Prevention of labor complication via the improvement of vaginal microbiocenosis
DOI: 10.32364/2618-8430-2021-4-1-31-35
L.Yu. Karakhalis, N.S. Ivantsiv
Kuban State Medical University, Krasnodar, Russian Federation
Aim: to assess the effect of Lactobacilli on vaginal microbiocenosis in pregnant women with its pre-existing disturbances manifested as an increase in vaginal pH levels (>4.5) and pathological vaginal discharge in the 1st trimester of pregnancy.
Patients and Methods: a prospective study involved 261 pregnant women who registered their pregnancy before 14 weeks. Group 1 included 147 women with vaginal pH>4.5 and gray white smelling discharge, but no cornified squamous epithelial cells and negative whiff test. Group 2 included 114 pregnant women with vaginal pH 3.8–4.5 and no vaginal discharge. At 11–14 weeks, 18–21 weeks, 30–34 weeks, and before delivery (36–41 weeks), vaginal pH, the composition of opportunistic flora, and Lactobacilli count were evaluated. In group 1, intravaginal lyophilized culture of L. casei rhamnosus (LCR) Doderleini was prescribed after each screening and before the delivery (in total, 4 courses).
Results: the use of LCR preparation throughout the gestation reduced vaginal pH from 4.9 (11–14 weeks) to 4.5 (36–41 weeks) (p=0.001). In group 2, vaginal pH increased from 4.35 to 4.7 (p=0.000). In group 1 (probiotic containing LCR Lactobacilli was prescribed), the percentage of women with isolated L. jensenii strain increased by 1.6 times (from 9.52% to 14.96%). Meanwhile, in group 2 (no probiotic was prescribed), the percentage of women with isolated L. jensenii strain reduced by 4.2 times (from 14.91% to 3,51%; p=0.000). In group 1, abnormal birth activity and premature rupture of membranes were reported significantly less common (р=0.0001 and р=0.0001, respectively).
Conclusions: probiotic containing LCR is favorable in terms of reducing the rate of pregnancy and birth complications. This fact is of particular importance for women who are at risk of bacterial vaginosis.
Keywords: pregnancy, Lactobacilli, vaginal microbiocenosis, pH measurement, probiotics.
For citation: Karakhalis L.Yu., Ivantsiv N.S. Prevention of labor complication via the improvement of vaginal microbiocenosis. Russian Journal of Woman and Child Health. 2021;4(1):31–35. DOI: 10.32364/2618-8430-2021-4-1-31-35.
2. Conlon M.A., Bird A.R. The impact of diet and lifestyle on gut microbiota and human health. Nutrients. 2015;7:17–44. DOI: 10.3390/nu7010017.
3. Chabanova N.B., Mataev S.I., Vasilkova T.N., Shevlyukova T.P. Role of systemic inflammation in the development of pregnancy complications in obese women. Obsterics and Gynecology. 2017;10:12–18 (in Russ.). DOI: 10.18565/aig.2017.10.12-18.
4. Smirnova E.I. Threat of abortion and bacterial vaginosis: is there a connection? Journal of new medical technologies (eEdition). 2017;1 (in Russ.). DOI: 10.12737/25076.
5. Vorontsova M.S., Kravchenko E.N. The importance of bacterial vaginosis in the formation of a short cervix in pregnant women. Vrach-aspirant. 2016;4:43–49 (in Russ.).
6. Aylamazyan E.K., Shipitsyna E.V., Savicheva A.M. Woman’s microbiota and pregnancy outcomes. Journal of Obstetrics and Women’s Diseases. 2016;65(4):6–14 (in Russ.). DOI: 10.17816/JOWD6546-14.
7. Giakoumelou S., Wheelhouse N., Cuschieri K. et al. The role of infection in miscarriage. Hum Reprod Update. 2016;22(1):116–133. DOI: 10.1093/humupd/dmv041.
8. Petrova M., Lievens E., Malik S. et al. Lactobacillus species as biomarkers and agents that can promote various aspects of vaginal health. Front Physiol. 2015;6:81. DOI: 10.3389/fphys.2015.00081.
9. Romero R., Miranda J., Chaemsaithong P. et al. Sterile and microbial-associated intra-amniotic inflammation in preterm prelabor rupture of membranes. Matern Fetal Neonatal Med. 2015;28(12):1394–1409. DOI: 10.31 09/14767058.2014.958463.
10. State Register of Medicines of Russia. Encyclopedia of Medicines and Pharmacy Products (Electronic resource.) URL: https://www.rlsnet.ru (access date: 02.28.2020) (in Russ.).
11. Russian Society of Obstetricians and Gynecologists. Clinical guidelines for the diagnosis and treatment of diseases accompanied by pathological discharge from the genital tract of women. M.; 2019 (in Russ.).
12. Antonio M.A.D., Hawes S.E., Hillier S.L. The identification of vaginal Lactobacillus species and the demographic and microbiologic characteristics of women colonized by these species. J Infect Dis. 1999;180:1950–1956. DOI: 10.1086/315109.
13. Xiao B., Wu C., Song W. et al. Association analysis on recurrence of bacterial vaginosis revealed microbes and clinical variables important for treatment outcome. Front Cell Infect Microbiol. 2019;9:189. DOI: 10.3389/fcimb.2019.001189.
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Распечатать