PREVALENCE OF AEROBIC VAGINITIS AFTER GYNECOLOGICAL SURGERIES AND ASSOCIATED ADVERSE PREGNANCY OUTCOME IN UKRAINE

OBJECTIVE

Aim: To determine prevalence of Aerobic Vaginitis (AV) after gynecologic surgery, risk factors and antimicrobial resistance of responsible pathogens, and adverse pregnancy outcomes in Ukraine.

PATIENTS AND METHODS

Materials and Methods: Multicenter retrospective cohort study was conducted from January 2020 to December 2022 in fifteen medical clinics from eight regions of Ukraine. Smears were analyzed using Donders' classification method and Dong's modified AV diagnosis for Gram stains. Definitions of HAIs were adapted from the CDC/NHSN. Antibiotic susceptibility testing of bacteria was determined by Kirby-Bauer disc diffusion test according to the protocol of the EUCAST.

RESULTS

Results: Prevalence of AV among women's undergoing gynecologic surgery in Ukraine was 68.7%. Of the total AV cases, 70.3% were in non-pregnant and 29,7% in pregnant women. The most common pathogen of AV was Escherichia coli, followed by Enterococcus faecalis, Streptococcus agalactiae, Staphylococcus aureus, Enterococcus faecium, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Among the S. aureus strains, 11,6% of MRSA (Methicillin resistant S.aureus) were isolated whereas none of the CoNS were cefoxitin resistant. History of vaginal infection, history of post-operative infection and antibiotic use acted as an important risk factor of AV incidence rate. The presence of AV worsened pregnancy outcomes, by increasing the incidence of preterm birth, the premature rupture of membranes, miscarriage, neonatal jaundice, and neonatal infection.

CONCLUSION

Conclusions: Aerobic Vaginitis after gynecological surgeries in Ukraine is a common medical problem in women that is associated with significant morbidity, adverse pregnancy outcome, and hence frequent medical visits.

Epidemiology of endometriosis in Ukraine: results a multicenter study (2019-2021)

OBJECTIVE

Aim: To estimate the prevalence and incidence of endometriosis, and to evaluate risk factors associated with endometriosis in Ukraine.

PATIENTS AND METHODS

Materials and Methods: The multicenter cohort study was performed partly as a cross-sectional study to estimate occurrence of endometriosis, partly as a case-control study to look for factors associated with endometriosis. The study was carried out during the period from January 1st, 2019 to December 31st, 2021.This study included adolescent girls and adult women from 15 Ukrainian regions.

RESULTS

Results: Among 15,458 patients, 4,397 (28.4%) endometriosis were observed. Of all endometriosis cases, 48.5% were peritoneal/superf i cial endometriosis (SPE), 34.6% were ovarian endometriotic cyst/endometrioma (OMA), and 16.9% were deep inf i ltrating endometriosis (DIE). The prevalence of the three types of endometriosis was: SPE, 13.8%; OMA, 9.8%; and DIE, 4.8%. The factors associated with an increased risk for endometriosis include age 23-32 years, parity (small number of births), age of fi rst sexual intercourse <20 years, history of healthcare-associated infection after gynecological surgery (pelvic abscess or cellulitis, salpingitis and oophoritis), history of infertility, early menarche (before the age of 11), dysmenorrhea, dyspareunia, pelvic pain, intermenstrual bleeding, heavy uterine bleeding and dysmenorrhea, and heavy uterine bleeding.

CONCLUSION

Conclusions: Endometriosis is a common gynecological disease in Ukraine and the relative frequency of dif f erent types of endometriosis: the most common were ovarian and peritoneal endometriosis. Healthcare services and public health strategies need to be strengthened to ensure timely endometriosis diagnosis in adolescent girls and adult women and treatment.