DIAGNOSTIC CHARACTERISTICS OF ORAL PATHOLOGIES DURING PREGNANCY: CLINICAL AND LABORATORY PERSPECTIVE

Аннотация

The study analyzed the dental status of pregnant women using modern clinical and laboratory diagnostic methods. Special attention is paid to the study of the condition of periodontal tissues, oral mucosa and hard dental tissues. The characteristic changes in the oral cavity associated with the physiological characteristics of the body of pregnant women were revealed.The results obtained make it possible to optimize approaches to the prevention and treatment of dental diseases in pregnant women, taking into account their special status. The practical significance of the work lies in the development of recommendations for the timely diagnosis, prevention and treatment of oral diseases in pregnant women, which contributes to the preservation of the health of mother and child Keywords: pregnancy, dental diseases, oral cavity, clinical and laboratory diagnostics, periodontal disease, prevention of dental diseases, gestational period. Introduction. Currently, it has been proven that the frequency of carious process and inflammatory periodontal diseases (gingivitis and periodontitis) increases significantly during pregnancy. According to WHO, "one of the most common diseases during pregnancy are diseases of the oral cavity (OCD), which are one of the most significant medical and social problems"1. ZRS are a provoking factor for an inflammatory response from the whole body and in the future can have an adverse effect on the course of pregnancy, childbirth and the postpartum period. ZRS are a stomatogenic focus of infection in the pregnant woman's body, pathogenic microorganisms and their waste products penetrate into all organs and systems of the mother and child's body, which can cause purulent-septic complications. At the beginning of the new millennium, paradoxically, infections occupy the fourth place in the structure of maternal mortality and account for 11%, and in developing countries septic shock associated with septic abortion and postpartum endometritis still occupies one of the leading places . According to foreign statistics, the incidence of sepsis with fatal outcomes in obstetric practice increases by 10% per year, while the main risk factors are: late maternal age, obesity, pregnancy against the background of chronic diseases, ART and multiple pregnancies, high frequency of cesarean 26 ACADEMIC RESEARCH IN MODERN SCIENCE International scientific-online conference sections (the risk is 5-20 times higher). According to a confidential study of maternal mortality and morbidity in the UK, 63% of fatal maternal sepsis cases had a delay in recognition or treatment. The results of studies conducted to date on a global scale have shown that septic complications in the postpartum period, as a cause of maternal mortality, continue to lead, taking 1-2 place, sharing it with obstetric bleeding. According to WHO experts, despite significant advances in diagnosis and antimicrobial therapy, a high proportion of postpartum sepsis remains in the structure of maternal mortality in the world: from 10.7% to 15%. According to J. Barton and B. Sibai , the incidence of severe sepsis with fatal outcomes increases by 10% annually. WHO experts note that 1/10 of maternal deaths are caused by septic complications of pregnancy and childbirth, most of which are registered in low- resource countries, however, birth infection still remains the direct cause of maternal mortality in highly developed countries. In addition, infectious diseases of the mother before or during childbirth are the cause of death of 1 million newborns per year[4]. A woman's oral health and oral microbiota can directly affect her pregnancy and developing fetus. A review of 23 systematic publications on the relationship between maternal periodontitis and pregnancy complications showed that if a mother has periodontal disease, she has a 1.6 (95% confidence interval: 1.3-2.0) times higher risk of premature birth, 1.7 (95% confidence interval: 1.3-2.1) times higher risk of premature birth, the risk of having a low-weight baby is higher, the risk of preeclampsia is 2.2 (95% confidence interval: 1.4-3.4) times higher, and the risk of premature birth is 3.4 (95% confidence interval: 1.3-8.8) times higher, plus the birth of a child with a low birth weight [6]. It may seem more than reasonable to treat periodontal disease during pregnancy to reduce these risks. However, there is currently insufficient evidence to conclude that periodontal treatment during pregnancy is effective in reducing the risk of adverse pregnancy outcomes [7]. With regard to such a common disease as caries, it was found that even during the physiological course of pregnancy, the prevalence of dental caries is 91.4% of lesions of previously intact teeth (with a predominance of the acute course of the carious process) in 38% of pregnant patients. Conclusions: Thus, improving a woman's dental status and preventing purulent-septic complications during pregnancy, childbirth and the postpartum period