The role of the infectious factor in the genesis of perinatal losses in pregnant women who have birth in maternity hospitals in St. Petersburg and Leningrad Region in 2009–2018

Abstract

BACKGROUND: One of the tasks of modern medicine is to reduce the level of perinatal losses, for which it is necessary to know their main causes. AIM: To determine the course of an infectious disease in the genesis of perinatal losses. MATERIALS AND METHODS: In order to determine the role of infection in the genesis of perinatal losses, a retrospective study was conducted with two groups: the main group 307 women with perinatal fetal death, the control group 357 women without perinatal losses. An analysis was also made of the data of the statistical form No. 32 (annual) Information on medical care for pregnant women, women in childbirth and puerperas, presented by the Medical Information and Analytical Centers of St. Petersburg and the Leningrad Region for 20062018 and annual reports of the Leningrad Regional Pathological Anatomical Bureau for 20062016. RESULTS: In 20062018, the leading causes of perinatal death were intrauterine hypoxia and asphyxia during childbirth (ICD 10: P20, P21), that is, not diseases, but symptomatic conditions. Such features of reporting documentation complicate the analysis of the causes of perinatal losses and the implementation of a set of preventive measures, including at the state level. Also, according to the official report, it is impossible to assess the contribution of a specific virus and a specific localization of the lesion to the genesis of perinatal losses. In the main group, hematogenous viral and ascending bacterial infection of the placenta was detected 4 times more often. With a combination of bacterial and viral infection of the placenta, the risk of a fatal outcome increases. Infectious pathogens most frequently encountered in perinatal losses have been established. CONCLUSIONS: The cause of more than half of the cases of perinatal losses in women who gave birth in maternity hospitals in St. Petersburg and Leningrad Region in 20092018 is an infectious pathology: viral, bacterial and viral-bacterial, and not intrauterine hypoxia/asphyxia during childbirth, as stated by the official statistics. In this regard, the main direction in the prevention of perinatal losses is the timely detection and treatment of infectious pathology.