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Возможности лечения оппортунистических инфекций влагалища во время беременности
Возможности лечения оппортунистических инфекций влагалища во время беременности
Карапетян Т.Э., Муравьева В.В., Анкирская А.С. и др. Возможности лечения оппортунистических инфекций влагалища во время беременности. Гинекология. 2017; 19 (6): 11–15. DOI: 10.26442/2079-5696_19.6.11-15
19 (6): 11–15. DOI: 10.26442/2079-5696_19.6.11-15
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19 (6): 11–15. DOI: 10.26442/2079-5696_19.6.11-15
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Цель исследования – оценить эффективность лечения женщин с оппортунистическими инфекциями влагалища во время беременности.
Материалы и методы. Проспективное когортное исследование включало 330 беременных, из которых у 151 диагностирован бактериальный вагиноз (БВ), у 37 – аэробный вагинит (АВ), у 109 – кандидозный вульвовагинит (КВ), у 20 – сочетание КВ+БВ. При проведении антибактериальной терапии в ранние сроки беременности соблюдался принцип местного лечения.
Результаты. Чаще всего (46,0%) вагинальные инфекции выявляли при обращении женщин в ранние сроки беременности. При лечении БВ в ранние сроки беременности антисептиком хлоргексидином положительный результат терапии отмечен у 97,6% женщин. Терапия метронидазолом или клиндамицином БВ у женщин, обратившихся во II и III триместрах, дала положительный результат соответственно в 90,0% и 89,5% случаев. Курс терапии хлоргексидином беременных с АВ был эффективным в 91,7% случаев при обращении в I триместре и 92,0% при обращении во II и III триместрах. При лечении КВ в ранние сроки беременности терапия натамицином была эффективной у 95,0% женщин. Во II и III триместрах лечение эконазолом было успешным соответственно у 88,2 и 88,6% беременных. При лечении сочетания БВ+КВ в ранние сроки гестации комплексный курс хлоргексидин + натамицин был эффективным у 76,5% женщин, во II и III триместрах терапия Нео-Пенотраном Форте оказалась эффективной у 93,8% беременных. Рецидивы вагинальных инфекций наблюдали у 34 беременных (10,3%). Суперинфекция грибами отмечена в 9,3% случаев лечения БВ и у 8,1% беременных с АВ. Среди женщин, наблюдавшихся с ранних сроков беременности, не было случаев преждевременных родов, проявления внутриутробных инфекций отмечены у 5,3% новорожденных. При обращении во II и III триместрах преждевременные роды были у 6,5% и 13,5% женщин, а проявления внутриутробных инфекций – у 15,3% новорожденных. Таким образом, микробиологический мониторинг по своевременному выявлению и лечению оппортунистических инфекций влагалища у беременных групп риска показал целесообразность лечения этих инфекций в ранние сроки гестации.
Ключевые слова: беременность, преждевременные роды, бактериальный вагиноз, аэробный вагинит, кандидозный вульвовагинит, оппортунистические инфекции.
Materials and methods. A prospective cohort study included 330 pregnant women, of whom 151 were diagnosed with bacterial vaginosis (BV), 37 had aerobic vaginitis (AB), 109 had vulvovaginal candidiasis (VC), 20 had a combination of VC + BV. When carrying out antibiotic therapy in the early stages of pregnancy, the principle of local treatment was observed.
Results. Most often (46.0%), vaginal infections were detected when women were treated early in pregnancy. In the treatment of BV in the early stages of pregnancy with antiseptic chlorhexidine, a positive result of therapy was noted in 97.6% of women. Therapy with metronidazole or clindamycin BV in women who applied in the II and III trimesters, gave a positive result, respectively, in 90.0% and 89.5% of cases. The course of therapy with chlorhexidine pregnant women with AB was effective in 91.7% of cases with treatment in the first trimester and 92.0% in treatment in the II and III trimesters. In the treatment of VC in early pregnancy, natamycin was effective in 95.0% of women. In the II and III trimesters, econazole treatment was successful in 88.2% and 88.6%, respectively. In the treatment of combination of BV + VC in early gestation, the complex course of chlorhexidine + natamycin was effective in 76.5% of women, in II and III trimesters Neo-Penotran Forte was effective in 93.8% of pregnant women. Relapses of vaginal infections were observed in 34 pregnant women (10.3%). Superinfection with fungi was noted in 9.3% of cases of BV treatment and in 8.1% of pregnant women with AB. Among women observed from early pregnancy, there were no cases of premature birth, manifestations of intrauterine infections were noted in 5.3% of newborns. At treatment in the II and III trimesters, premature birth was in 6.5% and 13.5% of women, and manifestations of intrauterine infections – in 15.3% of newborns. Thus, microbiological monitoring of timely detection and treatment of opportunistic vaginal infections in pregnant at-risk groups showed the advisability of treating these infections in early gestation.
