Purpose of the study. To evaluate the clinical and laboratory effectiveness and long-term results of the two-stage therapy for nonspecific vulvovaginitis in pregnant women in the third trimester using the antiseptic dequalinium chloride (Fluomizin) and the probiotic (Gynoflor E).
MATERIAL AND METHODS
There were sixty-nine pregnant women in the third trimester of gestation observed in the outpatient setting. The treatment was carried out in two sequent stages. Patients of the main and the control groups (n=69) received local treatment with an antiseptic: dequalinium chloride (Fluomizin) containing 10 mg in a vaginal tablet for six days, one tablet intravaginally per day in the first stage. Topical probiotics were used to restore the vaginal normocenosis state in the second stage. Patients in the main group (n=36) used a drug containing L. acidophilus lyophilisate 50.00 mg (at least 108 viable bacteria) and an ultra-low dose of estriol — 0.03 mg (Gynoflor E) for six days, one tablet intravaginally per day. Patients in the control group (n=33) received a course of treatment using intravaginal capsules containing a lyophilized culture of lactobacilli L. casei rhamnosus Doderleini (at least 108 CFU), one capsule twice per day for seven days. Evaluation of the effectiveness of the therapy included primary results such as dynamics of complaints, findings on vaginal speculum examination and microscopic examination of vaginal smears. Secondary results of the assessment included the overall duration and dynamics of the labor (vaginal or surgical intervention), birth trauma (rupture of the cervix or vagina), the development of signs of chorioamnionitis and intra-amniotic infection of the fetus, the condition of newborns and the postpartum period.
RESULTS
The improvement in the condition was noted such as a relief of clinical manifestations in 97.2% (35/36) (p<0.05) of patients in the main group and in 93.9% (31/33) (p<0.05) of patients control group in the absence of statistical significance of differences between groups (p = 0.51) during the threatment. Microscopy assessment showed that laboratory cure included in the normalization of leukocyte number in 94.4% (34/36, p<0.05) of patients in the main group and in 93.9% (31/33, p<0.05) control groups. The use of the complex two-stage therapy: an antiseptic (Fluomizin) and a probiotic with a microdose of estriol (Ginoflor E), contributed to a decrease in the concentration of small gram-variable cocci towards the predominance of single (1—10 per p/z) and moderate amounts (11—100 p/z) microorganisms with a simultaneous increase in the content of lactobacilli and their prevalence (moderate and large numbers) over other microflora in 91.7% (33/36) compared to the initial data (p<0.05).
CONCLUSION
The data showed the high effectiveness of the complex two-stage therapy by using the antiseptic dequalinium chloride and the probiotic Ginoflor E in the treatment of nonspecific vulvovaginitis in pregnant women in the third trimester with the frequency of achieving a general therapeutic effect in 95.8% of patients (p<0.05), the absence of serious adverse events and the high satisfaction from using the drug in 97.2% of pregnant women.
