Іntroduction. Intrauterine infection of the fetus is oneof the most important problems in obstetrics. The absenceof adequate treatment leads to a number of complicationsthat develop during pregnancy, childbirth, and postpartumperiod. There are often situations when the consequences ofthe invasion of microorganisms are more important than thepresence of an infectious agent itself.The aim is to analyze the indicators of microcytosis ofthe vagina, cervical canal, the peculiarities of pregnancywith infection of the fetus, and the effectiveness of varioustreatment regimens.Material and methods. 20 healthy women withphysiological course of pregnancy (the control group) and62 pregnant women with signs of fetal infection (the maingroup) were examined using clinical, microbiological,bacteriological, serological methods, statistical analysis,and fetal ultrasound.Results. Depending on the trimester, pregnant womenof the main group were divided into two subgroups: thefirst subgroup - at 18-24 weeks (50 pregnant women), thesecond - at 28-34 weeks (12 pregnant women).The statistical analysis of changes in vaginalmicrocynosis was conducted depending on the term. Thesignificant difference regarding the effect of gram negativediplococci, morphologically similar to gonococcus,Streptococcus agalactiae in the third trimester was found outalong with Ureaplasma urealyticum, Chlamidia trahomatisin the second trimester and Trichomonas vaginalis andMycoplasma hominis regardless of trimester.Ultrasound in the first subgroup revealed a syndromeof fetal growth retardation in 20 % of women, an abnormalamount of amniotic fluid in 24 %, changes in the structureof the placenta in 14 %, enlargement of the pelvic system ofthe kidneys in 52 %, intestinal hyperechogenicity in 60 %,and hepatomegaly in 4 % of cases. In the second subgroup,the abnormal amount of amniotic fluid was found in 16.7 %of pregnant women, changes in the structure of the placentain 83,3 %, and progressive shortening of the cervix in 33.3% of cases.Pregnant women of the main group were offered acourse of specific antibacterial therapy.In case of positive dynamics within three days (reductionof pathological secretions, polyhydramnios and otherultrasound signs of fetal infection), treatment is continued.In case of negative dynamics or no effect within three daysantibacterial agent must be changed. If symptoms reoccur,a repeat course with a new antibacterial agent is prescribed.Conclusions. Disorders of vaginal microcynosis andcervical canal were found in 80.6% of pregnant women,the rest of them were diagnosed with the ultrasound signsof infection of the fetus without changes in vagina andcervical canal.The proposed regimens of antibacterial therapy areeffective in the second trimester of pregnancy, indicatingthe necessity of examination and treatment during thisperiod, and in case of structural changes in the cervix causedby gram-negative diplococci, morphologically similarto gonococcus and Trichomonas vaginalis. Antibacterialtherapy is not effective enough in case of the developmentof placental dysfunction, and the threat of premature birthin the third trimester.

Іntroduction. Currently, endometrial polyps (EMP)are the most common pathology of the uterine mucosa,detected in miscarriage and infertility. However, thequestion of the relationship between the mechanisms thatregulate proliferation processes and the morphofunctionaland microbiological features of the endometrium, whichare often confirmed by changes in immunohistochemicalparameters and may be important in treatment, remainsopen.The aim is to optimize the results of treatment inpatients with EMP and infertility by using antioxidantsin combination with immunomodulatory therapy andnonsteroidal anti-inflammatory drugs.Materials and methods. We examined 30 healthywomen who hadn’t had any gynecological diseases,abortions or intrauterine interventions in history and hadnot used intrauterine contraception (the control group), and60 women with EMP and infertility (the main group) byusing clinical, microbiological, bacteriological, ultrasound,hysteroscopic pathohistological and laboratory methods,statistical analysis.Results. In order to assess the effectiveness of theproposed treatment, the main group was divided into twosubgroups: the first one included 30 patients who have beenreceiving the proposed treatment and prevention algorithmand the second one with 30 patients receiving traditionaltreatment.After targeted polypectomy with the basal layer of theendometrium at the site of EMP had been provided, thepatients of the first subgroup were prescribed to take 100mg of doxycycline orally twice a day for 2 weeks and 100mg of vitamin E per day for 4 weeks in combination withimmunomodulatory therapy - cycloferon 12.5% 2.0 mlintramuscularly №10 every other day and anti-inflammatorytherapy with the appointment of rectal suppositoriescontaining non-steroidal anti-inflammatory components - 1suppository per night for 10 days.The patients of the second subgroup were prescribedtraditional antibiotic prophylaxis after hysteroscopy: 100mg of doxycycline orally twice a day for 5 days. Also, thepatients of the main group have been receiving 10 mg ofduphaston twice a day from the 11th to the 25th day of MC.The species composition of the vaginal microflora inwomen with EMP is represented mainly by anaerobic flora.Every second patient with EMP (46%; р І-ІІІ = 0,007) in theabsence of clinical symptoms, and along with a moderateor reduced number of lactobacilli, was diagnosed withopportunistic bacteria, uremicoplasma or Candida fungus.Pregnancies occurred in 9 (47%) of the 19 patients in thefirst natural menstrual cycle after polypectomy and proposedtreatment. Six (31%) women became pregnant during thefirst three menstrual cycles. The remaining patients havebeen observed during six months and were recommendedin vitro fertilization due to long-term infertility. Women ofthe main group who did not plan to get pregnant had norecurrence of EMP for two years. 19 (63.3%) patients ofthe second subgroup faced the recurrence of EMP duringtwo years of follow-up. 11 (30.5%) pregnant womengave physiological childbirth; the labor of 3 patients wascomplicated by hypotonic bleeding in the early postpartumperiod; 3 (11.1%) women are currently pregnant. In patientsof the second subgroup, pregnancy occurred in 5 (16.6%)cases only.Conclusions. The use of the developed method of EMPand infertility treatment allows to restore reproductivefunction in more than half of women. Thus, theimplementation of the method of EMP treatment indicatesits positive effect. In addition, it helps to achieve lastingremission and solves the medical and social problems ofwomen's health and motherhood.