Key words: pregnancy, premature birth, bacterial vaginosis, aerobic vaginitis, candidal vulvovaginitis, opportunistic infections.
Материалы и методы. Проспективное когортное исследование включало 330 беременных, из которых у 151 диагностирован бактериальный вагиноз (БВ), у 37 – аэробный вагинит (АВ), у 109 – кандидозный вульвовагинит (КВ), у 20 – сочетание КВ+БВ. При проведении антибактериальной терапии в ранние сроки беременности соблюдался принцип местного лечения.
Результаты. Чаще всего (46,0%) вагинальные инфекции выявляли при обращении женщин в ранние сроки беременности. При лечении БВ в ранние сроки беременности антисептиком хлоргексидином положительный результат терапии отмечен у 97,6% женщин. Терапия метронидазолом или клиндамицином БВ у женщин, обратившихся во II и III триместрах, дала положительный результат соответственно в 90,0% и 89,5% случаев. Курс терапии хлоргексидином беременных с АВ был эффективным в 91,7% случаев при обращении в I триместре и 92,0% при обращении во II и III триместрах. При лечении КВ в ранние сроки беременности терапия натамицином была эффективной у 95,0% женщин. Во II и III триместрах лечение эконазолом было успешным соответственно у 88,2 и 88,6% беременных. При лечении сочетания БВ+КВ в ранние сроки гестации комплексный курс хлоргексидин + натамицин был эффективным у 76,5% женщин, во II и III триместрах терапия Нео-Пенотраном Форте оказалась эффективной у 93,8% беременных. Рецидивы вагинальных инфекций наблюдали у 34 беременных (10,3%). Суперинфекция грибами отмечена в 9,3% случаев лечения БВ и у 8,1% беременных с АВ. Среди женщин, наблюдавшихся с ранних сроков беременности, не было случаев преждевременных родов, проявления внутриутробных инфекций отмечены у 5,3% новорожденных. При обращении во II и III триместрах преждевременные роды были у 6,5% и 13,5% женщин, а проявления внутриутробных инфекций – у 15,3% новорожденных. Таким образом, микробиологический мониторинг по своевременному выявлению и лечению оппортунистических инфекций влагалища у беременных групп риска показал целесообразность лечения этих инфекций в ранние сроки гестации.
Ключевые слова: беременность, преждевременные роды, бактериальный вагиноз, аэробный вагинит, кандидозный вульвовагинит, оппортунистические инфекции.
________________________________________________
Materials and methods. A prospective cohort study included 330 pregnant women, of whom 151 were diagnosed with bacterial vaginosis (BV), 37 had aerobic vaginitis (AB), 109 had vulvovaginal candidiasis (VC), 20 had a combination of VC + BV. When carrying out antibiotic therapy in the early stages of pregnancy, the principle of local treatment was observed.
Results. Most often (46.0%), vaginal infections were detected when women were treated early in pregnancy. In the treatment of BV in the early stages of pregnancy with antiseptic chlorhexidine, a positive result of therapy was noted in 97.6% of women. Therapy with metronidazole or clindamycin BV in women who applied in the II and III trimesters, gave a positive result, respectively, in 90.0% and 89.5% of cases. The course of therapy with chlorhexidine pregnant women with AB was effective in 91.7% of cases with treatment in the first trimester and 92.0% in treatment in the II and III trimesters. In the treatment of VC in early pregnancy, natamycin was effective in 95.0% of women. In the II and III trimesters, econazole treatment was successful in 88.2% and 88.6%, respectively. In the treatment of combination of BV + VC in early gestation, the complex course of chlorhexidine + natamycin was effective in 76.5% of women, in II and III trimesters Neo-Penotran Forte was effective in 93.8% of pregnant women. Relapses of vaginal infections were observed in 34 pregnant women (10.3%). Superinfection with fungi was noted in 9.3% of cases of BV treatment and in 8.1% of pregnant women with AB. Among women observed from early pregnancy, there were no cases of premature birth, manifestations of intrauterine infections were noted in 5.3% of newborns. At treatment in the II and III trimesters, premature birth was in 6.5% and 13.5% of women, and manifestations of intrauterine infections – in 15.3% of newborns. Thus, microbiological monitoring of timely detection and treatment of opportunistic vaginal infections in pregnant at-risk groups showed the advisability of treating these infections in early gestation.
Key words: pregnancy, premature birth, bacterial vaginosis, aerobic vaginitis, candidal vulvovaginitis, opportunistic infections.
