POSSIBILITY OF RAPID DIAGNOSTIC OF VAGINA MICROBIOCENOSIS AT PREGNANT WOMEN WITH RISK FACTORS OF POSTPARTUM COMPLICATIONS

Prevention of postpartum infection includes the identification of risk factors for purulent-inflammatory diseases, sanation of foci of genital and extragenital infection, rational management of labor and should begin during antenatal care and continue in the hospital, but in the vast majority of cases, data on the state of vaginal microbiocenosis in the hospital are absent.The aim of the study. was to evaluate the possibilities and effectiveness of express diagnostics of the state of the vaginal microbiocenosis of pregnant women to substantiate the measures for the prevention of postpartum purulent-inflammatory complications.Materials and methods. The study included 58 pregnant women, the main group included 38 women with complicated course of the gestational process, the comparison group - 20 women with a physiological pregnancy. The determination of the state of the vaginal microbiocenosis was carried out by bacterioscopy of vaginal smears stained by Gram, using the R.Amsel (1983) criteria, a bacteriological express method using the genital system, real-time PCR (Florocenosis) with determination of aerobic, anaerobic flora, Candida spp. and NCMT.Results of the study and their discussion. Comparing the results of studies of the state of the vaginal microbiocenosis (genital express system and Florocenosis) normocenosis in the main group occurred on average 25.0 ± 1.3% at 67.5 ± 2.5% (p <0.05). A retrospective study of the course of labor and the postpartum period in women with dysbiotic vaginal processes showed that the postpartum period was uncomplicated in 89.5% of the women in the main group and 95.0% in the comparison group. However, the development of postpartum endometritis in 5.0% of cases in the comparison group in the presence of mixed dysbiosis of the vagina, and in 10.5% of pregnant women of the main group with anaerobic and aerobic dysbiosis suggests that assessing the state of the vaginal microbiocenosis on the eve of birth does not allow to prevent in all cases postpartum purulent -septic complications, and confirms the importance of identifying the dysbiotic processes and conducting appropriate medical and prophylactic measures at an earlier time of pregnancy.Conclusion. The use of the genital express system for determining the state of the vaginal microbiota in conditions of limited economic resources makes it possible to assess the presence of dysbiotic processes in a short time and to carry out appropriate correction before delivery in order to reduce the risk of postpartum inflammatory complications.