Modern methods of diagnosis and treatment of vaginal dysbiosis caused by mushrooms of the genus Candida
Keywords:candidiasis, habitual miscarriage, ART, sertaconazole
The article presents literature data on modern approaches to diagnosis and treatment of vaginal dysbiosis caused by fungi of the genus Candida and personal data on the effectiveness of vaginal dysbiosis treatment in women with recurrent miscarriage occurring in ART cycles by combined local therapy with sertaconazole and povidone-iodine.
240 patients of reproductive age with habitual miscarriage of pregnancy after ART and 30 conditionally healthy fertile women were examined. The state of vaginal microbiota was studied using PCR and culture. It were carried out a species identification of the fungi of the genus Candida and their susceptibility to antimycotics.
It has been established that among women with a recurrent miscarriage after cycles of ART that repeatedly receive antibacterial therapy in preparation in the ART cycles and after abortion, in the vaginal microbiota in 39.75% of cases Candida fungi are diagnosed in diagnostically significant quantities, including C. albicans registered in 75.79% of cases, and non-albicans – in 24.21%. Fungi of the genus Candida in diagnostically significant amounts in 92.63% of cases occurs against the background of aerobic, anaerobic or aerobic-anaerobic imbalance. In 87.36% of ART patients with recurrent miscarriage, the detection of fungi of the genus Candida in diagnostically significant amounts is not accompanied by clinical manifestations of the vaginal candidiasis, but proceeds according to the type of asymptomatic increased colonization by these yeasts.
For the treatment of patients prescribed vaginal suppositories Zalain (sertaconazole 0.3 g) per night once, after 7 days – suppositories Betadine (povidone-iodine) at night once a day for 14 days. The culture and PCR studies after the end of treatment showed normalization of the urogenital microbiota and the absence of fungi of the genus Candida in diagnostically significant amounts in all patients.
Thus, sertaconazole in combination with povidone iodine is a highly effective regimen of vaginal microbiota normalization in patients with ART with a recurrent miscarriage.
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