The aim: To obtain the estimates of the сurrent incidence rate of perinatal infections, risk factors, as well as their associated impact on mortality and determine the antimicrobial resistance of responsible pathogens in Ukraine. Materials and methods: We performed a multicentre retrospective cohort study was based on surveillance data. This study included infants aged 0 to 6 days delivered in 2017-2019 at 11 Ukrainian regional perinatal centers. Definitions of perinatal infections and mortality were used from the CDC/WHO/UNICEF. Results: Of 18,348 liveborn infants, 472 (2.6%) perinatal infections were detected. The incidence of perinatal infection was 25.7 per 1000 live births. The most frequently identified types of infections were: bloodstream infections, 35.6 %, lower respiratory tract infections, 21.4%, Meningitis, 18.2%, Conjunctivitis, 11.9%, skin and soft tissue infections, 6.6%, Dacryocystitis, 3.8%, and urinary tract infections, 2.5%. Early mortality rates from perinatai infections was 51.1%, with an incidence of 13.1 deaths/1000 live births. Potential risk factors the development of perinatal infections and mortality were low birth weight, prematurity, low gestasional age, mode of delivery (manual aid), premature rupture of membranes, preterm premature rupture of membranes, prolonged rupture of membranes, turbid and meconeal amniotic fluid, infection of the mother during labor. resuscitation during delivery, invasive procedure, asphyxia. Main causative agents of perinatal infections were Escherichia coli, Streptococcus agalactiae, Staphylococcus aureus, Klebsiella pneumoniae, CoNS, Enterobacter cloacae, Pseudomonas aeruginosa. Conclusions: This study showing that the high incidence rate of perinatal bacterial infections, as well as their associated impact on mortality, and presents a significant burden to the Ukraine.

The aim: To determine trend of legal induced surgical abortion and to assess the frequency of infection complications after termination of pregnancy in Ukraine. Materials and methods: We conducted a prospective multicentre cohort study was based on surveillance data of healthcare-associated infection (HAI) after legal induced surgical abortion in women’s from January 2017 to 2019 in Ukraine. Definitions of HAI after induced abortion were used from the CDC/ NHSN. Results: The number of surgical abortions in Ukraine increased by 32.8%. A total of 25.9% HAIs were identified after surgical abortion. Of these HAIs, 25.9 were Endometritis, 21.8% Bacterial Vaginitis, 14.3% Parametritis, 13.1% Cervicitis, 9.9% Adnexa utery, 7.8% Salpingitis, 6.3% Chorioamnionitis, and 0.9% other reproductive tract infections. E.coli were most commonly reported, accounting for 25.9% of all organisms, followed by Enterococcus spp. (16.2%), Staphylococcus aureus (15.5%), P. aeruginosa (10.9%), and Enterobacter spp. (10.1%). Antimicrobial resistance in the isolates associated with HAIs showed, among the gram-positive bacteria, that 19.1% and 3.6% of coagulase-negative staphylococci isolates were b-lactam (oxacillin) − and glycopeptide-resistant, respectively. Meticillin resistance was reported in 23.2% of S aureus isolates. Vancomycin resistance was reported in 3.7% of isolated enterococci. Among the gram-negative bacteria, third-generation cephalosporins resistance was found in 33.1% of Klebsiella spp and in 24.1% of E.coli isolates. Conclusions: The results of this study revealed high rates of HAIs after surgical abortion and most causing pathogens were associated with resistant to antibiotic strains. This knowledge is essential to develop targeted strategies to surveillance and reduce the incidence of post-abortion infections.

The objective: to evaluate of postoperative complications, duration of surgical intervention and hospital stay of patients after hysteroscopic surgery using monopolar or bipolar electrodes.Materials and methods. Eighty gynecological patients who had hysteroscopic surgery were divided into two groups of 40 women each. Patients of the I (main) group had hysteroscopic procedures using a bipolar electrode, the persons in the II (comparison) group – a monopolar electrode. The registration of operative complications was carried out – bleeding, perforation, excess fluid and hyponatremia. The time of operation and stay in a gynecological hospital were also taken into account.Results. There were no statistically significant differences between the two groups regarding patient’s characteristics, ultrasound findings, serum sodium levels before and after surgery, uterine perforation, and intraoperative bleeding. Fluid overload was significantly higher in patients of the II group (p<0.03). Postoperative hyponatremia was also significantly pronounced in the II group (p<0.05). The average operation time was significantly shorter in women of the I group compared to the II group (p=0.01), and the hospital stay was significantly shorter for patients after hysteroscopic intervention using bipolar energy compared to the group in which monopolar energy was used (p=0.04). Conclusions. Hysteroresectoscopy with the use of bipolar electrodes is accompanied by a significant decrease in cases of hyponatremia, reduction of the duration of surgical intervention and the stay of gynecological patients in the hospital after surgery. Therefore, this method is safe and effective compared to the use of monopolar electrodes.

Висвітлено огляд літератури з проблеми передчасного розриву плідних оболонок (ПРПО) у другому триместрі вагітності, визначено сучасний науковий погляд на дану проблему. ПРПО у другому триместрі являє сукупність складних медичних та етичних питань як для пацієнта, так і для лікаря. Варіанти ведення таких хворих коливаються від вичікувальної тактики до консервативного або агресивного втручання залежно від гестаційного віку, клінічних ознак інфекції і стану матері та плода. Такі вагітності мають високий ризик передчасних пологів, хорiоамніоніту та неонатальних ускладнень. ПРПО є важливим фактором впливу на перинатальну смертність і захворюваність. При вагітності, яка супроводжується ПРПО на ранніх термінах, серед новонароджених, що вижили, високий відсоток захворюваності пов'язаний з респіраторним дистрес синдром, легеневою гіпоплазією, внутрішньошлуночковими крововиливами і контрактурами кінцівок. Автори заявляють про відсутність конфлікту інтересів. Ключові слова: передчасний розрив плідних оболонок, невиношування, загроза переривання вагітності, передчасні пологи.

Інфекційні хвороби, яким можна запобігти шляхом вчасної вакцинації, є причиною значного рівня захворюваності та смертності серед матерів, новонароджених і немовлят. Зміни імунної відповіді, що відбуваються у вагітної, як вважають, для того, щоб дозволити жінці виносити плід, можуть перешкоджати розвитку специфічної імунної відповіді на патогенні агенти. Крім прямих переваг для матері, вакцинація під час вагітності, ймовірно, забезпечує прямий вплив на плід та новонародженого через створення пасивного імунітету (трансплацентарне перенесення антитіл, утворених завдяки вакцинації матері). Ключові слова: вакцинація, вагітність.