[Specific features of normal vaginal microflora in girls of preschool age]. / Osobennosti normal'noi mikroflory vlagalishcha u devochek doshkol'nogo vozrasta.

The study of the vaginal microbial cenosis in 20 healthy girls aged 3-7 years did not confirm the notion on the dominating role of cocci (including epidermal staphylococci). The associations of 2-5 different microorganisms represented by more than 20 species in an amount of 4-6 Ig PFC/g of discharge were established. In the overwhelming majority of the examinees (84.2%) the microbial associations of the vagina were found to contain bifidobacteria. Gram positive cocci (staphylococci and streptococci) took the 2nd and 3rd places in the isolation rates and were detected in vaginal associations in 78.9% of the girls. Staphylococci were represented by 5 coagulase-negative staphylococcal species with S. simulans and S. epidermidis prevailing. Hemolytic streptococci variants alpha and beta were isolated in the proportion of 2:1. The latter belonged to serogroups C and F. No S. aureus, Lactobacillus sp., streptococci of groups A and B, yeast-like fungi were detected. Genital mycoplasms (M. hominis) could rarely be found in the vaginal discharge of the girls aged 3-7 years (5.3%). No resident and transitory components could be isolated from the normal vaginal microflora and no quantitative domination of any bacterial species (genus) was shown. The concentrations of all organisms in this association were moderate or low.

[Evaluation of the sensitivity and specificity of methods of rapid diagnosis in bacterial vaginosis]. / Otsenka chuvstvitel'nosti i spetsifichnosti uskorennykh metodov diagnostiki bakterial'nogo vaginoza.

Bacterial vaginosis was diagnosed in 35.8% of 109 patients of a reproductive age complaining of discharge from the genital tract. In 33% of cases bacterial vaginosis was associated with vaginal candidiasis. The most sensitive and specific method of rapid diagnosis of bacterial vaginosis is microscopic examination of Gram-stained smears, which may be used as a diagnostic method, whose sensitivity and specificity are almost 100%. Such tests as pH-metry, amine test, "key" cells, and assessment of vaginal discharge (normal or abnormal), should be used in complex. They may be performed by the therapist screening patients to detect bacterial vaginosis.

[Obligate anaerobic microbes in obstetric and gynecologic diseases]. / Obligatno-anaérobnye mikroorganizmy pri akushersko-ginekologicheskoi patologii.

The paper reviews recent-years' papers and the data of their own investigations on a role of obligate anaerobic microbes in obstetric and gynecological abnormality. The fact that secondary pelvic inflammatory processes caused chiefly by non spore-forming anaerobes is ascertained. There is evidence that obligate anaerobic bacteria are involved in the abnormality directly unassociated with the development of an inflammatory process: preterm labor, premature discharge of amniotic fluid, intranatal fetal hypoxia, respiratory distress syndrome and hyaline membrane disease of the premature newborn. Among vaginal infections the key role is played by bacterial vaginosis which is, from the pathophysiological point of view, now a severe derangement of the vaginal environment system with greatly prevalent obligate anaerobic bacteria and without lactoflora. Complications associated with this abnormality are noted.

[The significance of genital mycoplasmas in the etiology of puerperal endometritis]. / Znachenie genital'nykh mikoplazm v étiologii poslerodovogo éndometrita.

The rate of genital Mycoplasma isolation from the uterine cavity was studied in 147 puerperae (80 ones with a normal course of the puerperium and 67 with acute postpartum endometritis). Mycoplasma were isolated from the metroaspirate in 11.3% of puerperae in whom the postpartum period ran a normal course; M. urealyticum were found in 8.8% and M. hominis in 2.5% of cases. In endometritis Mycoplasma were isolated from the infection focus 2.5 times more often, i.e. from 28.4% of patients with postpartum endometritis (M. urealyticum were detected in 9.0% and M. hominis in 19.4% of cases). Mycoplasma were the sole agents of endometritis in 9.0% of patients. Hysteroscopic and morphologic studies helped verify the contribution of genital Mycoplasma to the development of acute postpartum endometritis in 19.4% of the patients. Therefore, virtually every fifth patient with postpartum endometritis was in need of purposeful antimycoplasma therapy with tetracycline.

