Аннотация:
Infectious diseases are still one of the main causes of perinatal losses worldwide. The consequences for the fetus and the newborn vary from asymptomatic infection to sepsis, malformations and the fetal death. Examination of pregnant women for the presence of infectious agents is an important part of the antenatal care program. The purpose of the work was to assess the structure of infectious screening in various medical institutions in Moscow, as well as the comparison of the recommended in Russia examinations with the main programs of antenatal monitoring in the world. Material and methods. The retrospective study was executed on the basis of four medical institutions: two state women’s clinics and two commercial clinics (the total number of patients - 902 people). The comparison was made with antenatal care programs of the antenatal observation in Centers for Disease Control and Prevention (CDC), 2015 (Centers for Disease Control and Prevention) in the United States of America, and the National Institute for Health and Care Excellence (NICE), 2017 (National Institute for Health and Medical Quality assistance), Great Britain. Results. Basic screening of pregnant women for infection in the Russian Federation includes 8 items (serological study of the blood for syphilis, HIV, hepatitis B and C, rubella, toxoplasmosis, microscopic examination of genital secretions on Neisseria gonorrhoeae and fungi of the genus Candida), which is significantly higher than in the USA and Great Britain (5 and 4 respectively). According to the results of our study, the volume of the compulsory examination of pregnant women is wider than abroad, due to serological examination of blood for the presence of antibodies to cytomegalovirus (CMV) and herpes simplex virus (HSV) of types 1 and 2, microbiological examination of genital secretions, molecular biological diagnosis (polymerase chain reaction - PCR, real-time PCR). Conclusion. Screening of pregnant women for infection in public and commercial clinics has a number of differences. The actual scope of the survey is higher than recommended by the state. The Russian list of tests in comparison with foreign analogs is much wider in terms of the number of nosologies and the frequency of the research. It is necessary to conduct multicenter epidemiological studies throughout the Russian Federation to create optimal regional programs for examining pregnant women for infection that meet the criteria for effective screening.
Naumenko N.S. Natalya S.
Nikonov A.P.
Astsaturova O.R.
Belova A.V. Anastasiya V.
Первый МГМУ им. И.М. Сеченова МЗ РФ
I.M. Sechenov First Moscow State Medical University
STRUCTURE OF INFECTIOUS SCREENING OF PREGNANTS: RUSSIAN AND OVERALL PRACTICE
Текст визуальный электронный
Архив акушерства и гинекологии им. В.Ф. Снегирева
Eco-Vector
Т. 5, № 1 С. 26-30
2018
беременность
pregnancy
внутриутробная инфекция
intrauterine infection
инфекционный скрининг
infectious screening
неблагоприятные исходы беременности
adverse pregnancy outcomes
TORCH-инфекции
TORCH-infection
эпидемиология
epidemiology
Статья
Infectious diseases are still one of the main causes of perinatal losses worldwide. The consequences for the fetus and the newborn vary from asymptomatic infection to sepsis, malformations and the fetal death. Examination of pregnant women for the presence of infectious agents is an important part of the antenatal care program. The purpose of the work was to assess the structure of infectious screening in various medical institutions in Moscow, as well as the comparison of the recommended in Russia examinations with the main programs of antenatal monitoring in the world. Material and methods. The retrospective study was executed on the basis of four medical institutions: two state women’s clinics and two commercial clinics (the total number of patients - 902 people). The comparison was made with antenatal care programs of the antenatal observation in Centers for Disease Control and Prevention (CDC), 2015 (Centers for Disease Control and Prevention) in the United States of America, and the National Institute for Health and Care Excellence (NICE), 2017 (National Institute for Health and Medical Quality assistance), Great Britain. Results. Basic screening of pregnant women for infection in the Russian Federation includes 8 items (serological study of the blood for syphilis, HIV, hepatitis B and C, rubella, toxoplasmosis, microscopic examination of genital secretions on Neisseria gonorrhoeae and fungi of the genus Candida), which is significantly higher than in the USA and Great Britain (5 and 4 respectively). According to the results of our study, the volume of the compulsory examination of pregnant women is wider than abroad, due to serological examination of blood for the presence of antibodies to cytomegalovirus (CMV) and herpes simplex virus (HSV) of types 1 and 2, microbiological examination of genital secretions, molecular biological diagnosis (polymerase chain reaction - PCR, real-time PCR). Conclusion. Screening of pregnant women for infection in public and commercial clinics has a number of differences. The actual scope of the survey is higher than recommended by the state. The Russian list of tests in comparison with foreign analogs is much wider in terms of the number of nosologies and the frequency of the research. It is necessary to conduct multicenter epidemiological studies throughout the Russian Federation to create optimal regional programs for examining pregnant women for infection that meet the criteria for effective screening.