Pregnancy complications in type 1 diabetes mellitus in combination with urinary tract infections with various treatment options

• Main Authors: I V Alekseenko, L A Ivanova
• Format: Article
• Language: Russian
• Published: ECO-vector 2020-02-01
• Series: Kazanskij Medicinskij Žurnal
• Subjects: type 1 diabetes mellitus; urinary infection; pregnancy complications
• Online Access: https://kazanmedjournal.ru/kazanmedj/article/viewFile/17919/pdf

Aim. To assess the frequency of pregnancy complications in women with type 1 diabetes mellitus and without diabetes combined with urinary infection and the effect of various treatment options for urinary infection on the frequency of pregnancy complications in type 1 diabetes. Methods. Pregnant women with urinary tract infection were examined: 110 people with type 1 diabetes (main group) and 133 women without diabetes (comparison group). The diagnosis of urinary infection was confirmed by a double bacteriological culture. Patients of the main group were divided into three subgroups depending on the method of treatment of urinary tract infection: subgroup A received antibiotic therapy and phytopreparation (Centaurium + Lovage root + Rosemary leaves), subgroup Б received antibiotic therapy, subgroup B received phytopreparation. After treatment, the preservation of pregnancy complications such as the threat of miscarriage, proteinuria, intrauterine infection of fetus, anemia, premature birth, which developed on a background of urinary tract infection, was evaluated. The significance of differences in groups was evaluated using the Pearson chi-square tests, and the effectiveness of each type of therapy was evaluated using the McNemar test. Results. The risk of miscarriage, intrauterine infection, anemia, and premature birth was higher in pregnant women of main group with all types of urinary infection, preeclampsia with pyelonephritis, and asymptomatic bacteriuria. Both complex therapy of pyelonephritis (antibiotics with phytopreparation) and monotherapy with antibiotics were effective in eliminating the threat of miscarriage, intrauterine infection and anemia. Adding herbal medicine to antibiotic therapy for pyelonephritis reduced the preterm birth rate compared with antibiotic monotherapy, and other complications did not reveal differences between subgroups. In asymptomatic bacteriuria, complex therapy and monotherapy with antibiotics were effective in eliminating the threat of miscarriage, intrauterine infection and anemia. Monotherapy with a phytopreparation in pregnant women with type 1 diabetes did not lead to the elimination of these complications. Combination therapy asymptomatic bacteriuria was more effective than antibiotic monotherapy in terms of the effect on preterm delivery and equally effective in terms of the threat of miscarriage, intrauterine infection and anemia. Conclusion. Adding phytopreparation to antibiotic therapy for pyelonephritis and asymptomatic bacteriuria in pregnant women with type 1 diabetes mellitus to prevent premature birth seems appropriate; monotherapy of asymptomatic bacteriuria with a phytopreparation is ineffective for eliminating the threat of miscarriage, intrauterine infection, anemia, therefore antibiotics should be prescribed at the beginning of therapy for asymptomatic bacteriuria.