Justification of systemic antibacterial therapy in patients with subclinical intrauterine infection during pregnancy

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OBJECTIVE

To evaluate the efficacy of systemic antibacterial therapy in different terms of pregnancy in patients with subclinical intrauterine infection for the prevention of preterm labor.

MATERIAL AND METHODS

Clinical examination of 112 pregnant women with subclinical intrauterine infection was carried out. Three groups were formed: Group 1 — 22 patients with subclinical intrauterine infection who received systemic antibacterial therapy before 20 weeks of pregnancy, Group 2 — 30 patients with subclinical intrauterine infection who received systemic antibacterial therapy after 20 weeks of pregnancy. As a result of retrospective analysis, the 3rd group («historical control») was formed, including 60 patients with subclinical intrauterine infection who were not treated with systemic antibacterial therapy during pregnancy.

RESULTS

Systemic antibiotic therapy during pregnancy in patients with subclinical intrauterine infection reduces the risk of preterm labor by 2 times (p<0.0001) compared to that in untreated patients. At the same time, administration of therapy before 20 weeks of pregnancy has a statistically more significant effect on this indicator — risk reduction by 8 times (p<0.0001) compared to its late onset — risk reduction by 3 times (p<0.0001).

CONCLUSION

Appointment of reasonable systemic antibacterial therapy to pregnant women with subclinical intrauterine infection is an effective way to prevent spontaneous preterm labor. Administration of pathogenetically justified antibacterial therapy to patients with subclinical intrauterine infection before 20 weeks of pregnancy has a more significant effect on reducing the risk of spontaneous preterm labor.

Keywords:

pregnancy

intrauterine infection

preterm labor

antimicrobial therapy

Authors:

Dolgushina V.F.

South Ural State Medical University

ORCID: 0000-0002-3929-7708

Kurnosenko I.V.

South Ural State Medical University

ORCID: 0000-0003-2309-2983

Astashkina M.V.

South Ural State Medical University

ORCID: 0000-0003-4756-4500

Received:

18.04.2023

Accepted:

17.05.2023

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