OZONE THERAPY IN THE OBSTETRICS & GYNAECOLOGY
Obstetrics and gynecology can be with certainty numbered among the fields of medicine where the whole spectrum of therapeutic properties of ozone can be successfully used. The list of indications for ozone therapy is as wide as the totality of medical problems requiring an improvement of macro- and microcirculation, correction of immunological status or lipid peroxidation processes. Owing to the capacity of medical ozone to act on the basic links of pathogenesis, ozone therapy has proved to be particularly effective in the following pathologies:
· Spontaneous abortion
· Pregnancy anemia
· Early toxicosis
· Fetoplacental insufficiency
· Inflammatory diseases of internal genital organs (adnexitis, endomyometritis)
· Inflammatory diseases of lower female genital organs (colpitis, endocervicitis, bacterial vaginosis)
· Oncogynecological pathology
· Vulva dystrophy
Ozone therapy is successfully used fro prophylaxis of:
· Intrauterine fetus infection
· Fatness-associated pregnancy complications
The therapeutic effect of ozone is based on the well-known mechanisms of its biological action:
1. Owing to its high oxidating power, highly concentrated ozone used at the local level produces a bactericidal, fungicidal and viricidal effect versus the most important species of gram-positive and gram-negative bacteria, viruses, pathogenic fungi and protista;
2. The systemic effect of medium and low ozone concentrations produced by parenteral route of administration in medical conditions associated with hypoxia situations is based on the activation of the oxygen-dependent processes;
3. The ozonides resulted from the ozonolysis of unsaturated fatty acids modify cell membranes at the structural-functional level, intensify the enzymatic systems and thereby improve the energy metabolism.
4. The immunomodulating effect of ozone is based on its ability to activate the phagocytosis through the formation of peroxides and stimulation of the production of cytokines by lymphocytes and monocytes.
5. Modification of blood corpuscle membranes and fine-structure of vascular bed as well as a decrease in the viscosity properties of blood lead to an improvement of the blood micro-flow and respiratory metabolism at the tissue level.
Before the practical use of ozone in clinics for women, the following fundamental facts were experimentally established:
1. During the pregnancy ozone concentration in gas mixture bubbled into saline solution (method of intravenous drop-by-drop infusions of ozonated saline solution) may range within 400-800 mcg per liter. This result was obtained on the basis of investigations into the influence of different ozone concentrations on the parameters of lipid peroxidation and antioxidant defense system in blood samples taken from the patients with different obstetric pathologies (series of experiments in vitro).
2. The safety of these ozone concentrations relating to teratogenecity was confirmed by a series of experiments in vivo on pregnant laboratory rats.
Further fundamental investigations have fully confirmed the applicability of ozone therapy in the treatment of gestational complications since it has been reliably established that the use of ozone leads to correction of basic links of the pathogenesis and the most important clinical appearances of disease:
· Improvement of macro- and microcirculation that results in the normalization of placenta hormonogenic function;
· Decrease in the activity of lipid peroxidation processes and simultaneous stimulation of the antioxidant defense system of human body;
· Immunomodulating action develops particularly through a decrease in blood level of circulating immune complexes, IgM, group and Rh antibodies, increase in the phagocytic activity of neutrophiles;
· Decrease (if available) in the hypercoagulation activity of blood;
· Intensification of the protein-synthesizing function of liver;
· Ozone therapy exerts a beneficial influence on the clinical course of threatened abortion, gestosis, pregnancy anemia, fetoplacental insufficiency, reduces a risk of intrauterine fetus infection and a risk of fatness-associated pregnancy complications, improves a prognosis of these diseases;
· Ozone therapy reduces stationary treatment time, reduces the use of medicinal agents;
· Ozone therapy significantly reduces a risk of such complications as delivery weakness, postnatal and early postnatal bleedings;
· The use of ozone as a component of treatment complex improves perinatal adaptation of newborn children.
Inflammatory diseases of pelvic organs i.e. internal genitals being considered one of the most frequent pathologies of the woman's body require a new therapeutic approach due to resistance of microorganisms to available antibiotics, high allergization of human body, immunodeficiency and metabolic disturbances associated with the basic pathology.
As a result of the experiments conducted in vivo the pathogenetically proved and at the same time safe ozone concentration is 1200 mcg/L bubbled into saline solution.
The clinical investigations allow making the following conclusions:
1. Ozone therapy for inflammatory diseases of pelvic organs is considered as a component of antioxidant therapy as well as exerts a corrective influence on the cellular and humoral immunity confirmed by an increase in immunoregulative index, a decrease in the level of IgM and circulating immune complexes.
2. The addition of medical ozone to the multimodality therapy exerts a positive influence on the clinical appearances of acute inflammatory diseases of pelvic organs providing a detoxication, analgesic and sedative effect that allows considerably reducing the use of appropriate traditional medicaments. This improves immediate results, particularly reduces residuals of inflammation. A decrease in relapse percentage after the use of ozone as a component of pathogenetic therapy speaks in favor of optimization of remote results.
The experimental-clinical investigations into the influence of ozone on the course of inflammatory processes of lower female genital organs have shown that ozone in gas phase at certain concentrations and methods of administration exerts a beneficial influence on the factors of local genital immunity that allows stopping the inflammation.
The well-known antimicrobic properties of ozonized olive oil as found out can be successfully used in the treatment of vulvar dystrophic diseases. Ozone therapy produces not only an anti-inflammatory effect, but also improves tissue trophism, allows rejecting the use of hormonal ointments and laser therapy.
The practice has shown that the method of intravenous drop-by-drop infusions of ozonated saline solution is the most suitable and applicable one for obstetric clinic. Saline solution is the optimal carrying agent of ozone as it does not undergo any chemical conversions during the ozonization. Ozonated saline solution is produced by conveying an ozone-oxygen gas mixture through a standard glass bottle with 400 ml of sterile 0,9% sodium chloride solution for 15-20 minutes (by using a 200 ml bottle the ozonization lasts for 10-15 minutes). With consideration for instability of ozone in aqueous medium, the ozonated saline solution should be used immediately after its production. It is recommended to administer the ozonated saline solution in the form of drips into the cubital vein at a flow rate of 8-10 ml per minute similar to flow infusions that ensures a minimum loss of ozone. With consideration for dose-related effects of ozone, it is necessary to strictly follow the given mode of ozonization. The safety measures are usual for intravenous infusions.
The method of intravenous drop-by-drop infusions of ozonated saline solution has proved very well in the treatment of inflammatory diseases of pelvic organs as well. Systemic ozone therapy can be also provided in the form of flow rectal insufflations of an ozone/oxygen gas mixture.
In case of inflammatory process in uterine or vaginal cavity it is possible to use the antimicrobic effect of ozone in different variants of its local application (as a carrying agent of ozone can be used distilled water, purified olive oil, ozone therapy in gas phase is possible too).
Ozonized distilled water is produced like the ozonated saline solution, but with consideration that the half-life of ozone in distilled water is more (1,5-2 hrs); therefore the ozonized distilled water keeps its properties longer than the ozonated saline solution.
Production of ozonized olive oil requires more time due to lower solubility of ozone in olive oil and depends on the volume of oil produced (ozone saturation of 100 ml of oil lasts for 2 hrs). It is recommended to use the ready-made ozonized olive oil O'THREE-Ozonide.