[Augmentin in the combined therapy of puerperal diseases]. / Augmentin v kompleksnoi terapii nekotorykh poslerodovykh zabolevanii.

Augmentin was used in treatment of mild forms of postnatal endometritis and serous mastitis. Augmentin tablets proved to be efficient in endometritis due to enterobacteria and obligate nonsporulating anaerobes and mastitis due to Staphylococcus aureus strains sensitive to the preparation. No adverse events were recorded. It was shown that in the treatment of mild postnatal infections the augmentin tablets were not inferior by their activity of combinations of antibiotics against aerobic and anaerobic microflora.

[Partial separation of sutures of the uterus after cesarean section (diagnosis and treatment tactics)]. / Chastichnoe raskhozhdenie shvov na matke posle kesareva secheniia (diagnostika i taktika lecheniia).

Echography supplemented by hysteroscopy helped detect signs of partial separation of the sutures on the uterus in 12 of 33 patients with grave endometritis following cesarean section. Therapeutic policy in such cases should be based on rational etiotropic antibiotic therapy and active local treatment of the involved focus (surgical treatment of the uterine cavity walls, drainage of the uterus, local multicomponent ointments with a hydrophilic base). The treatment helped preserve the uterus and resulted in complete cure in 11 of the 12 cases.

[Features of the endometrial steroid receptor system in habitual abortion with high risk of infectious complications]. / Osobennosti steroidretseptornogo apparata éndometriia pri privychnom nevynashivanii beremennosti s vysokim riskom infektsionnykh oslozhnenii.

Analysis of microbiologic and histologic findings and measurements of estrogen and gestagen receptors in the endometrium have shown manifest shifts in the endometrial steroid receptor system in women with asymptomatic chronic endometritis. The authors claim that disordered reception of steroid hormones may be regarded as one of the causes of spontaneous, abortions.

[Diagnostic value of lochial pH, pCO2,and pO2 in puerperal endometritis]. / Diagnosticheskoe znachenie opredeleniia pH, pCO2 i pO2 lokhii pri poslerodovom endimetrite.

A new method has been developed for rapid diagnosis of puerperial endometritis, based on measurements of lochial pH, pCO2, and pO2. Endometritis development is associated with acidosis in the uterine cavity (pH 6.8-7.2), elevation of pCO2 to make 40-70 mm Hg, and reduction of pO2 to make 40-80 mm Hg. The degree of these shifts is in direct relationship with the inflammatory process severity. The method is simple, almost noninvasive, and quite reliable.

[Substantiation of active surgical tactics for patients with puerperal endometritis]. / Obosnovanie aktivnoi khirurgicheskoi taktiki vedeniia bol'nykh s poslerodovy éndometritom.

An active surgical tactics for managing patients (uterine wash and its cavity content vacuum aspiration) was applied in 34 patients with postnatal endometritis. Echography and hysteroscopy demonstrated that in 28 of 34 patients, the endometritis developed in the presence of pathological involvements into the uterine cavity, which made the use of surgical endometrial treatment justifiable. In addition, the surgical treatment substantially decreased the bacterial dissemination of the content in the uterine cavity. The proposed procedure enabled uterine extirpation to be avoided in 5 of 6 patients with partial suture inadequacy.

[Genital Mycoplasma as a risk factor of obstetric and perinatal pathology]. / Genital'nye mikoplazmy kak faktor riska razvitiia akusherskoi i perinatal'noi patologii.

The paper gives the results of the study into genital Mycoplasma in 1,200 females and 254 newborns and provides strong evidence for the fact that there is a relationship between the Mycoplasma carriage and the inflammatory urogenital processes. It also shows that M. hominis and Ur. urealyticum may persist in the endometrium of females suffering from isthmo-cervical insufficiency. Genital Mycoplasma have been found to play an etiological role in intrauterine infection in premature neonates and in inflammatory processes (endometritis, wound infection following cesarean section) in parturients.