COMPREHENSIVE ASSESSMENT OF RISK FACTORS AND OPTIMIZATION OF MANAGEMENT OF PREGNANT WOMEN WITH CERVICAL PATHOLOGY
Keywords:
pregnancy, HPV, cervix, vaginal microbiota, vitamin DAbstract
Objective: to perform a comprehensive assessment of clinical and laboratory risk factors and to improve the management of pregnant women with cervical pathology.Materials and Methods. The study included 120 pregnant women aged 18–45 years with cervical pathology. According to HPV status, patients were divided into three groups: Group 1 — HPV-positive patients (n=40); Group 2 — HPV-negative patients (n=40); Group 3 — control group, clinically healthy pregnant women (n=40). Clinical, cytological, colposcopic, and molecular-biological methods (PCR diagnostics of HPV, vaginal microbiota assessment using Femoflor) were used. Serum vitamin D and ferritin levels were also determined.Results. HPV infection was associated with significant disturbances of the vaginal microbiota, a high prevalence of co-infections, and deficiency of vitamin D and iron. The most significant risk factors were Gardnerella vaginalis (OR=8.9), cytomegalovirus (OR=7.8), and Ureaplasma spp. (OR=7.5). An inverse correlation between vitamin D levels and HPV infection was observed.Conclusion. Cervical pathology in pregnant women has a multifactorial nature. A comprehensive diagnostic and therapeutic approach improves treatment effectiveness and clinical outcomes.
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