Полный текст
Список литературы
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3. Подгорная А.В., Махмутходжаев А.Ш., Михеенко Г.А., Кох Л.И. Ведение беременных женщин с рецидивирующим бактериальным вагинозом. Соврем. проблемы науки и образования. 2016 (6): 172. / Podgornaya A.V., Makhmutkhodzhaev A.Sh., Mikheenko G.A., Kokh L.I. Vedenie beremennykh zhenshchin s retsidiviruiushchim bakterial'nym vaginozom. Sovrem. problemy nauki i obrazovaniia. 2016 (6): 172. [in Russian]
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5. Aguin T, Akins RA, Sobel JD. High-dose vaginal maintenance metronidazole for recurrent bacterial vaginosis: a pilot study. Sex Transm Dis 2014; 41 (5): 290–1.
6. Amaya-Guio J, Viveros-Carreño DA, Sierra-Barrios EM et al. Antibiotic treatment for the sexual partners of women with bacterial vaginosis. Cochrane Database Syst Rev 2016; 10: CD011701.
7. Beghini J, Giraldo PC, Linhares IM et al. Neutrophil Gelatinase-Associated Lipocalin Concentration in Vaginal Fluid: Relation to Bacterial Vaginosis and Vulvovaginal Candidiasis. Reprod Sci 2015; 22 (8): 964–8.
8. Catallozzi M, Fraiz L, Hargreaves KM et al. Pregnant women's attitudes about topical microbicides for the prevention and treatment of bacterial vaginosis during pregnancy. Int J STD AIDS 2016.
9. Chavoustie SE, Jacobs M, Reisman HA et al. Metronidazole vaginal gel 1.3% in the treatment of bacterial vaginosis: a dose-ranging study. J Low Genit Tract Dis 2015; 19 (2): 129–34.
10. Foxman B, Wen A, Srinivasan U et al. Mycoplasma, bacterial vaginosis-associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort. Am J Obstet Gynecol 2014; 210 (3): 226.
11. Haahr T, Ersbøll AS, Karlsen MA et al. Treatment of bacterial vaginosis in pregnancy in order to reduce the risk of spontaneous preterm delivery – a clinical recommendation. Acta Obstet Gynecol Scand 2016; 95 (8): 850–60.
12. Heczko PB, Tomusiak A, Adamski P et al. Supplementation of standard antibiotic therapy with oral probiotics for bacterial vaginosis and aerobic vaginitis: a randomised, double-blind, placebo-controlled trial. BMC Womens Health 2015; 15: 115.
13. Hilbert DW, Smith WL, Chadwick SG et al. Development and Validation of a Highly Accurate Quantitative Real-Time PCR Assay for Diagnosis of Bacterial Vaginosis. J Clin Microbiol 2016; 54 (4): 1017–24.
14. Liang Q, Li N, Song S et al. High-dose nifuratel for simple and mixed aerobic vaginitis: A single-center prospective open-label cohort stud. J Obstet Gynaecol Res 2016; 42 (10): 1354–60.
15. Liu MB, Xu SR, He Y et al. Diverse vaginal microbiomes in reproductive-age women with vulvovaginal candidiasis. PLoS One 2013; 8(11).
16. Mengistie Z, Woldeamanuel Y, Asrat D, Yigeremu M. Comparison of clinical and gram stain diagnosis methods of bacterial vaginosis among pregnant women in Ethiopia. J Clin Diagn Res 2013; 7 (12): 2701–3.
17. Nasioudis D, Linhares IM, Ledger WJ, Witkin SS. Bacterial vaginosis: a critical analysis of current knowledge. BJOG 2017; 124 (1): 61–9.
18. Nelson DB, Komaroff E, Nachamkin I et al. Relationship of selected bacterial vaginosis-associated bacteria to Nugent score bacterial vaginosis among urban women early in pregnancy. Sex Transm Dis 2013; 40 (9): 721–3.
19. Nelson DB, Hanlon AL, Wu G et al. First Trimester Levels of BV-Associated Bacteria and Risk of Miscarriage Among Women Early in Pregnancy. Matern Child Health J 2015; 19 (12): 2682–7.
20. Singh RH, Zenilman JM, Brown KM et al. The role of physical examination in diagnosing common causes of vaginitis: a prospective study. Sex Transm Infect 2013; 89 (3): 185–90.
21. Sioutas A, Sandström A, Fiala C et al. Effect of bacterial vaginosis on the pharmacokinetics of misoprostol in early pregnancy. Hum Reprod 2012; 27 (2): 388–93.
