Tactic of conduct of multiparous women is with the second infertility on a background chronic urogenital infection
Keywords:multiparous women, infertility, chronic infection
The objective: decline of frequency of violations of genesial function miscarring of pregnancy for multiparous women from chronic urogenital infection in anamnesis on the basis of study clinical-and-microbiological, immunological and endocrinology changes, and also improvement of algorithm of treatment-and-prophylactic measures.
Materials and methods. By us 100 multiparous patients were inspected with the different forms of urogenital infection in anamnesis, which were up-diffused on two groups: 1 group – 50 multiparous women which got the generally accepted treatment-and-prophylactic measures; 2 groups are 50 multiparous women, conducted stage-by-stage on the method developed by us.
A control group was made 50 gynaecological and somatically healthy women of genesial age.
In the complex of the conducted researches булі is included clinical, echographic, immunological, endocrinological, microbiological and statistical.
Results. Etiology of chronic urogenital infection for multiparous women is characterized by predominance of the united forms: viral, chlamydial, candida infection with the stamms of staphylococcus (26,0%); viral, candida, mycoplasma and уреаплазменної infections with the stamms of staphylococcus (22,0%); chlamydial, mycoplasma and ureaplasmic infections with the stamms of staphylococcus (20,0%); chlamydial and candida infection (16,0%); viral and candida infection (16,0%).
Do the changes of system immunity for multiparous patients with a chronic urogenital infection carry reliable not character, but violation of local immunity characterized by the reliable increase (р<0,05) of content of IgМ and β-lysins at the simultaneous decline (р<0,05) of level of IgА; basic parameters of phagocytosis and lysozyme. A chronic urogenital infection for multiparous women assists to development of violations of menstrual function in 32,0% cases and reliable dishormonal changes: in a 1 phase of menstrual cycle – decline of content of estradiol and follicle-stimulating hormone at the simultaneous increase of level of luteinizing hormone, aldosterone, cortisol and thyrotropic hormone; in the II phase of menstrual cycle - decline of content of progesterone increase of level of luteinizing hormone, cortisol and thyrotropic hormone.
The use of the offered treatment-and-prophylactic measures with subsequent pregravid preparation is instrumental in the increase of frequency of offensive of pregnancy at 2,1 time and decline of level of miscarring of pregnancy at 4,2 time.
Conclusions. Decline of frequency of miscarring for multiparous women with a chronic urogenital infection in anamnesis it costs to begin with the stage of treatment of chronic hearths of infection with the subsequent passing to proceeding in a genesial function. Taking into account circumstance that the women of this group have a high risk of the intraamnial infection, predefined by the
whole complex of negative influence from the carried urogenital infection basis of miscarring of pregnancy.
The got results appeared a convincing enough ground for the treatment-and-prophylactic method improved by us. A substantial increase of frequency of proceeding in a genesial function on a background the decline of frequency of miscarring of pregnancy is foundation for wide introduction of the offered method in a practical health protection.