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P530 Periodontal disease and its relation with birth outcomes
Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729
P527 The association between chronic periodontitis & pre-term low birth weight infants M. EL-Gharib. Tanta University, Tanta, Egypt Objectives: To study the relationship between PLBW and chronic periodontitis through estimation of levels of IL-6 and TNF-a in gingival cervicular fluid, serum and amniotic fluid in women having premature labour. Also, to find any correlation between the serum levels of IL-6 and TNF-a and the C-Reactive protein. Patients: This study included 200 pregnant women in the first stage of labour of a single baby, with intact membranes. One hundred women had definite preterm labour and delivered, later live infants whose birth weight were <2500 g and 100 women with full term labour and delivered, later live infants weighting ≥2500 g. Intervention: Patients were subjected to history taking, clinical and periodontal examination, CPTIN scoring, estimation of IL-6 and TNFa in gingival cervicular fluid, serum and amniotic fluid. Determination of serum level of C-reactive protein, and TNFa. Results: We found a significant higher incidence of clinical periodontitis among the patients undergoing preterm labour. A statistically significant relation was found between the periodontal indices and the level of IL6 in gingival cervicular fluid and in amniotic fluid, with the level of TNFa in gingival cervicular fluid and in amniotic fluid. Similarly, we found a statistically significant relation was found with probing depth and CPITN score, with the level of IL-6 in gingival cervicular fluid, with the level of TNFa in gingival cervicular fluid and in amniotic fluid. We, also found a significant relation between C-reactive protein and probing depth, bleeding on probing, CPITN score, and the level of IL-6 in gingival cervicular fluid, in serum and in the amniotic fluid, with the level of TNFa in gingival cervicular fluid, in serum and in amniotic fluid. Conclusion: We concluded that there is a relationship between PLBW and chronic periodontitis. So, clinical screening of pregnant women with CPITN score may be helpful in prediction of preterm labour. Also, the level of TNFa in gingival cervical fluid, serum, amniotic fluid and IL-6 level in gingival cervical fluid may be used as a predictor of preterm labour. P528 The effect of honey on vulvovaginal candidiasis N. Fazel, M. Hashemian Objective: Vulvovaginal candidiasis (VVC) is most common vaginitis in between women. The purpose of this study was comparison efficacy of honey and clotrimazo 100 mg on vaginitis candidiasis. To evaluate the efficacy and tolerability of a vaginal clotrimazole and honey or both used daily for 7 days in the treatment of vaginitis candidiasis. Methods: This double-blind clinical trial study performed on nonpregnant women aged 18 to 49 years with vaginitis candidiasis who participated in this study using vaginal clotrimazole and vaginal honey or both daily for 7 days. Furthermore, information was baseline Candida culture requested with clinical diagnosis of vaginitis and patient said sense signes said by patient entered this open comparative study. They regard to diagnostic and preferred treatment when dealing with vulvovaginal candidiasis. Gynecological and microbiological evaluations were carried out prior to and following 7 and 30 days after the start of therapy. Student’s t-test and k-skier was used for the statistical analysis. Results: Out of 90 patients who were initially recruited to the study, 15 were subsequently excluded, leaving a total of 75 patients. Reductions occurred in symptoms and signs of vaginitis. Seventyfive (30 in clotrimazole group 3, 15 in honey group 1, 30 in honey and clotrimazole group 2) women were recruited, success rate for the treatment of vaginitis candidiasis was 100% in 1 and 2 group in 7 and 30 days after intervention. In contrast, with group 3 the cure rates was significanc (p < 0.001). The medication was well tolerated.