22. Subramaniam A, Kumar R, Cliver SP et al. Vaginal Microbiota in Pregnancy: Evaluation Based on Vaginal Flora, Birth Outcome, and Race. Am J Perinatol 2016; 33 (4): 401–8.
23. Sungkar A, Purwosunu Y, Aziz MF et al. Influence of early self-diagnosis and treatment of bacterial vaginosis on preterm birth rate. Int J Gynaecol Obstet 2012; 117 (3): 264–7.
24. Sobel R, Sobel JD. Metronidazole for the treatment of vaginal infections. Expert Opin Pharmacother 2015; 16 (7): 1109–15.
25. Tellapragada C, Eshwara VK, Bhat P et al. Screening of vulvovaginal infections during pregnancy in resource constrained settings: Implications on preterm delivery. J Infect Public Health 2016; 16: 1876.
26. Vieira-Baptista P, Lima-Silva J, Pinto C et al. Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities. Eur J Clin Microbiol Infect Dis 2016; 35 (4): 657–64.
27. Vitali B, Cruciani F, Picone G et al. Vaginal microbiome and metabolome highlight specific signatures of bacterial vaginosis. Eur J Clin Microbiol Infect Dis 2015; 34 (12): 2367–76.
28. Wang ZL, Fu LY, Xiong ZA et al. Diagnosis and microecological characteristics of aerobic vaginitis in outpatients based on preformed enzymes. Taiwan J Obstet Gynecol 2016; 55 (1): 40–4.
29. Xiao B, Niu X, Han N et al. Predictive value of the composition of the vaginal microbiota in bacterial vaginosis, a dynamic study to identify recurrence-related flora. Sci Rep 2016; 6: 26674.
30. Yang S, Reid G, Challis JR et al. Is there a role for probiotics in the prevention of preterm birth? Front Immunol 2015; 6: 62.
2. Vasil'chenko O.N., Baev O.R. Effektivnost' lecheniia bakterial'nogo vaginoza u beremennykh antiseptikom oktenidina digidrokhlorid. Med. sovet. 2016; 12: 21–23. [in Russian]
3. Podgornaya A.V., Makhmutkhodzhaev A.Sh., Mikheenko G.A., Kokh L.I. Vedenie beremennykh zhenshchin s retsidiviruiushchim bakterial'nym vaginozom. Sovrem. problemy nauki i obrazovaniia. 2016 (6): 172. [in Russian]
4. Uitkin Stiven S. Vaginal'nyi mikrobiom, mekhanizmy antimikrobnoi zashchity vlagalishcha i klinicheskaia problema snizheniia riska prezhdevremennykh rodov, sviazannykh s infitsirovaniem. Akusherstvo i ginekologiia: novosti, mneniia, obuchenie. 2016; 1 (11): 20–6. [in Russian]
5. Aguin T, Akins RA, Sobel JD. High-dose vaginal maintenance metronidazole for recurrent bacterial vaginosis: a pilot study. Sex Transm Dis 2014; 41 (5): 290–1.
6. Amaya-Guio J, Viveros-Carreño DA, Sierra-Barrios EM et al. Antibiotic treatment for the sexual partners of women with bacterial vaginosis. Cochrane Database Syst Rev 2016; 10: CD011701.
7. Beghini J, Giraldo PC, Linhares IM et al. Neutrophil Gelatinase-Associated Lipocalin Concentration in Vaginal Fluid: Relation to Bacterial Vaginosis and Vulvovaginal Candidiasis. Reprod Sci 2015; 22 (8): 964–8.
8. Catallozzi M, Fraiz L, Hargreaves KM et al. Pregnant women's attitudes about topical microbicides for the prevention and treatment of bacterial vaginosis during pregnancy. Int J STD AIDS 2016.
9. Chavoustie SE, Jacobs M, Reisman HA et al. Metronidazole vaginal gel 1.3% in the treatment of bacterial vaginosis: a dose-ranging study. J Low Genit Tract Dis 2015; 19 (2): 129–34.
10. Foxman B, Wen A, Srinivasan U et al. Mycoplasma, bacterial vaginosis-associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort. Am J Obstet Gynecol 2014; 210 (3): 226.
11. Haahr T, Ersbøll AS, Karlsen MA et al. Treatment of bacterial vaginosis in pregnancy in order to reduce the risk of spontaneous preterm delivery – a clinical recommendation. Acta Obstet Gynecol Scand 2016; 95 (8): 850–60.
12. Heczko PB, Tomusiak A, Adamski P et al. Supplementation of standard antibiotic therapy with oral probiotics for bacterial vaginosis and aerobic vaginitis: a randomised, double-blind, placebo-controlled trial. BMC Womens Health 2015; 15: 115.
