PREGNANCY AND BIRTH OUTCOMES IN FEMALE WITH AND WITHOUT ASSISTED REPRODUCTIVE TECHNOLOGY IN UKRAINE.

OBJECTIVE: The aim: To assess and compare the risk of maternal/perinatal complications and adverse outcomes in pregnancy and childbirth conceived by ART with those conceived naturally in Ukraine. PATIENTS AND METHODS: Materials and Methods: We conducted a retrospective multicenter cohort study from January 1st, 2019 to December 31st, 2021. This study included pregnant women who delivered at 14 Women's Hospitals from 8 regions of Ukraine. RESULTS: Results: A total of 21,162 pregnancies were included. Of these, there were 19,801 natural pregnancies and 1,361 pregnancies after ART. The proportion of ART. pregnancies has increased every year in during study period, peaking in 2021 (6.7%). Data analysis showed that the risks of gestational diabetes, preeclampsia, moderate or severe anemia, liver-related diseases, thyroid-related diseases, preterm birth, placenta previa, postpartum hemorrhage, and cesarean section were significantly increased in ART pregnancy. For neonatal outcomes, women conceived by ART were more likely to have twins. The effects of ART on the risk of premature rupture of membrane, cord entanglement, intrapartum fever, and cesarean section were more pronounced in singletons pregnancies. CONCLUSION: Conclusions: Women conceived by ART were at increased risks of several adverse pregnancy outcomes compared with women conceived naturally. Therefore, prenatal and intrapartum monitoring should be strengthened, and neonatal outcomes should be closely observed for ART pregnancy.

CERVICITIS AS A CAUSE OF PRETERM BIRTH IN WOMEN.

OBJECTIVE: The aim: To evaluate the prevalence of preterm birth and to determine the role of cervicitis as a cause of preterm birth in women in Ukraine. PATIENTS AND METHODS: Materials and methods: We conducted a retrospective multicentre cohort study from January 1st, 2019 to December 31st, 2021. This study included pregnant women aged 17-50 years admitted to the labor ward at the 13 hospitals from 10 regions of Ukraine. RESULTS: Results: Of the 8151 participants, the prevalence of preterm birth was 2226 (27.3%, [95% CI 26.8 - 27.8]) whereas 5925 (72.7% [95% CI 72.2-73.2]) delivered at term. Preterm birth associated with cervicitis was 76.3% (4,388/2666). History of cervicitis, maternal age, previous preterm labor or premature birth, and pregnancy with twins, triplets or other multiples were identified as independent risk factors of preterm birth. CONCLUSION: Conclusions: Preterm birth in Ukraine is widespread, the number of which tends to increase. Infection and inflammation of the cervix seem to play a significant role for preterm birth. Early detection and treatment of cervicitis can reduce the risk of preterm birth. Women who have a history of poor pregnancy outcomes are at greater risk of poor outcomes in following pregnancies. Health providers should be aware of this risk when treating patients with a history of poor pregnancy outcomes.

VAGINAL CUFF INFECTION AFTER HYSTERECTOMY IN UKRAINE.

OBJECTIVE: The aim: To obtain the first estimates of the current prevalence of vaginal cuff infection after hysterectomy and antimicrobial resistance of causing pathogens in Ukraine. PATIENTS AND METHODS: Materials and methods: We performed a retrospective multicenter cohort study was based on surveillance data. The study population consisted of women who had an abdominal, vaginal or laparoscopic hysterectomy from 2017 to 2019 in 7 women hospitals of Ukraine. Definitions of vaginal cuff infections were used from the Centers for Disease Control and Prevention's National Healthcare Safety Network, USA. RESULTS: Results: Total 12.6% women's after hysterectomy had vaginal cuff infections. Of these cases, 20.3% after abdominal, 15.5% vaginal and 4.1% laparoscopic hysterectomy were identified. The predominant pathogens of VCUF infections were: Escherichia coli (18.6%), Enterobacter spp. (12.4%), Staphylococcus aureus (10.8%), Streptococcus spp. (9,7%), Klebsiella pneumoniae (8.2%), Pseudomonas aeruginosa (7.6%), Enterococcus faecalis (7,0%) and Proteus spp. (7.0%). Methicillin-resistance was observed in 12.9% of S. aureus (MRSA) and 9.7% CoNS. Carbapenem resistance was identified in 7.3% of P.aeruginosa isolates. Resistance to thirdgeneration cephalosporins was observed in 8.9% K. pneumoniae and E.coli 11.9% isolates. The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 22.7%. The prevalence of ESBL production among E. coli isolates was significantly higher than in K. pneumoniae (32.6%, vs 12.3%). CONCLUSION: Conclusions: Vaginal cuff infections in women after hysterectomy are common in Ukraine and most of these infections caused by antibiotic-resistant bacteria. The incidence of VCUF infections after hysterectomy differs depending on the type of surgical procedure.