S563
Conclusion: Use of honey alone represent a novel and effective formulation for the treatment of common type of vaginitis. And so a combination of 100 mg of clotrimazole and 5 ml of honey application was found to be effective in the treatment of the most common causes of vaginitis. P529 Features of clinical course and outcome of therapy of mycoplasmal urogenital infections during pregnancy I. Fofanova, V. Prilepskaya Goal: To evaluate the patterns of clinical course, the effeciency of therapy of monomycoplasmal infection during pregnancy. Subjects: 375 pregnant women with urogenital mycoplasmas infection (examined by PCR and culture methods) were investigated. 60 women (16%) had urogenital mycoplasmal monoinfection (basic group), in other cases there was an association with another opportunistic microflora (E.coli, Enterococciae, Streptococci et ctr) In basic group the rate of U. urealyticum was 48 (80%), U. urealyticum + M. hominis – 6 (10%), M. hominis – 6 (10%). Control group – 45 healthy pregnant women. Methods: ultrasound method, biochemical (a-FP, hGG, E3), control of gemostasis, clinical blood analysis. Results: 7(11.8%) pregnant women basic group had no complications during pregnancy, perinatal period or pathological changes in analysis. It was proposed, that the presence of urogenital mycoplasmas in those cases was not accompanied by systemic inflammatory response and did not require specific therapy. In 53 (88.2%) cases the level of fibrinogen was higher from 11–12 weeks of gestation. The same patients had a progressive increasing of the level of erithrocyte sedimentation rate. In 38 (71.7%) cases it was founded the decline of hemoglobine, hematocrite from 20–22 weeks of gestation. In control group anemia was diagnosed in 6 (13.3%) cases. (p ≤ 0.01). In basic group simptoms of spontaneous abortion were were in 33 (66.2%) in I trimester, in in 28 (52.8%) in II trimester. In basic group the decreasing level of hCG was in 47 (88.7%), moderate decreasing level of estriol in 34 (64.1%) of 53 patients. The level of a-FP was at the norm. Oligohydramnion (by US) in 7 (13.2%), polyhydramnion in 5 (9.4%), premature aging of placenta – 31 (58.5%) were in this group. Antibacterial therapy at 18–19 weeks (Josamycin 1.5 g/day for 10 days) was in 53 cases. After the therapy all deliveries were at term. The average weight of newborns was 3116±273 g, the evaluation of Apgar-8.1±0.89 points. Conclusion: In identifying the urogenital mycoplasmas the pregnancy proceeds without complication in 11.8% cases. In another cases we noted some markers of inflammation from 14–16 weeks: increased level of serum fibrinogen, erythrocyte sedimentation rate, reduction of hCG, estriol level, premature aging of placenta, oligohydramnion, polyhydramnion. Timely delivery of antibacterial therapy (from 18–19 weeks) allows to prolong the pregnancy till the term and to avoid complications during pregnancy and the perinatal period. P530 Periodontal disease and its relation with birth outcomes L. Garcia Capote, L. Forbes. University of Puerto Rico, General Practice Residency Program Many publications suggest that maternal periodontal disease may be a risk factor for pre term labor and low birth weight. This is a description of the proposed mechanisms by which periodontal disease may affect birth outcomes and a review of the most important studies made on the subject so far. We also present data collected in a dental clinic at the Center of Diabetes of Puerto Rico.
P527 The association between chronic periodontitis & pre-term low birth weight infants M. EL-Gharib. Tanta University, Tanta, Egypt Objectives: To study the relationship between PLBW and chronic periodontitis through estimation of levels of IL-6 and TNF-a in gingival cervicular fluid, serum and amniotic fluid in women having premature labour. Also, to find any correlation between the serum levels of IL-6 and TNF-a and the C-Reactive protein. Patients: This study included 200 pregnant women in the first stage of labour of a single baby, with intact membranes. One hundred women had definite preterm labour and delivered, later live infants whose birth weight were <2500 g and 100 women with full term labour and delivered, later live infants weighting ≥2500 g. Intervention: Patients were subjected to history taking, clinical and periodontal examination, CPTIN scoring, estimation of IL-6 and TNFa in gingival cervicular fluid, serum and amniotic fluid. Determination of serum level of C-reactive protein, and TNFa. Results: We found a significant higher incidence of clinical periodontitis among the patients undergoing preterm labour. A statistically significant relation was found between the periodontal indices and the level of IL6 in gingival cervicular fluid and in amniotic fluid, with the level of TNFa in gingival cervicular fluid and in amniotic fluid. Similarly, we found a statistically significant relation was found with probing depth and CPITN score, with the level of IL-6 in gingival cervicular fluid, with the level of TNFa in gingival cervicular fluid and in amniotic fluid. We, also found a significant relation between C-reactive protein and probing depth, bleeding on probing, CPITN score, and the level of IL-6 in gingival cervicular fluid, in serum and in the amniotic fluid, with the level of TNFa in gingival cervicular fluid, in serum and in amniotic fluid. Conclusion: We concluded that there is a relationship between PLBW and chronic periodontitis. So, clinical screening of pregnant women with CPITN score may be helpful in prediction of preterm labour. Also, the level of TNFa in gingival cervical fluid, serum, amniotic fluid and IL-6 level in gingival cervical fluid may be used as a predictor of preterm labour. P528 The effect of honey on vulvovaginal candidiasis N. Fazel, M. Hashemian Objective: Vulvovaginal candidiasis (VVC) is most common vaginitis in between women. The purpose of this study was comparison efficacy of honey and clotrimazo 100 mg on vaginitis candidiasis. To evaluate the efficacy and tolerability of a vaginal clotrimazole and honey or both used daily for 7 days in the treatment of vaginitis candidiasis. Methods: This double-blind clinical trial study performed on nonpregnant women aged 18 to 49 years with vaginitis candidiasis who participated in this study using vaginal clotrimazole and vaginal honey or both daily for 7 days. Furthermore, information was baseline Candida culture requested with clinical diagnosis of vaginitis and patient said sense signes said by patient entered this open comparative study. They regard to diagnostic and preferred treatment when dealing with vulvovaginal candidiasis. Gynecological and microbiological evaluations were carried out prior to and following 7 and 30 days after the start of therapy. Student’s t-test and k-skier was used for the statistical analysis. Results: Out of 90 patients who were initially recruited to the study, 15 were subsequently excluded, leaving a total of 75 patients. Reductions occurred in symptoms and signs of vaginitis. Seventyfive (30 in clotrimazole group 3, 15 in honey group 1, 30 in honey and clotrimazole group 2) women were recruited, success rate for the treatment of vaginitis candidiasis was 100% in 1 and 2 group in 7 and 30 days after intervention. In contrast, with group 3 the cure rates was significanc (p < 0.001). The medication was well tolerated.