13. Hilbert DW, Smith WL, Chadwick SG et al. Development and Validation of a Highly Accurate Quantitative Real-Time PCR Assay for Diagnosis of Bacterial Vaginosis. J Clin Microbiol 2016; 54 (4): 1017–24.
14. Liang Q, Li N, Song S et al. High-dose nifuratel for simple and mixed aerobic vaginitis: A single-center prospective open-label cohort stud. J Obstet Gynaecol Res 2016; 42 (10): 1354–60.
15. Liu MB, Xu SR, He Y et al. Diverse vaginal microbiomes in reproductive-age women with vulvovaginal candidiasis. PLoS One 2013; 8(11).
16. Mengistie Z, Woldeamanuel Y, Asrat D, Yigeremu M. Comparison of clinical and gram stain diagnosis methods of bacterial vaginosis among pregnant women in Ethiopia. J Clin Diagn Res 2013; 7 (12): 2701–3.
17. Nasioudis D, Linhares IM, Ledger WJ, Witkin SS. Bacterial vaginosis: a critical analysis of current knowledge. BJOG 2017; 124 (1): 61–9.
18. Nelson DB, Komaroff E, Nachamkin I et al. Relationship of selected bacterial vaginosis-associated bacteria to Nugent score bacterial vaginosis among urban women early in pregnancy. Sex Transm Dis 2013; 40 (9): 721–3.
19. Nelson DB, Hanlon AL, Wu G et al. First Trimester Levels of BV-Associated Bacteria and Risk of Miscarriage Among Women Early in Pregnancy. Matern Child Health J 2015; 19 (12): 2682–7.
20. Singh RH, Zenilman JM, Brown KM et al. The role of physical examination in diagnosing common causes of vaginitis: a prospective study. Sex Transm Infect 2013; 89 (3): 185–90.
21. Sioutas A, Sandström A, Fiala C et al. Effect of bacterial vaginosis on the pharmacokinetics of misoprostol in early pregnancy. Hum Reprod 2012; 27 (2): 388–93.
22. Subramaniam A, Kumar R, Cliver SP et al. Vaginal Microbiota in Pregnancy: Evaluation Based on Vaginal Flora, Birth Outcome, and Race. Am J Perinatol 2016; 33 (4): 401–8.
23. Sungkar A, Purwosunu Y, Aziz MF et al. Influence of early self-diagnosis and treatment of bacterial vaginosis on preterm birth rate. Int J Gynaecol Obstet 2012; 117 (3): 264–7.
24. Sobel R, Sobel JD. Metronidazole for the treatment of vaginal infections. Expert Opin Pharmacother 2015; 16 (7): 1109–15.
25. Tellapragada C, Eshwara VK, Bhat P et al. Screening of vulvovaginal infections during pregnancy in resource constrained settings: Implications on preterm delivery. J Infect Public Health 2016; 16: 1876.
26. Vieira-Baptista P, Lima-Silva J, Pinto C et al. Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities. Eur J Clin Microbiol Infect Dis 2016; 35 (4): 657–64.
27. Vitali B, Cruciani F, Picone G et al. Vaginal microbiome and metabolome highlight specific signatures of bacterial vaginosis. Eur J Clin Microbiol Infect Dis 2015; 34 (12): 2367–76.
28. Wang ZL, Fu LY, Xiong ZA et al. Diagnosis and microecological characteristics of aerobic vaginitis in outpatients based on preformed enzymes. Taiwan J Obstet Gynecol 2016; 55 (1): 40–4.
29. Xiao B, Niu X, Han N et al. Predictive value of the composition of the vaginal microbiota in bacterial vaginosis, a dynamic study to identify recurrence-related flora. Sci Rep 2016; 6: 26674.
30. Yang S, Reid G, Challis JR et al. Is there a role for probiotics in the prevention of preterm birth? Front Immunol 2015; 6: 62.
