Pasiyeshvili N.M., Vdovychenko Yu.P., Karpenko V.G., Lazurenko V.V.

PATHOGENETIC SUBSTANCE OF SYSTEMIC PREVENTION AND THERAPY OF INFECTIOUS-INFLAMMATORY LESIONS OF THE FETUS OF WOMEN SUFFERING MATERNAL AND FETAL INFECTION

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About the author:	Pasiyeshvili N.M., Vdovychenko Yu.P., Karpenko V.G., Lazurenko V.V.
Heading	CLINICAL MEDICINE
Type of article	Scentific article
Annotation	Modern scientific studies show the relationship between infectious-inflammatory diseases of the pregnant woman and perinatal fetal lesions. In the majority of women with maternal and fetal infections (MPI), various complications of pregnancy and childbirth (miscarriage, placental dysfunction, polyhydramnios, chorionic colitis, maternity trauma), fetal and infantile lesions (infectious and inflammatory lesions, fetal distress, newborn asphyxia, respiratory failure syndrome, cerebrovascular accident, neurological disorders, and others). In this case, the role of infectious factors related to their action of pro- and anti-inflammatory reactions of the organism, the level of vascular-endothelial potential, the activity of free radical lipid-oxidation processes and antioxidant defense in the pathogenesis of IDU remains unclear. The foregoing points out the urgency of the research of the problem and the need for the development of new pathogenetic means of its treatment and prevention. The purpose of the work was to clarify the mechanisms of development of infectious and inflammatory lesions of the fetus in women with maternal and fetal infection and to develop clinical and pathogenetic approaches to their treatment and prevention. In infected pregnant women, an increase in the concentration of secretory IgA (sIgA) was by 2.2 times, in bacterial lesions – by 1.6 times in mixed lesions as compared to the control, which is interpreted as the imbalance of local immunity. In viral damage, a decrease in the content of sIgA was detected due to the inhibition of the viruses action on its synthesis or the depletion of products at high demand, which is regarded as a defect in local protection. A retrospective analysis of the causes of perinatal morbidity and mortality in 14276 women was performed as well as infectious monitoring of 1043 pregnant women with infectious-inflammatory lesions of the fetus (IILF); 50 pregnant women with antenatal fetal death are examined; pathological and immunohistochemical study of 55 placentas from pregnant women with IILF; evaluation of the effectiveness of complex treatment and prevention of IILF in 423 pregnant women suffering maternal and fetal infection using immunocorrectors and ozone therapy. Based on the results of the study, it is proved that the pathogenesis of IILF includes a complex cytokine dysfunction, endothelial dysfunction, oxidative stress in the organism of a pregnant woman (which is due to the type of infection), causes complications of pregnancy and labour, increases perinatal morbidity and mortality. Comprehensive treatment and prevention of IILF by prescription of immunocorrectors and ozone therapy lead to normalization of immune and endothelial homeostasis, promote the decrease of infectious complications in newborns, have no side effects. As a result, we observe increase in treatment effectiveness of pregnant women suffering maternal and fetal infection, decrease in the number of obstetric complications and improvement in perinatal indicators.
Tags	perinatal morbidity, infectious monitoring of pregnant women, infectious-inflammatory lesions of the fetus
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Publication of the article	«World of Medicine and Biology» №2(68), 2019 year, 096-100 pages, index UDK 618.33+616-036.88-053.31
DOI	10.26724/2079-8334-2019-2-68-96-100