[TO THE STATE OF THE FETOPLACENTAL COMPLEX IN WOMEN WITH THE THREAT OF ABORTION].

The goal is a comprehensive study of the morphofunctional state of the mother-placenta-fetus system in placental insufficiency and infection. 250 pregnant and puerperas for the period 2008-2014 were examined. Detection of bacterial flora was carried out in 35 pregnant women aged 20.4±0.8 years with the threat of abortion from an early gestation period and a prolonged persistent infection of the genitals, bacterial vaginosis. Methods are applied: culture, ion chromatography, gas-liquid chromatography with mass spectrometry. The presence of placental insufficiency was found in 32.0% of patients. In the vagina, Staphylococcus epidermidis, Escherichia coli (culture method), in the vagina and placenta of the bacteria of the genus Staphylococcus aureus, Proteus mirabilis, Klebsiella pneumoniae (IC method) were detected; Proponibacterium, Bacteroides Afipia, Helocobacter musteloe, Actinomyces, Candida albicans. In the placental suspension, Pentadiecanoic acid, 14-methyl, methyl ester, Octadecanoic acid, methyl ester, 9-Octadecanoic acid, methyl ester (E), 9-Octadecanoic acid, methyl ester (Z), 9-12 Octadecanoic acid, methyl Ester (EE), Eicosanoic acid, methyl ester, 12,15 Octadecanoic acid, methyl ester (ZZZ). CONCLUSIONS: 1. The spectrum of detected microorganisms indicates the possibility of detecting not only aerosols, but also facultative anaerobes, capsular bacteria, facultative intracellular parasites using chromatomass spectrometry. 2. The detected infectious factor, which causes placental insufficiency, is confirmed by morphotopographic diagnosis.

[Leading role of infection in formation of placental insufficiency].

AIM: Evaluate the role of endotoxinemia in pregnancy complicated with placental insufficiency. MATERIALS AND METHODS: Complex clinical-laboratory examination of 130 pregnant women in 70 of which placental insufficiency was diagnosed (main group) was carried out. The examinees of the main group were divided into 3 subgroups: 36, 20 and 14 pregnant women with compensated, subcompensated and decompensated placental insufficiency, respectively. The control group was composed of 60 pregnant women with physiological course of gestation. Levels of LPS, LPS-binding protein and IgG against core-region, cytokines (TNF-alpha, IL13, IL2, IL4, IL6, IL8, IL10, IFNgamma), C-reactive protein were determined in blood plasma. Infection by Chlamydia trachomatis, Mycoplasma genitalium, Treponema vaginalis, Neisseria gonorrhoeae, Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum were evaluated by PCR. RESULTS: In the main group in 64.2% of cases the presence of genital tract infection was established, in 47.0%--urinary system. An increase of LPS level, titers of IgG against LPS core-region and LPS-binding protein in blood plasma of pregnant women with placental insufficiency was shown. Cytokine profile in placental dysfunction was characterized by a significant increase of IL1beta, IL8, TNF-alpha Th1 cytokine and IL10 Th2 cytokine concentrations and a decrease of pro-inflammatory IL2, IFNgamma levels. CONCLUSION: The results indicate a leading role of infection in formation of placental dysfunction as well as prove involvement of LPS Gram-negative bacteria in pathogenesis of this complication.

[The effect of ecological and microbiological factors on the health status of pregnant women with pyelonephritis and on their newborn infants]. / Vplyv ekolohichnykh ta mikrobiolohichnykh faktoriv na stan zdorov'ia vahitnykh, khvorykh na piielonefryt, ta ïkh novonarodzhenykh.

An analysis was performed of history, course of pregnancy, parturition, and condition of the newborn babies in female patients with pyelonephritis depending on the microbiological factor and environmental situation in the zone of residence. The pregnant women living under adverse environmental conditions display high levels of endocrine, cardiovascular, gastrointestinal disorders, and of tonsillitis. In the majority of cases, pregnancy is noted to be complicated by anemia (76.7%) and fetoplacental incompetence (62.9%), with infants being born in asphyxia presenting with signs of hypotrophy, congenital infection. Of the above infants, 37% develop postnatal inflammatory conditions. Two variants were shown to play a part in the etiology of pyelonephritis: monoetiological one marked by predominance of Staphylococcus aureus and Escherichia coli and polyetiological variant characterized by predominance of Candida fungi, Staphylococcus aureus, and mycoplasma. Irrespective of the microbiological factor, the female patients with pyelonephritis demonstrated high levels of premature birth, had a history of infertility, and were presenting with genital and extragenital pathologies.