INFLUENCE OF THE MASSIVENESS OF INFECTION OF THE GENITAL TRACT WITH UROGENITAL MYCOPLASMAS ON THE COURSE AND OUTCOMES OF PREGNANCY IN WOMEN OF THE AMUR REGION

In order to study the role of urogenital mycoplasmas on the course and outcomes of pregnancy, depending on its quantitative assessment using the real-time PCR, 159 rural women of the Amur region were examined. Infection with Ureaplasma species (spp.) was revealed in 51.2% of cases, among them in clinically significant concentrations (in the form of monoinfection or in combination with other opportunistic microorganisms) it was found in 39.0% of cases. Mycoplasma hominis in clinically significant concentration was determined in 15.1% of pregnant women, among them in 8.8% it was in combination with Ureaplasma spp. The effects of massive infection of the genital tract with urogenital mycoplasmas on the course and outcomes of pregnancy were evaluated in 85 patients. Four groups of pregnant women were formed according to the results of clinical and laboratory examinations. Group 1 (n=19) included pregnant women with convenional normocenosis ( Lactobaccilus spp. ≥10⁶ GE/mL, Ureaplasma spp ≥10⁴ GE/mL); group 2 (n=23) included patients with identified urogenital mycoplasma ( Ureaplasma spp and Mycoplasma hominis ) in clinically significant concentrations in combination with other opportunistic microorganisms ( Streptococcus agalactiae , Enterobacteriaceae , Staphylococcus spp., Gardnerella vaginalis , Bacteroides spp. and others). Pregnant women with vaginal dysbiosis ( Lactobacillus sp. ≤10⁶ GE/mL) and the absence of urogenital mycoplasmas were included in group 3 (n=13). The control group included 30 pregnant women with normal vaginal flora and the absence of urogenital mycoplasmas. The exclusion criteria were the identification of unconditional pathogens ( Chlamydia trachomatis , Neisseria gonorrhoeae , Trichomonas vaginalis , Мycoplasma genitalium ) and the activation of herpesvirus infections ( HSV and CMV ). As a result of the study, pregnant women in the main groups were 4.7-7 times more often to be diagnosed with fetal growth retardation syndrome; 2.0-3.2 times more often to have placental insufficiency compared with subjects in the control group. Premature birth in women of group 1 was registered 3.3 times more often than in the control group. In the same group, there was a tendency to increase the number of pregnant women with a long anhydrous period and premature discharge of amniotic fluid.

Ureaplasma, Mycoplasma, dysbiosis, pregnancy complications, labor outcomes

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