Some ethical and medical aspects of preventing repeated death of the fetal egg in women of reproductive age

Ruhlyada Nikolaj Nikolaevich, Vinnikova Simona Viktorovna, Tsechoyeva Leyla Shihmurzaeva

The subject of the study was 60 patients from the gynecological Department No. 1 Of the St. Petersburg Institute of emergency medicine named after I. I. Dzhanelidze. We have analyzed the medical history, interviewed and examined the dead woman with the fertilized egg. The main goal of the work is to adjust the treatment and management recommendations for this category of patients. As a result of the study, the following data were obtained: the average age of women with this pathology was 30.9 ± 6.5 years. At the time of treatment, 33.3% were 6/7 weeks pregnant, and 61.7% were not registered in the women's clinic. 38.3% took medications to maintain and develop pregnancy. At least one dead fetal egg in the anamnesis was in 61.7%. Changes in the vaginal flora were detected in 63.3%, only 8.3% sent material for a detailed study. Antibacterial therapy was received by 93.3% without taking into account the microbiota. 20% of patients did not have a mandatory health insurance pole. 45% had a difficult financial situation, and 75% had psychological disorders at the time of admission to the hospital. Today, there is a tendency to increase the number of dead fetal eggs in women of reproductive age, so this category of patients should be observed in a women's clinic and examined for STIs. Monitor the vaginal biocenosis using real-time PCR and perform its correction. Explain to patients about the probable reasons for the development of this pathology and to recommend to the departure of their material on genetic and immunohistochemical research. Patients with a history of 2 or more dead fetal eggs deserve close attention for subsequent diagnosis of the causes of this diagnosis. The appointment of antibacterial drugs in this category of patients should be reviewed, because in the future this leads to changes in the vaginal flora. For preventive purposes, it is recommended to use the probiotic lactojinal, conduct psychological support courses after the transfer of this pathology, so that in the future they are not afraid to plan further pregnancy. Explain to foreign citizens about the possibility of obtaining a temporary health insurance pole so that they can get the necessary medical care.

Keywords:lost fetal egg, mental disorders, financial aspect, vaginal microflora, CHI policy, women's consultation, probiotic, psychological support.