Značenje patoloških cervikalnih bioloških agenasa na perinatalni ishod

master's thesis

• Title (english): The significance of pathological cervical biological agents on perinatal outcome
• Author: Ana Bokor
• Mentor: Josip Juras (mentor)
• Committee member: Mato Pavić (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Josip Juras (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Brojni mikrobiološki agensi koloniziraju donje dijelove genitalnog sustava žena, kako tijekom cijelog života, tako i u trudnoći. Iako mnoge vaginalne infekcije u žena prolaze asimptomatski i bez ozbiljnijih posljedica, u trudnoći ti patogeni posebno dobivaju na značaju, s obzirom na to da predstavljaju potencijalnu ugrozu trudnice i ploda. Od značajnih patogena potrebno je izdvojiti beta-hemolitički streptokok skupine B (BHSB) koji ima velik doprinos u morbiditetu i mortalitetu novorođenčadi, ali za koji također postoji vrlo efikasna profilaksa intrapartalnom primjenom antibiotika. Mehanizmima ascendentnog širenja infekcije dolazi do komplikacija poput korioamnionitisa, prijevremene rupture plodovih ovoja i intrauterine infekcije ploda koja može dovesti do sindroma fetalnog upalnog odgovora, a cjelokupna kaskada koju pokreće širenje infekcije nerijetko dovodi do prijevremenog porođaja te posljedično do komplikacija prematuriteta. Osim navedenog, ascendentne infekcije tijekom trudnoće mogu dovesti i do neželjnih perinatalnih ishoda u vidu rane novorođenačke sepse, pneumonije i meningitisa koji predstavljaju značajan rizik za nastanak trajnih ireverzibilnih posljedica na zdravlje djeteta. Ne treba zanemariti ni ostale česte uzročnike poput Ureaplasma spp. koji katkada, zbog dijagnostičkog pristupa i metode kultivacije uzorka brisa cerviksa koja je različita nego u slučaju BHSB-a, ostaje neporepoznat. Cilj ovog rada je predstaviti potencijalno štetne biološke agense koji koloniziraju rodnicu, navesti loše perinatalne ishode do kojih isti dovode te na taj način naglasiti važnost preventivnih metoda poput rutinskog provođenja cervikalnih briseva u trudnoći („screening“, eng.) te primjene intrapartalne antibiotske profilakse.

Abstract (english)

A number of microbial agents colonize the female lower genital tract throughout the whole life as well as in pregnancy. Even though many vaginal infections in women are asymptomatic and don’t leave any serious consequences, in pregnancy, those pathogens are considered especially harmful, because they represent a potential threat for the fetus and the mother. One of the more notable pathogens is group B Streptococcus (GBS), which plays a big role in neonatal morbidity and mortality, but has a very efficient prophylaxis method using intrapartum antibiotics. The ascension of the infection may lead to complications like chorioamnionitis, premature rupture of membranes and intrauterine fetal infection leading to fetal inflammatory response syndrome. This whole cascade can often end with premature birth and thus, prematurity. Apart from this, the ascension of infections may also result in unwanted perinatal outcomes such as early onset neonatal sepsis, pneumonia and meningitis, which carry the risk of irreversible consequences. Other pathogens should not be disregarded, particularly Ureaplasma spp., as the diagnostic approach and the method of cultivation of the cervical swab is different than the one for group B Streptococcus and can sometimes remain undiagnosed. The objective of this paper is to present the potentially harmful biological agents, determine unwanted perinatal outcomes which they may lead to and to emphasize the importance of preventive measures, namely routine cervical screening as well as the use of intrapartum antibiotic prophylaxis.

• Keywords: infekcije u trudnoći; perinatalni ishod; beta-hemolitički streptokok skupine B; probir; prijevremeni porođaj
• Keywords (english): infections in pregnancy; perinatal outcome; group B Streptococcus; screening; preterm delivery
• Language: croatian
• URN:NBN: urn:nbn:hr:105:018638
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-01-04 09:07:37