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Acta Facultatis Medicae Naissensis
2005, vol. 22, br. 4, str. 161-165
jezik rada: engleski
vrsta rada: pregledni članak
objavljeno: 02/06/2007
Komplikacije nastale usled bakterijske vaginoze
Institut za zaštitu zdravlja, Niš

Sažetak

Bakterijska vaginoza (BV) je promena normalne vaginalne mikroflore. Normalna flora u kojoj dominiraju laktobacili je odsutna ili veoma umanjena i zamenjena mešovitom, uglavnom anaerobnom florom koja se sastoji od sledećih vrsta bakterija: Gardnerella vaginalis, Mycoplasma hominis, Mobiluncus spp, Bacteroides spp, Prevotela spp, Peptostreptococcus spp, Fusobacterium spp i Porphyromonas spp. Četiri studije, objavljene i izvedene u zemljama SAD-a, Africi i Tajlandu pokazale su da žene sa bakterijskom vaginozom imaju povećanu prevalencu HIV infekcije. Veliki broj epidemioloških studija pokazao je da postoji "dozno-zavisna" veza između stepena promene vaginalne flore kod BV i rizika od HIV infekcije. Razumevanje ove " dozno-zavisne" veze između BV i HIV infekcije pomaže u pojašnjavanju patogenetskog mehanizma ove komplikacije. Takođe je jednom opsežnom multi-varijantnom studijom utvrđeno da su žene bez laktobacila 70% podložnije oboljevanju od gonoreje i drugih seksualno prenosivih bolesti. Kod žena sa BV-om može doći do sledećih komplikacija: salpingitisa i/ili endometritisa, posthirurških infekcija (endometritis, posle porođaja carskim rezom, posthisterektomijski vaginalni celulitis), i lošeg ishoda trudnoće, uključujući prevremeno pucanje plodovih ovojaka, prevremeni porođaj i horioamnionitis. Postoji mogućnost da je BV na neki način povezana sa razvojem cervikalne intraepitelijalne neoplazije (CIN). Takođe, postoje podaci koji povezuju BV sa citološkim upalnim promenama na cerviksu. Povezanost BV sa brojnim akušerskim i ginekološkim komplikacijama zahteva obavezan skrining žena i lečenje BV kod različitih drugih kliničkih stanja. Dodatna istraživanja ove bolesti moraju uključiti i pronalaženje načina sprečavanja komplikacija u trudnoći, kao i postupka izlečenja BV kod žena koje nisu gravidne.

Ključne reči

bakterijska vaginoza; infekcije genitalnog trakta žena; HIV infekcija; CIN; prevremeni porođaj

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