M.A. KAGANOVA¹, N.V. SPIRIDONOVA¹, O.O. DEVYATOVA²

¹Samara State Medical University, Samara

²N.I. Pirogov Municipal Clinical Hospital No. 1, Samara

Contact:

Kaganova M.A. — PhD (medicine), Associate Professor of the Department of Obstetrics and Gynecology

Address: 80 Polevaya Str., 443100, Samara, Russian Federation, tel. +7-462-07-19-68, e-mail: [email protected]

 Objective. To evaluate the effect of asymptomatic bacteriuria (AB) and its drug therapy on the frequency of premature rupture of membranes (tPROM) in a full-term pregnancy.

Material and methods. A prospective analysis of the course of pregnancy and delivery was conducted in 279 patients with low and moderate risk groups according to the clinical management “Obstetrics and Gynecology” No. 572 of 11.01./2012. The main group consisted of patients with tPROM – 159 pregnant women, the comparison group – patients who entered delivery with intact membranes – 120 cases. The analysis of anamnesis, course of pregnancy, results of bacteriological cultures of urine in the first trimester of pregnancy, methods of treating asymptomatic bacteriuria, and their relationship with tPROM was performed.

Results. Urine culture was positive in 68 pregnant women of the main group (42.8%) and 43 pregnant women in comparison groups (35.8%, p = 0.24), asymptomatic bacteriuria was detected in 38 pregnant women, which amounted to 13.6% of all examined. The main pathogens in urine culture were: Enterobacteriaceae spp. – 37.8% (E. coli – 31.5%), Staphylococcus spp. – 34.2% (pathogenic species – 10.8%), Enterococcus faecalis – 31.5%. The rate of kidney infection during pregnancy (O 23.0) was only 4.2% higher in patients with positive urine cultures than in patients with initially negative urine cultures (9.0% and 4.8%, respectively, p = 0.16). In patients of the main group (with tPROM), the frequency of clinical manifestations of kidney infection during pregnancy was higher by 4% (8.2% and 4.2%, respectively, p = 0.17). In pregnant women who did not receive treatment for bacterial growth in the urine (23 cases), the frequency of tPROM was higher (10.7% and 5.0%, p = 0.08), but there were no clinical manifestations of kidney infection.

Conclusions. Positive results of urine culture during pregnancy are not a risk factor for tPROM, but there is a connection with a higher growth rate of absolute pathogens: E. coli, Staphylococcus spp. The frequencies of clinical manifestations of kidney infection during pregnancy (O 23.0) in patients with positive and negative urine culture were comparable.

Key words: microbiota, premature rupture of membranes, gestational pyelonephritis, E. coli, asymptomatic bacteriuria.

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