Influence of local hypoxia on the effectiveness of treatment of vaginal infectious pathology

The analysis of the results of treatment of infectious vaginal pathology in 162 women, depending on the local hypoxia of the vaginal walls, was carried out. With chronic infectious diseases of the vagina (chronic colpitis — 84, bacterial vaginosis — 78 women). All study participants signed informed consent and an additional bilateral agreement on non-disclosure of personal data and the specifics of the study program. Depending on the oxygen content in the vaginal wall, the patients were divided into 2 groups. Group I included 88 women, whose coefficient of oxygen content in the vaginal mucosa wall (K_mucus%) exceeded 97.0%. Group II consisted of 74 women, whose coefficient of oxygen content in the wall of the vaginal mucosa (K_mucus%) was lower than 97.0%. Accordingly, in group I K- mucus% was 98.3 ± 0.2%, and in group II — 96.9 ± 0.3%, while the differences in the coefficient K_mucus%, reflecting the oxygen content in the vaginal wall, were significant (P < 0.05). It was found that against the background of local hypoxia 14 days after the completion of treatment, leukocytosis was significantly more often detected in the material from the vagina (P <0.05), and the frequency of detecting “key cells” in the material from the vagina, the number of which exceeded the permissible threshold of 3.0 % in group II, where local hypoxia took place, was significantly higher than in group I (P < 0.05). Evaluation of the effectiveness of general and local ozone therapy, which provides a decrease in the intensity of hypoxia, in combination with lymphogenous administration of antibiotics, in the treatment of infectious vaginal pathology against the background of local hypoxia and local immunodeficiency, is a promising direction for further research.

1. Bingbing Xiao, Xiaoxi Niu, Na Han, et al. Predictive value of the composition of the vaginal microbiota in bacterial vaginosis, a dynamic study to identify recurrence-related flora. Scientific Reports 6, 2016, article number: 26674. DOI:10.1038/srep26674

2. Salimova S.S., Zhubaeva G.S., Zhukembaeva A.M. Lokal''naya endogennaya intoksikatsiya pri bakterial''nom vaginoze [Local endogenous intoxication in bacterial vaginosis]. International Journal of Medicine and Psychology, 2019, vol. 2, no.3, pp.16-20.

3. Krauss-Silva L., Almada-Horta A., Alves M.B., et al. Basic vaginal pH, bacterial vaginosis and aerobic vaginitis: prevalence in early pregnancy and risk of spontaneous preterm delivery, a prospective study in a low socioeconomic and multiethnic South American population. BMC Pregnancy Childbirth, 2014, vol.14, article number:107. DOI:10.1186/1471-2393-14-107

4. Taylor B.D., Darville T., Haggerty C.L. Does bacterial vaginosis cause pelvic inflammatory disease? Sex Transm Dis., 2013, v.40(2), p.117-122. DOI: 10.1097/OLQ.0b013e31827c5a5b

5. Tsevat D.G., H.C. Wiesenfeld, C. Parks, J.F. Peipert Sexually transmitted diseases and infertility. Am J Obstet Gynecol., 2017, no.216 (1), pp. DOI: 10.1016/j.ajog.2016.08.008

6. Konovalova M.V., Vorobtsova I.N., Vasil''ev V.V. Patogeneticheskie osobennosti transportirovki kishechnoy mikroflory v matku posle rodov [Pathogenetic features of the transportation of intestinal microflora into the uterus after birth]. International Journal of Medicine and Psychology, 2021, vol.4, no.1, pp.154-159.

7. Tyurin Yu.A. et al. Osobennosti mukozal'nogo immuniteta i sostoyaniya bakteriotsenoza pri razlichnykh formakh allergicheskogo rinita [Peculiarities of mucosal immunity and state of bacteriocenosis in various forms of allergic rhinitis]. Kazanskiy meditsinskiy zhurnal, 2013, v.94, no.5, p.766-770.

8. Salekhov S.A., Maksimyuk N.N., Begimbetova R.S. et al. Sposob diagnostiki lokal'nogo immunodefitsita slizistykh obolochek [A method of diagnostics of local immunodeficiency of mucous membranes]. Patent RF no. 2732681, 2020.

9. Zhukembayeva A.M., Dergunov A.V., Alimanova ZH.M. i dr. Patogeneticheskiye osobennosti razvitiya infektsionnoy patologii vlagalishcha na fone khronicheskoy venoznoy i limfovenoznoy nedostatochnosti [Pathogenetic features of the development of infectious pathology of the vagina against a background of chronic venous and lymphovenous insufficiency]. International journal of medicine and psychology, 2019, vol.2, no. 4, pp.142-146.

10. Salekhov S.A., Zhukembaeva A.M., Ibraeva O.Sh. Patogeneticheskoe znachenie limfovenoznoy nedostatochnosti v razvitii disbioza vlagalishcha [Pathogenic importance of lymphovenous insufficiency in the development of vaginal dysbiosis]. Vestnik NovSU, 2018, no.3, pp.61-64.

11. Salekhov S.A., Zhukembaeva A.M., Begimbetova R.S., et al. Sposob prognozirovaniya rezul'tatov lecheniya infektsionnoy patologii slizistoy obolochki [A method of predicting the results of treatment of infectious mucosal pathology]. Patent RF, no.RU 2675199 C1, 2018.

12. Konovalova M.V., Rukhlyada N.N., Vorobtsova I.N. Patogeneticheskoe obosnovanie lokal'nogo primeneniya ozonirovannykh rastvorov pri lechenii infektsionnoy patologii vlagalishcha [Pathogenetic substantiation of local use of ozonized solutions in treatment of infectious vaginous pathology]. Vestnik NovSU, 2020, no.1(117), pp.47-49.

13. Gaydukov S.N., Konovalova M.V., Vorobtsova I.N., et al. Patogeneticheskoe obosnovanie limfogennoy antibiotikoterapii posle embolizatsii matochnykh arteriy pri miome matki [Pathogenetic substantiation of lymphogenic antibiotic therapy after embolization of uterine arteries in uterine myoma]. Vestnik NovSU, 2018, no.5(111), pp.23–26.