2. Васильченко О.Н., Баев О.Р. Эффективность лечения бактериального вагиноза у беременных антисептиком октенидина дигидрохлорид. Мед. совет. 2016; 12: 21–23. / Vasil'chenko O.N., Baev O.R. Effektivnost' lecheniia bakterial'nogo vaginoza u beremennykh antiseptikom oktenidina digidrokhlorid. Med. sovet. 2016; 12: 21–23. [in Russian]
3. Подгорная А.В., Махмутходжаев А.Ш., Михеенко Г.А., Кох Л.И. Ведение беременных женщин с рецидивирующим бактериальным вагинозом. Соврем. проблемы науки и образования. 2016 (6): 172. / Podgornaya A.V., Makhmutkhodzhaev A.Sh., Mikheenko G.A., Kokh L.I. Vedenie beremennykh zhenshchin s retsidiviruiushchim bakterial'nym vaginozom. Sovrem. problemy nauki i obrazovaniia. 2016 (6): 172. [in Russian]
4. Уиткин Стивен С. Вагинальный микробиом, механизмы антимикробной защиты влагалища и клиническая проблема снижения риска преждевременных родов, связанных с инфицированием. Акушерство и гинекология: новости, мнения, обучение. 2016; 1 (11): 20–6. / Uitkin Stiven S. Vaginal'nyi mikrobiom, mekhanizmy antimikrobnoi zashchity vlagalishcha i klinicheskaia problema snizheniia riska prezhdevremennykh rodov, sviazannykh s infitsirovaniem. Akusherstvo i ginekologiia: novosti, mneniia, obuchenie. 2016; 1 (11): 20–6. [in Russian]
5. Aguin T, Akins RA, Sobel JD. High-dose vaginal maintenance metronidazole for recurrent bacterial vaginosis: a pilot study. Sex Transm Dis 2014; 41 (5): 290–1.
6. Amaya-Guio J, Viveros-Carreño DA, Sierra-Barrios EM et al. Antibiotic treatment for the sexual partners of women with bacterial vaginosis. Cochrane Database Syst Rev 2016; 10: CD011701.
7. Beghini J, Giraldo PC, Linhares IM et al. Neutrophil Gelatinase-Associated Lipocalin Concentration in Vaginal Fluid: Relation to Bacterial Vaginosis and Vulvovaginal Candidiasis. Reprod Sci 2015; 22 (8): 964–8.
8. Catallozzi M, Fraiz L, Hargreaves KM et al. Pregnant women's attitudes about topical microbicides for the prevention and treatment of bacterial vaginosis during pregnancy. Int J STD AIDS 2016.
9. Chavoustie SE, Jacobs M, Reisman HA et al. Metronidazole vaginal gel 1.3% in the treatment of bacterial vaginosis: a dose-ranging study. J Low Genit Tract Dis 2015; 19 (2): 129–34.
10. Foxman B, Wen A, Srinivasan U et al. Mycoplasma, bacterial vaginosis-associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort. Am J Obstet Gynecol 2014; 210 (3): 226.
11. Haahr T, Ersbøll AS, Karlsen MA et al. Treatment of bacterial vaginosis in pregnancy in order to reduce the risk of spontaneous preterm delivery – a clinical recommendation. Acta Obstet Gynecol Scand 2016; 95 (8): 850–60.
12. Heczko PB, Tomusiak A, Adamski P et al. Supplementation of standard antibiotic therapy with oral probiotics for bacterial vaginosis and aerobic vaginitis: a randomised, double-blind, placebo-controlled trial. BMC Womens Health 2015; 15: 115.
13. Hilbert DW, Smith WL, Chadwick SG et al. Development and Validation of a Highly Accurate Quantitative Real-Time PCR Assay for Diagnosis of Bacterial Vaginosis. J Clin Microbiol 2016; 54 (4): 1017–24.
14. Liang Q, Li N, Song S et al. High-dose nifuratel for simple and mixed aerobic vaginitis: A single-center prospective open-label cohort stud. J Obstet Gynaecol Res 2016; 42 (10): 1354–60.
15. Liu MB, Xu SR, He Y et al. Diverse vaginal microbiomes in reproductive-age women with vulvovaginal candidiasis. PLoS One 2013; 8(11).
16. Mengistie Z, Woldeamanuel Y, Asrat D, Yigeremu M. Comparison of clinical and gram stain diagnosis methods of bacterial vaginosis among pregnant women in Ethiopia. J Clin Diagn Res 2013; 7 (12): 2701–3.
17. Nasioudis D, Linhares IM, Ledger WJ, Witkin SS. Bacterial vaginosis: a critical analysis of current knowledge. BJOG 2017; 124 (1): 61–9.
18. Nelson DB, Komaroff E, Nachamkin I et al. Relationship of selected bacterial vaginosis-associated bacteria to Nugent score bacterial vaginosis among urban women early in pregnancy. Sex Transm Dis 2013; 40 (9): 721–3.
19. Nelson DB, Hanlon AL, Wu G et al. First Trimester Levels of BV-Associated Bacteria and Risk of Miscarriage Among Women Early in Pregnancy. Matern Child Health J 2015; 19 (12): 2682–7.
20. Singh RH, Zenilman JM, Brown KM et al. The role of physical examination in diagnosing common causes of vaginitis: a prospective study. Sex Transm Infect 2013; 89 (3): 185–90.
