 1996, Moscow). - M., 1996. - C. 35.

7. Casava centuries of Probiotics lactobacilli in the Arsenal of bacterial therapy // Disbacteriosis and eubiotics: proc. Dokl. All-Russian scientific-practical conference (26 - 28 March 1996, Moscow). - Moscow, 1996. - S. 39.

8. Glazkova L. K., N. Gerasimov.And. Bacterial vaginosis. Method. The allowance. - Ekaterinburg, 1996. - C. 7 - 13, 21 - 22, 38 - 40.

The method of rehabilitation of the urogenital system of pregnant women by antibiotic therapy, characterized in that the treatment is carried out on a background of stimulation of interferon status drug NEOVIR with subsequent rehabilitation microbiocenosis.

 

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