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EVALUATION OF THE QUALITY OF LIFE REPRODUCTIVE AGE WOMEN WITH MIXED CERVICAL INFECTIONS




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Inflammatory diseases of the cervix and vagina for today are the most frequent diseases of the female genital organs [1,2]. Chlamydia and herpes — are the most common human infections with chronic character and long-term persistence of the pathogen, affecting the quality of life of patients [1,5].

In modern medicine, research of quality of life (QOL) enables the use of statistically significant results in clinical practice based on evidence-based medicine [3].

Background. Determine the level of quality of life in reproductive age women with chronic recurrent herpetic, chlamydial cervicitis (HСMI) for the development of optimal treatment and rehabilitation tactics.

Research methods. We have comprehensively examined 90 reproductive age women with cervicitis Chlamydia-herpetic etiology (main group research). The control group consisted of 30 women without gynecological and somatic pathology. The groups were representative.

Identification of Chlamydia trachomatis and HSV-2 (PCR, ELISA) is defined in all cases. It was also carried out clinical, bacterioscopic, cytological, colposcopic examination. The criterion for selection of patients had laboratory confirmed the presence of chlamydial cervicitis, and genital herpes, duration at least one year and relapse rate at least twice a year.

Assessment of QOL was conducted using a standard questionnaire Short Form Medical Outcomes Study (SF-36).

Results. All examined women were in the age group from 18 to 45 years. The median age in the main group 28,5 ± 2,2 years, in control group — 29,3 ± 3,6 years. By marital status composed most of them were married women (study group – 81,16%, the control – 86,6%) (p <0,05).

During colposcopy examination patients: on the background mucosal edema and dilated brittle capillaries, typical for the cervicitis, which were determined in 100% of cases, revealed the true erosion of 14,4% (at 13 women), 4.4% (at 4 women) combine with leukoplakia. In 24,4% of cases (at 22 women) was detected ectopia prismatic epithelium (pseudoerosion). Iodine negative zone and aсetic-white epithelium was determined mainly in the entrance to the cervical canal, in 12,2% of women (11 persons).

The cytological examination have shown that 69% of women (62 persons) revealed cytological picture, characterized by inflammatory infiltration of white blood cells, immature squamous metaplasia and mature class of ASCUS, 25,5% (23 women) — LSIL, 3,3% (3 women) — HSIL. Only 2,2% of women (2 persons) defined NILM class. An important moment of chlamydia infection in combination with genital herpes is oncological aspects, exactly the potential factors such as dysplasia and cervical cancer [4].

Exploring the quality of life of surveyed women we found a decrease both components — physical and mental. Patients with HCMI physical health component was 72,1 ± 8,8 points, in contradistinction to the women in the control group (94,37 ± 7,2 points). We found a large decrease mental component of QOL in women with mixed-cervical infections, which amounted to 51,54 ± 6,1 points (control group 91,09 ± 4,1 points), which are an integral parameters such as attitude to the disease activity , energy, mood, shyness and sexual function. In this way, the assessment of the overall quality of life, was in the main group 61,82 ± 7,45 points, the control — 92,73 ± 5,65 points (p <0,05). This information can be seen in picture 1.

Picture 1. Quality of life according to the standard questionnaire SF-36

Conclusions. Conducted examination in reproductive age women with chronic recurrent herpetic, chlamydial cervicitis have shown a high frequency of cervical pathology with colposcopy examination (inflammatory changes — 49%, to 24,4% — ectopia prismatic epithelium (pseudoerosion), true erosion 14,4%, which is 4,4% combined with leukoplakia, dysplasia — 12,2%), which be correlated with cytology (ASCUS — 69%, LSIL — 25,5%, HSIL — 3,3%, NILM — 2,2%).

Analysis of the level of quality of life in reproductive age women with chronic recurrent herpetic, chlamydial cervicitis infections, showed a decreased in the general quality of life in half as much again (30,9 points), which depend of physical and especially the psychological components.

Used literature:

  1. Бенюк В.О., Щерба О.А., Ластовецька Л.Д. Етіопатогенетичні підходи до діагностики та лікування кандидозно-герпетичного вульвовагініту //Здоровье женщины, №9(64); 2011.- с. 158-160.
  2. Подольский В. В. Клинико-эпидемиологическая характеристика женщин фертильного возраста с хроническими воспалительными заболеваниями половых органов / В. В. Подольский // Акушерство и гинекология. – 2013. – № 4. – С. 61–66.
  3. В.Л. Дронова, О.А. Щерба, БУ Вейвей, Ю.І. Бойчук Якість життя у жінок з хронічною рецидивуючою хламідійно-вірусною інфекцією нижнього відділу геніталій // Збірник наукових праць акушерів – гінекологів України — К.: ТОВ «Видавництво «ЮСТОН», Випуск 2(38).- 2016– с. 156-
  4. Прилепская В.Н., Патология шейки матки и генитальные инфекции //Медпресс-информ. — с. 19-21.
  5. Benyuk V., Shcherba O., Dronova V., Kovalyuk T., Bu Weiwei. The problem of the lower genital tract mixed infections in reproductive age women. Clinico-pathogenic treatment in modern conditions. // Wschodnioeuropejskie Czasopismo Naukowe №4, część 1,- 2015.- p. 153-156.
    EVALUATION OF THE QUALITY OF LIFE REPRODUCTIVE AGE WOMEN WITH MIXED CERVICAL INFECTIONS
    In order determine the level of quality of life in women with chronic recurrent chlamydial-herpetic cervicovaginitis to develop optimal treatment and rehabilitation tactics. We are ex-amined 90 women with mixed infection and 30 healthy women aged 18 to 45 years old by the methods of estimation quality of life assessment based on the SF-36 standard questionnaire. Results. In women with that pathology decreased general assessment quality of life 61,82 ± 7,45 points, by physical (72,1 ± 8,8 points) and mental (51,54 ± 6,1 points) parts in compara-tive with the control. Conclusion. Analysis of the quality of life in women of reproductive age with herpetic, chla-mydial cervicitis, showed a decreased in the general quality of life in half as much again (30,9 points).
    Written by: Shcherba Olena Anatoliyivna, Lastovetska Liliia Dmytrivna, Kobylinskyi Ihor Anatolіyovich
    Published by: БАСАРАНОВИЧ ЕКАТЕРИНА
    Date Published: 01/16/2017
    Edition: ЕВРАЗИЙСКИЙ СОЮЗ УЧЕНЫХ_30.10.16_31(1)
    Available in: Ebook