ASSESSMENT OF THE PREVALENCE OF ABNORMAL VAGINAL DISCHARGES IN WOMEN OF REPRODUCTIVE AGE WHO HAVE UNDERGONE URGENT GYNECOLOGICAL SURGERY

The problem of restoring women’s reproductive health after emergency operations for acute gynecological pathology has been social and medical significance in recent years. This is due to both the increase in its frequency and long-term negative outcomes – a decrease fertility rate, the development of pain syndrome, changes in hormonal homeostasis, etc. One of the manifestations of postoperative dysfunction in the organism is the appearance of an excessive amount of vaginal secretions in female patients. However, the targeted studies about the state of the vaginal microbiota in women after urgent surgical interventions for acute gynecological pathology are rare, and the results are contradictory. The objective: to assess the prevalence and nature of vaginal discharge in women of reproductive age after urgent gynecological operations. Materials and methods. The studied cohort included 125 women of reproductive age. The main group included 60 women of reproductive age after urgent operations because of ovarian apoplexy, ectopic pregnancy, complicated ovarian neoplasm; the comparison group – 35 patients after planned surgery for gynecological pathology; the control group consisted of 30 healthy women. The diagnosis of the causes of vaginal secretions and infection with sexually transmitted pathogens was carried out by the method of pH-metry, bacterioscopic and molecular biological research. The examination was carried out on the 5th day after the operation. Results. Before planned surgical operations, bacterial vaginosis was diagnosed in 22.9% of women in the comparison group, vulvovaginal candidiasis – in 2.9%. The urgency of the operation because of acute gynecological pathology led to the preoperative determination of the state of the vaginal microbiota in only 56.7% of patients in the main group, with the detection of bacterial vaginosis in 26.5%, aerobic vaginitis in 17.7%. After surgery, vaginal microbiota was abnormal in 78.3% of patients in the main group and in 34.3% – in the comparison group (bacterial vaginosis – 53.3% and 31.4%, respectively). Conclusions. Dysbiosis and inflammatory diseases (aerobic vaginitis) of the lower genital organs should be considered as one of the risk factors for acute gynecological pathology. Dysbiotic processes have a tendency to progress after surgery, which makes it necessary to carry out preoperative sanitation of the vagina to reduce the risk of postoperative complications development