Preventive therapy for postoperative complications in patients with old ruptures of the cervix uteri
Objective. To present the experience with intravaginal Gaynomax in the complex preoperative preparation of patients with cicatricial deformity of the cervix uteri.Mazitova M.I., Mardieva R.R., Antropova E.Yu.
Materials and methods. Fifty patients with old ruptures of the cervix uteri were examined and treated. The patients’ mean age was 32.5±5.6 years. Before surgery, the patients underwent an analysis of the vaginal microbiome by real-time PCR diagnosis using Femoflor 16 test systems and bacterial culture from the cervical canal. As preparation for elective surgery, the patients with an abnormal vaginal microbiome received a short 3-day regimen with the intravaginal administration of a combination of thioconazole and tinidazole. All the patients underwent Emmet's operation.
Results. Exploring the composition of the vaginal microbiota revealed that 30 patients had the following dysbiotic conditions: Gardnerella vaginalis 105 in 8 (40%) women; Escherichia coli 105 in 5 (25%), which totaled 65%; at the same time 7 (35%) of them had vaginal dysbiosis associated with a combination of several pathogens: Gardnerella vaginalis, Enterobacterium spp., Streptococcus spp., Klebsiella pneumonia, and Candida albicans. No specific infections were detected in the patients. The control examination made within 2 weeks after surgical treatment showed suture competences and no signs of inflammation in the study group.
Conclusion. A wide antimicrobial spectrum and the efficiency of short exposure to a combination of thioconazole and tinidazole allow it to be recommended for use while preparing for elective surgery to restore the integrity of the cervix uteri with old ruptures.
Keywords
cervix uteri
Emmet’s operation
vaginal microbiome
References
- Бадретдинова Ф.Ф., Глебова Н.Н., Короткова Л.А., Хасанов А.Г., Трубин В.Б. Акушерская травма и рубцовая деформации шейки матки. Некоторые спорные вопросы проблемы (обзор литературы). Научное обозрение. Медицинские науки. 2016; 5: 23-31. [Badretdinova F.F., Glebova N.N., Korotkova L.A., Khasanov A.G., Trubin V.B. Obstetric trauma and cicatricial deformity of the cervix. Some controversial issues of the problem (literature review). Scientific Review. Medical Sciences. 2016; 5: 23-31.(in Russian)].
- Абдрахманов А.Р., Петрова А.С., Абдрахманов Р.М. Изменения клеточного гомеостаза тканей шейки матки, ассоциированные с условно-патогенными инфекциями, передаваемыми половым путем. Современные проблемы науки и образования. 2018; 5. [Abdrakhmanov A.R., Petrova A.S., Abdrakhmanov R.M. Changes in the cellular homeostasis of cervical tissues associated with opportunistic sexually transmitted infections. Modern problems of science and education. 2018; 5. (in Russian)]. https://dx.doi.org/10.17513/ spno.28137.
- Тютюнник В.Л., Вересова А.А., Сироткина Е.А., Кан Н.Е. Воспалительные заболевания органов малого таза: основные принципы терапии. Медицинский совет. 2018; 12: 160-3. [Tyutyunnik V.L., Veresova A.A., Sirotkina E.A., Kan N.Ye. Inflammatory diseases of the pelvic organs: basic principles of therapy. Medical Council. 2018; 12: 160-3.(in Russian)].
- Usyk M., Zolnik C.P., Castle P.E., Porras C., Herrero R., Gradissimo A. et al.; Costa Rica HPV Vaccine Trial (CVT) Group. Cervicovaginal microbiome and natural history of HPV in a longitudinal study. PLoS Pathog. 2020; 16(3): e1008376. https://dx.doi.org/10.1371/journal.ppat.1008376.
- Сергеева Ю.А., Иванян А.Н., Густоварова Т.А., Крюковский С.Б. Возможности хирургической коррекции при рубцовой деформации шейки матки у беременных. Вестник Смоленской государственной медицинской академии. 2017; 16(1): 77-82. [Sergeeva Yu.A., Ivanyan A.N., Gustovarova T.A., Kryukovsky S.B. The possibility of surgical correction of the scar deformity of the cervix in pregnant women. Bulletin of the Smolensk State Medical Academy. 2017; 16 (1): 77-82.(in Russian)].
- Лосева О.И., Прохорович Т.И., Гайдуков С.Н. Современные подходы к ведению беременных женщин с истмико-цервикальной недостаточностью. Медико-фармацевтический журнал «Пульс». 2018; 20(1): 99-102. [Loseva O.I., Prokhorovich T.I., Gaidukov S.N. Modern approaches to the management of pregnant women with isthmic-cervical insufficiency. Medical and pharmaceutical journal "Pulse". 2018; 20 (1): 99-102. (in Russian)].
Received 25.08.2020
Accepted 08.09.2020
About the Authors
Madina I. Mazitova, professor of the Department of Obstetrics and Gynecology, Kazan State Medical Academy. Tel.: +7(843)555-73-03. E-mail: madina13@list.ru.420012, Russia, Kazan, Mushtari str., 11.
Rezeda R. Mardieva, obstetrician-gynecologist of the antenatal clinic No. 1 of the City Clinical Hospital No. 7. Tel.: +7(843)221-22-85. E-mail: rezedamardieva@gmail.com.
420137, Russia, Kazan, Marshala Chuikova str., 56.
Elena Yu. Antropova, candidate of medical sciences, associate professor of the Department of Obstetrics and Gynecology, Kazan State Medical Academy.
Tel.: +7(843)555-73-03. E-mail: antropoval@mail.ru. 420012, Russia, Kazan, Mushtari str., 11.
For citation: Mazitova M.I., Mardieva R.R., Antropova E.Yu. Preventive therapy for postoperative complications in patients with old ruptures of the cervix uteri.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 9: 180-184 (in Russian).
https://dx.doi.org/10.18565/aig.2020.9.180-184
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