Differentiated correction of vaginal microbiocenosis in women with nonspecific cervicovaginitis in the first pregnancy trimester
Objective. To develop and evaluate the efficiency of differentiated correction of the vaginal microbiocenosis in women with nonspecific cervicovaginitis in the first trimester of pregnancy.Dolgushina V.F., Shishkova Yu.S., Grafov E.D., Kurnosenko I.V.
Subjects and methods. The vaginal microflora was studied in 25 patients in the first trimester of pregnancy after using an antiseptic at Stage 1 of cervicovaginitis therapy (light electron microscopy, x1000, Gram staining). According to the status of the vaginal microflora, differentiated correction of the vaginal microbiocenosis was made in 24 women with nonspecific cervicovaginitis at 13-14 weeks’ gestation (a study group). In 26 patients (a comparison group), vaginal microbiocenosis was restored, without taking into account the pattern of microflora after the first stage of treatment.
Results. In the study group, recurrent cervicovaginitis was noted in 12.5% of cases; in the comparison group, the recurrence rate was 38.5% (p = 0.037). Preterm birth was observed in 19.2% of cases only among the patients of the comparison group (p = 0.05).
Conclusion. Differentiated correction of the vaginal microbiocenosis, according to the status of vaginal microflora, can reduce the rate of recurrent cervicovaginal infections and premature birth.
Keywords
cervicovaginitis
recurrence
vaginal microbiocenosis
first trimester of pregnancy
References
- Айламазян Э.К., Шипицына Е.В., Савичева А.М. Микробиота женщины и исходы беременности. Журнал акушерства и женских болезней. 2016; 65(4): 6-14. [Ailamazyan E.K., Shipitsyna E.V., Savicheva A.M. Microbiota of a woman and pregnancy outcomes. Zhurnal Akusherstva i Zhenskikh Bolezney (Journal of Obstetrics and Women’s Diseases). 2016; 65 (4): 6-14. (in Russian)]..
- Никонов А.П., Белова А.В., Асцатурова О.Р., Иванова Т.А., Гущин А.Е. Генитальные микоплазмы в структуре оппортунистических инфекций влагалища и шейки матки у беременных. Вопросы гинекологии, акушерства и перинатологии. 2010; 9(5): 5-9. [Nikonov A.P., Belova A.V., Astsaturova O.R., Ivanova T.A., Gushchin A.E. Genital mycoplasmas in the pattern of opportunistic infections of the vagina and cervix in pregnant women. Voprosy Ginekologii, Akusherstva i Perinatologii (Problems of Gynecology, Obstetrics, and Perinatology). 2010; 9 (5): 5-9 (in Russian)].
- Jefferson K.K. The bacterial etiology of preterm birth. Adv. Appl. Microbiol. 2012; 80: 1-22. https://dx.doi.org/10.1016/B978-0-12-394381-1.00001-5.
- Савченко Т.Н., Макаров О.В., Алешкин В.А., Афанасьев С.С., Воропаева Е.А., Мельников А.Н., Стрыгина В.А. Нарушение микробиоценоза влагалища как фактор невынашивания беременности. Лечение и профилактика. 2012; 1: 39-43. [Savchenko T.N., Makarov O.V., Aleshkin V.A., Afanasyev S.S., Voropaeva E.A., Melnikov A.N. et al. Abnormal vaginal microbiocenosis as a factor for miscarriage. Lechenie i Profilaktika (Treatment and Prevention. 2012; 3 (23): 6-14 (in Russian)].
- Бондаренко К.Р., Доброхотова Ю.Э., Новик М.Ю. Возможности профилактики поздних акушерских осложнений путем коррекции эндогенной микробиоты. Медицинский алфавит. 2017; 3(23): 6-14. [Bondarenko K.R., Dobrokhotova Yu.E., Novik M.Yu. Possibilities for the prevention of late obstetric complications by correcting the endogenous microbiota. Meditsinskiy Alfavit (Medical Alphabet). 2017; 3 (23): 6-14. (in Russian)].
- Карапетян Т.Э., Муравьева В.В., Анкирская А.С., Любасовская Л.А, Припутневич Т.В. Возможности лечения оппортунистических инфекций влагалища во время беременности. Гинекология. 2017; 19(6): 11-5. [Karapetyan T.E., Muravyeva V.V., Ankirskaya A.S., Lyubasovskaya L.A., Priputnevich T.V. Opportunities for treating opportunistic vaginal infections during pregnancy. Ginekologiya (Gynecology). 2017; 6: 11-15. (in Russian)].