21. Sioutas A, Sandström A, Fiala C et al. Effect of bacterial vaginosis on the pharmacokinetics of misoprostol in early pregnancy. Hum Reprod 2012; 27 (2): 388–93.
22. Subramaniam A, Kumar R, Cliver SP et al. Vaginal Microbiota in Pregnancy: Evaluation Based on Vaginal Flora, Birth Outcome, and Race. Am J Perinatol 2016; 33 (4): 401–8.
23. Sungkar A, Purwosunu Y, Aziz MF et al. Influence of early self-diagnosis and treatment of bacterial vaginosis on preterm birth rate. Int J Gynaecol Obstet 2012; 117 (3): 264–7.
24. Sobel R, Sobel JD. Metronidazole for the treatment of vaginal infections. Expert Opin Pharmacother 2015; 16 (7): 1109–15.
25. Tellapragada C, Eshwara VK, Bhat P et al. Screening of vulvovaginal infections during pregnancy in resource constrained settings: Implications on preterm delivery. J Infect Public Health 2016; 16: 1876.
26. Vieira-Baptista P, Lima-Silva J, Pinto C et al. Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities. Eur J Clin Microbiol Infect Dis 2016; 35 (4): 657–64.
27. Vitali B, Cruciani F, Picone G et al. Vaginal microbiome and metabolome highlight specific signatures of bacterial vaginosis. Eur J Clin Microbiol Infect Dis 2015; 34 (12): 2367–76.
28. Wang ZL, Fu LY, Xiong ZA et al. Diagnosis and microecological characteristics of aerobic vaginitis in outpatients based on preformed enzymes. Taiwan J Obstet Gynecol 2016; 55 (1): 40–4.
29. Xiao B, Niu X, Han N et al. Predictive value of the composition of the vaginal microbiota in bacterial vaginosis, a dynamic study to identify recurrence-related flora. Sci Rep 2016; 6: 26674.
30. Yang S, Reid G, Challis JR et al. Is there a role for probiotics in the prevention of preterm birth? Front Immunol 2015; 6: 62.
________________________________________________
2. Vasil'chenko O.N., Baev O.R. Effektivnost' lecheniia bakterial'nogo vaginoza u beremennykh antiseptikom oktenidina digidrokhlorid. Med. sovet. 2016; 12: 21–23. [in Russian]
3. Podgornaya A.V., Makhmutkhodzhaev A.Sh., Mikheenko G.A., Kokh L.I. Vedenie beremennykh zhenshchin s retsidiviruiushchim bakterial'nym vaginozom. Sovrem. problemy nauki i obrazovaniia. 2016 (6): 172. [in Russian]
4. Uitkin Stiven S. Vaginal'nyi mikrobiom, mekhanizmy antimikrobnoi zashchity vlagalishcha i klinicheskaia problema snizheniia riska prezhdevremennykh rodov, sviazannykh s infitsirovaniem. Akusherstvo i ginekologiia: novosti, mneniia, obuchenie. 2016; 1 (11): 20–6. [in Russian]
5. Aguin T, Akins RA, Sobel JD. High-dose vaginal maintenance metronidazole for recurrent bacterial vaginosis: a pilot study. Sex Transm Dis 2014; 41 (5): 290–1.
6. Amaya-Guio J, Viveros-Carreño DA, Sierra-Barrios EM et al. Antibiotic treatment for the sexual partners of women with bacterial vaginosis. Cochrane Database Syst Rev 2016; 10: CD011701.
7. Beghini J, Giraldo PC, Linhares IM et al. Neutrophil Gelatinase-Associated Lipocalin Concentration in Vaginal Fluid: Relation to Bacterial Vaginosis and Vulvovaginal Candidiasis. Reprod Sci 2015; 22 (8): 964–8.
8. Catallozzi M, Fraiz L, Hargreaves KM et al. Pregnant women's attitudes about topical microbicides for the prevention and treatment of bacterial vaginosis during pregnancy. Int J STD AIDS 2016.
9. Chavoustie SE, Jacobs M, Reisman HA et al. Metronidazole vaginal gel 1.3% in the treatment of bacterial vaginosis: a dose-ranging study. J Low Genit Tract Dis 2015; 19 (2): 129–34.
10. Foxman B, Wen A, Srinivasan U et al. Mycoplasma, bacterial vaginosis-associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort. Am J Obstet Gynecol 2014; 210 (3): 226.
11. Haahr T, Ersbøll AS, Karlsen MA et al. Treatment of bacterial vaginosis in pregnancy in order to reduce the risk of spontaneous preterm delivery – a clinical recommendation. Acta Obstet Gynecol Scand 2016; 95 (8): 850–60.