S563
Conclusion: Use of honey alone represent a novel and effective formulation for the treatment of common type of vaginitis. And so a combination of 100 mg of clotrimazole and 5 ml of honey application was found to be effective in the treatment of the most common causes of vaginitis. P529 Features of clinical course and outcome of therapy of mycoplasmal urogenital infections during pregnancy I. Fofanova, V. Prilepskaya Goal: To evaluate the patterns of clinical course, the effeciency of therapy of monomycoplasmal infection during pregnancy. Subjects: 375 pregnant women with urogenital mycoplasmas infection (examined by PCR and culture methods) were investigated. 60 women (16%) had urogenital mycoplasmal monoinfection (basic group), in other cases there was an association with another opportunistic microflora (E.coli, Enterococciae, Streptococci et ctr) In basic group the rate of U. urealyticum was 48 (80%), U. urealyticum + M. hominis – 6 (10%), M. hominis – 6 (10%). Control group – 45 healthy pregnant women. Methods: ultrasound method, biochemical (a-FP, hGG, E3), control of gemostasis, clinical blood analysis. Results: 7(11.8%) pregnant women basic group had no complications during pregnancy, perinatal period or pathological changes in analysis. It was proposed, that the presence of urogenital mycoplasmas in those cases was not accompanied by systemic inflammatory response and did not require specific therapy. In 53 (88.2%) cases the level of fibrinogen was higher from 11–12 weeks of gestation. The same patients had a progressive increasing of the level of erithrocyte sedimentation rate. In 38 (71.7%) cases it was founded the decline of hemoglobine, hematocrite from 20–22 weeks of gestation. In control group anemia was diagnosed in 6 (13.3%) cases. (p ≤ 0.01). In basic group simptoms of spontaneous abortion were were in 33 (66.2%) in I trimester, in in 28 (52.8%) in II trimester. In basic group the decreasing level of hCG was in 47 (88.7%), moderate decreasing level of estriol in 34 (64.1%) of 53 patients. The level of a-FP was at the norm. Oligohydramnion (by US) in 7 (13.2%), polyhydramnion in 5 (9.4%), premature aging of placenta – 31 (58.5%) were in this group. Antibacterial therapy at 18–19 weeks (Josamycin 1.5 g/day for 10 days) was in 53 cases. After the therapy all deliveries were at term. The average weight of newborns was 3116±273 g, the evaluation of Apgar-8.1±0.89 points. Conclusion: In identifying the urogenital mycoplasmas the pregnancy proceeds without complication in 11.8% cases. In another cases we noted some markers of inflammation from 14–16 weeks: increased level of serum fibrinogen, erythrocyte sedimentation rate, reduction of hCG, estriol level, premature aging of placenta, oligohydramnion, polyhydramnion. Timely delivery of antibacterial therapy (from 18–19 weeks) allows to prolong the pregnancy till the term and to avoid complications during pregnancy and the perinatal period. P530 Periodontal disease and its relation with birth outcomes L. Garcia Capote, L. Forbes. University of Puerto Rico, General Practice Residency Program Many publications suggest that maternal periodontal disease may be a risk factor for pre term labor and low birth weight. This is a description of the proposed mechanisms by which periodontal disease may affect birth outcomes and a review of the most important studies made on the subject so far. We also present data collected in a dental clinic at the Center of Diabetes of Puerto Rico.