Vaginal infections occupy an important place in the structure of obstetric-gynecological morbidity. Bacterial vaginosis, trichomoniasis and vulvovaginal candidiasis are the most common infectious causes of vaginitis. Foreign and domestic studies indicate a high frequency of adverse obstetric and neonatal outcomes with this pathology: premature termination of pregnancy, placental insufficiency, fetal growth retardation, chorioamnionitis, postpartum suppurative inflammatory diseases and other complications. Patients with ischemic-cervical insufficiency should be assigned to the group at high risk of developing the above complications. The mixed vaginal infections detected in them require the rehabilitation of the birth canal and the elimination of possible pathogens in a short time. In this regard, timely diagnosis and rational treatment of vaginal infection will reduce the frequency of complications of pregnancy, childbirth, the postpartum period, and neonatal morbidity.

Тютюнник Виктор Леонидович-д.м.н., профессор, заведующий 1-м акушерским физиологическим отделением Федерального государственного бюджетного учреждения «Национальный исследовательский медицинский центр акушерства, гинекологии и перинатологии им. акад. В.И. Кулакова» Минздрава России. 117997, г. Москва, ул. Академика Опарина, д. 4; тел.:

The Clinical Protocol “First-Trimester Medical Abortion” is written in accordance with the Russian laws on health protection, Procedure on medical care provision to women seeking for artificial termination of pregnancy, Law on drug circulation. The evidential base for the clinical protocol was constituted by the publications included in the Cochrane Library, PUBMED and MEDLINE databases, by the results of the Russian clinical studies on the medical abortion carried out with the permission of the Ethical Committee of the Ministry of Healthcare of the Russian Federation, by the Russian and international regulatory documents on safe abortion (FDA, HAS). The objective of these clinical protocol is to improve the quality of medical aid in the Russian Federation provided during early pregnancy termination. The comments were discussed jointly by the work group members; a consensus was reached on the key questions of the clinical protocol and practical recommendations were developed.

The urgency of the problem of vaginal infection is determined by its highest prevalence in the structure of obstetric-gynecological morbidity. Currently, the share of diseases of the lower genital tract associated with quantitative unbalance conditionally pathogenic microorganisms of bacterial and fungal origin vagina, which occur in 40-65% of pregnant women. Carried out a sufficient number of studies showing the role of vaginal microbiocenosis dysbiotic violations in the development of pathology of pregnancy, childbirth and postpartum infectious complications. It is known, that for vaginal infections and dysbiosis significantly more often increases the risk of chronic placental insufficiency, premature birth, low birth weight and postpartum endometritis, wound infection. In connection with the above, it is important to timely diagnose microflora disorders using clinical and laboratory research methods, followed by adequate etiotropic therapy. Timely and effective treatment of vaginal dysbiosis in pregnant women before delivery reduces the risk of postpartum infectious complications.