Preconception preparation of patients with bacterial vaginosis and chronic genital herpes infection

Introduction. Bacterial vaginosis is one of the most common types of infectious pathology of the female genital organs (10-70%), increasing the likelihood of complications during pregnancy and childbirth, which also affects the health of newborns. Viral infection is also a significant factor in the etiology of genital and obstetric disorders. Aim. To evaluate the effectiveness of using a combined drug with interferon alpha-2b, metronidazole, and fluconazole in conjunction with traditional comprehensive therapy of bacterial vaginosis combined with recurrent genital herpes in a pre-pregnancy preparation program. Materials and Methods. The study included 120 women aged 18 to 35 years suffering from recurrent genital herpes and bacterial vaginosis, who became pregnant within 12 months after completing the proposed therapy and gave birth. In Group I (n=60), standard antiviral therapy was used with acyclovir at a dose of 200 mg 5 times a day for a period of 5 days, along with the topical application of interferon alpha-2b, metronidazole, and fluconazole intravaginally for 10 days. In Group II (n=60), similar antiviral therapy was used, along with clindamycin suppositories for 3 days. The patient examination program included traditional diagnostic methods, such as microscopy, vaginal discharge pH measurement, and virus DNA detection, as well as questionnaires. Additionally, the concentration of cytokines in cervical mucus was tested using enzyme-linked immunosorbent assay (ELISA). MS Excel and Statistica 7.0 software programs were used for statistical processing. Differences were considered statistically significant at p<0.05. Results and Discussion. A higher clinical effectiveness of treatment of bacterial vaginosis was noted in Group I compared to Group II: 2 times higher after 10 days, 4.8 times higher after 30 days, and 4 times higher after 6 months; while for genital herpes, the respective figures were 1.8; 2.3; and 2.6 times higher. A greater microbiological effect was achieved after 6 months in Group I: 4.4 times higher for bacterial vaginosis and 2.8 times higher for herpes. A more significant decrease in cytokine concentration was established on the 10th day of therapy in Group I compared to the indicators of Group II (Il-10 was 1.4 times lower, IL-6 was 3 times lower, IL-1β was 2 times lower, TNFα was 2.7 times lower, and IFN-γ was 1.8 times lower) (p<0.001), with the immunomodulatory effect persisting for 30 days. Conclusions. The use of the proposed pre-pregnancy preparation option contributes to reducing the risk of genital herpes exacerbation during pregnancy by 3.8 times (p<0.001), bacterial vaginosis by 1.9 times (p<0.001), and intrauterine infection markers were detected 4.9 times less often on ultrasound examination (p<0.001), which improves pregnancy outcomes, increasing newborn health indicators by 4.7 times (p<0.001).