No abstract

Infections contribute greatly to the unfavorable course of pregnancy and gestational complications. Published data suggest a significant role of mixed infections and coinfections in vulvovaginitis as well as their association with intraamniotic infections caused by multiple microbes. This paper analyzes the studies on the current diagnostic and treatment approaches to mixed-etiology vulvovaginitis during pregnancy depending on gestational age and whether a medication is incorporated into the current clinical guidelines. The use of combination drugs with confirmed efficacy and broad-spectrum antimicrobial, fungicide, and antiprotozoal activity considering risk-benefit ratio for the mother and the child is highlighted. The efficacy of topical combination of metronidazole and miconazole for mixed-etiology vulvovaginitis during prepregnancy preparation and pregnancy based on various dosing regimens and the duration of use is addressed. KEYWORDS: pregnancy, vulvovaginitis, bacterial vaginosis, topical treatment, metronidazole, miconazole. FOR CITATION: Shaposhnikova E.V. Current treatment approaches to mixed-etiology vulvovaginitis during pregnancy. Russian Journal of Woman and Child Health. 2021;4(1):5–11. DOI: 10.32364/2618-8430-2021-4-1-5-11.

named after prof. V. F. Voyno-Yasenetsky the aim of the research. To conduct comparative analysis of pyoinflammatory complications after cesarean section in puerperas in a hospital of the third level (Krasnoyarsk regional clinical hospital) for the period 2004-2005 and 2012-2013. Materials and methods. It was done the retrospective analysis of 80 cases of pyoinflammatory complications after cesarean section. All patients were divided into two clinical groups: the main group consisted of 30 puerperas, were under observation and treated in the period from 2012-2013, the comparison group-50 puerperas treated between 2004-2005. results. The most frequent pyoinflammatory complications of postpartum period were: acute endometritis, metroendometritis, insolvency and festering stitches on the anterior abdominal wall. With regard to complications of postpartum period the average term to transport to the hospital of the third level in patients of the main group was 4,3 ± 0,3 days, and in the comparison group 7,0 ± 0,1 day (r≤0,001). This fact indicates the early diagnosis of septic complications in the initial stages of the main group of the patients. conclusion. Currently it continues to be the underestimation of the severity of the puerperants state and belated transporting to a multiprofile hospital that exacerbates the postpartum period, leading to the development of severe complications, increasing the percentage of organ removing operations.

Dandy-Walker malformation is a rare disease of the central nervous system pathology (congenital malformations of the fossa cranii posterior). The key features of this syndrome are an enlargement of the fourth ventricle; complete absence of the cerebellar vermis, the posterior midline area of cerebellar cortex responsible for coordination of the axial musculature; and cyst formation near the internal base of the skull. Pregnant patients with Dandy-Walker malformation are at high risk and are managed by multidisciplinary teams including neurologists and obstetricians. We present a case report of full-term pregnancy and uncomplicated delivery in a women with Dandy-Walker malformation.

Background: disorders of carbohydrate metabolism are one of the common complications of pregnancy associated with the increasing rate of adverse maternal and neonatal outcomes. The introduction of the guidelines-based approaches to the diagnosis of these conditions and the management of pregnancy and childbirth aims to reduce the risks of these complications.Aim: to assess the prevalence of the disorders of carbohydrate metabolism and to analyze the course of pregnancy and childbirth, and perinatal outcomes in 2017–2019.Patients and Methods: case records of 1,188 women with the disorders of carbohydrate metabolism who were admitted to a maternity hospital and gave birth were analyzed.Results: over the last 3 years, gestational diabetes ranks 1st among the disorders of carbohydrate metabolism. Its percentage increased by 1.7 times, i.e., from 11.4% to 19.8% (OR=0.6, 95% CI 0.51–0.67; p<0.001). The most common extragenital comorbidity was obesity (46.8%). During the analyzed period, a 1.8-fold reduction (from 11.6% to 6.3%) in the rate of moderate preeclampsia (OR=1.8, 95% CI 1.19–2.88, p=0.01) and a 2-fold reduction (from 21,9% to 10,8%) in the rate of diabetic fetopathy (OR=0.5, 95% CI 0.36–0.68, p<0.001) were observed. Careful examinations and follow-up allowed for the reduction in the rate of С-section by 11.5%, i.e., from 54.1% in 2017 to 42.6% in 2019 (OR=1.3, 95% CI 1.11–1.46, p=0.002). Meanwhile, the major indication to C-section in these women is diabetic fetopathy.Conclusions: early diagnosis of the disorders of carbohydrate metabolism and adequate management provide the reduction in the rate of complications and the conditions for vaginal delivery in full-term pregnancy.KEYWORDS: pregnancy, gestational diabetes, disorders of carbohydrate metabolism, glucose tolerance test, delivery, perinatal outcomes.FOR CITATION: Shaposhnikova E.V., Bazina M.I., Mentsik M.M. et al. Course of pregnancy and delivery in women with the disorders of carbohydrate metabolism. Russian Journal of Woman and Child Health. 2020;3(3):163–168. DOI: 10.32364/2618-8430-2020-3-3-163-168.