12. Heczko PB, Tomusiak A, Adamski P et al. Supplementation of standard antibiotic therapy with oral probiotics for bacterial vaginosis and aerobic vaginitis: a randomised, double-blind, placebo-controlled trial. BMC Womens Health 2015; 15: 115.
13. Hilbert DW, Smith WL, Chadwick SG et al. Development and Validation of a Highly Accurate Quantitative Real-Time PCR Assay for Diagnosis of Bacterial Vaginosis. J Clin Microbiol 2016; 54 (4): 1017–24.
14. Liang Q, Li N, Song S et al. High-dose nifuratel for simple and mixed aerobic vaginitis: A single-center prospective open-label cohort stud. J Obstet Gynaecol Res 2016; 42 (10): 1354–60.
15. Liu MB, Xu SR, He Y et al. Diverse vaginal microbiomes in reproductive-age women with vulvovaginal candidiasis. PLoS One 2013; 8(11).
16. Mengistie Z, Woldeamanuel Y, Asrat D, Yigeremu M. Comparison of clinical and gram stain diagnosis methods of bacterial vaginosis among pregnant women in Ethiopia. J Clin Diagn Res 2013; 7 (12): 2701–3.
17. Nasioudis D, Linhares IM, Ledger WJ, Witkin SS. Bacterial vaginosis: a critical analysis of current knowledge. BJOG 2017; 124 (1): 61–9.
18. Nelson DB, Komaroff E, Nachamkin I et al. Relationship of selected bacterial vaginosis-associated bacteria to Nugent score bacterial vaginosis among urban women early in pregnancy. Sex Transm Dis 2013; 40 (9): 721–3.
19. Nelson DB, Hanlon AL, Wu G et al. First Trimester Levels of BV-Associated Bacteria and Risk of Miscarriage Among Women Early in Pregnancy. Matern Child Health J 2015; 19 (12): 2682–7.
20. Singh RH, Zenilman JM, Brown KM et al. The role of physical examination in diagnosing common causes of vaginitis: a prospective study. Sex Transm Infect 2013; 89 (3): 185–90.
21. Sioutas A, Sandström A, Fiala C et al. Effect of bacterial vaginosis on the pharmacokinetics of misoprostol in early pregnancy. Hum Reprod 2012; 27 (2): 388–93.
22. Subramaniam A, Kumar R, Cliver SP et al. Vaginal Microbiota in Pregnancy: Evaluation Based on Vaginal Flora, Birth Outcome, and Race. Am J Perinatol 2016; 33 (4): 401–8.
23. Sungkar A, Purwosunu Y, Aziz MF et al. Influence of early self-diagnosis and treatment of bacterial vaginosis on preterm birth rate. Int J Gynaecol Obstet 2012; 117 (3): 264–7.
24. Sobel R, Sobel JD. Metronidazole for the treatment of vaginal infections. Expert Opin Pharmacother 2015; 16 (7): 1109–15.
25. Tellapragada C, Eshwara VK, Bhat P et al. Screening of vulvovaginal infections during pregnancy in resource constrained settings: Implications on preterm delivery. J Infect Public Health 2016; 16: 1876.
26. Vieira-Baptista P, Lima-Silva J, Pinto C et al. Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities. Eur J Clin Microbiol Infect Dis 2016; 35 (4): 657–64.
27. Vitali B, Cruciani F, Picone G et al. Vaginal microbiome and metabolome highlight specific signatures of bacterial vaginosis. Eur J Clin Microbiol Infect Dis 2015; 34 (12): 2367–76.
28. Wang ZL, Fu LY, Xiong ZA et al. Diagnosis and microecological characteristics of aerobic vaginitis in outpatients based on preformed enzymes. Taiwan J Obstet Gynecol 2016; 55 (1): 40–4.
29. Xiao B, Niu X, Han N et al. Predictive value of the composition of the vaginal microbiota in bacterial vaginosis, a dynamic study to identify recurrence-related flora. Sci Rep 2016; 6: 26674.
30. Yang S, Reid G, Challis JR et al. Is there a role for probiotics in the prevention of preterm birth? Front Immunol 2015; 6: 62.
Авторы
Т.Э.Карапетян*, В.В.Муравьева, А.С.Анкирская, Л.А.Любасовская, Т.В.Припутневич
ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова» Минздрава России. 117997, Россия, Москва, ул. Академика Опарина, д. 4
*tomamed02@mail.ru
V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Akademika Oparina, d. 4
*tomamed02@mail.ru
ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова» Минздрава России. 117997, Россия, Москва, ул. Академика Опарина, д. 4
*tomamed02@mail.ru
________________________________________________
V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Akademika Oparina, d. 4
*tomamed02@mail.ru
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