- Кира Е.Ф., Артымук Н.В., Савичева А.М., Роговская С.И., Гущин А.Е., Румянцева Т.А., Иванова О.В. Применение молочной кислоты в сочетании с гликогеном для лечения бактериального вагиноза. Гинекология. 2015; 17(2): 93-6. [Kira E.F., Artymuk N.V., Savicheva A.M., Rogovskaya S.I., Gushchin A.E., Rumyantseva T.A. et al. The use of lactic acid in combination with glycogen for the treatment of bacterial vaginosis. Ginekologiya (Gynecology). 2015; 2: 93-96. (in Russian)].
- Радзинский В.Е., Ордиянц И.М. Двухэтапная терапия вагинальных инфекций. М.: Редакция журнала StatusPraesens; 2012. 16 с. [Radzinsky V.E., Ordiyants I.M. Two-stage therapy for vaginal infections. Moscow: Redaktsiya Zhurnala StatusPraesens (Editorial Board of the Journal StatusPraesens), 2012. 16 p. (in Russian)].
- Кира Е.Ф. Пробиотики в восстановлении микробиоценоза влагалища. Акушерство и гинекология. 2017; 5: 32-8. https://dx.doi.org/10.18565/aig.2017.5.32-8.
- Кремлёва Е.А., Константинова О.Д. Состояние мукозального иммунитета влагалища при интравагинальной пробиотической терапии. Медицинский альманах. 2013; 6: 93-6. [Kremlyova E.A. The vaginal mucosal immunity status during intravaginal probiotic therapy. Meditsinskiy Almanakh (Medical Miscellany). 2013; 6 (30): 93-96. (in Russian)].
- Кира Е.Ф., Рыбальченко О.В., Орлова О.Г., Коршакова Н.Ю. Изучение активности молочной кислоты in vitro и ее значение для клинической практики в лечении инфекций влагалища. Акушерство и гинекология. 2017; 11: 84-91. https://dx.doi.org/10.18565.aig.2017.11.84-91. [Kira E.F., Rybalchenko O.V., Orlova O.G., Korshakova N.Yu. In vitro study of lactic acid activity and its significance for clinical practice in the treatment of vaginal infections. Akusherstvo i Ginekologiya (Obstetrics and Gynecology). 2017; 11: 84-91. (in Russian)]. DOI: 10.18565.aig.2017.11.84-91.
- Мелкумян А.Р., Припутневич Т.В., Анкирская А.С., Муравьева В.В., Любасовская Л.А. Влияние антибиотикотерапии на лактобациллярный состав вагинальной микробиоты. Бюллетень экспериментальной биологии и медицины. 2014; 158(12): 730-3. [Melkumyan A.R., Priputnevich T.V., Ankirskaya A.S., Muravyeva V.V., Lyubasovskaya L.A. The impact of antibiotic therapy on the Lactobacillus composition of the vaginal microbiota. Byulleten Eksperimental Biologii i Meditsiny ((Bulletin of Experimental Biology and Medicine). 2014; 158 (12): 730-3. (in Russian)].
- Petrova M.I., Lievens E., Malik S., Imholz N., Lebeer S. Lactobacillus species as biomarkers and agents that can promote various aspects of vaginal health. Front. Physiol. 2015; 6: 81. https://dx.doi.org/10.3389/fphya.2015.00081.
- Heczko P.B., Tomusiak A., Adamski P., Jakimiuk A.J., Stefanski G., Mikolajczyk-Cichonska A.M. et al. Supplementation of standard antibiotic therapy with oral probiotics for bacterial and aerobic vaginitis: a randomised, double-blind, placebo-controlled trial. BMC Women's Health. 2015; 15: 115. https://dx.doi.org/10.1186/s12905-015-0246-6.
- Bohbot J., Daraï E., Bretelle F., Brami G., Daniel C., Cardot J. Efficacy and safety of vaginally administered lyophilized Lactobacillus crispatus IP 174178 in the prevention of bacterial vaginosis recurrence. J. Gynecol. Obstet. Hum. Reprod. 2017; 47(2): 81-6. https://dx.doi.org/10.1016/j.jogoh.2017.11.005.
- Homayouni A., Bastani P., Ziyadi S., Mohammed-Alizadeh-Charandabi S., Ghalibag M., Mortazavian A.M., Mehrabany EV. Effects of probiotics on the recurrence of bacterial vaginosis: a review. J. Low. Genit. Tract Dis. 2014; 18(1): 79-86. https://dx.doi.org/10.1097/LGT.0b013e31829156ec.
- Recine N., Palma E., Domenici L., Giorgini M., Imperiale L., Sassu C. et al. Restoring vaginal microbiota: biological control of bacterial vaginosis. A prospective case- control study using Lactobacillus rhamnosus BMX 54 as adjuvant treatment against bacterial vaginosis. Arch. Gynecol. Obstet. 2016; 293(1): 101-7. https://dx.doi.org/10.1007/s00404-015-3810-2.
- Witkin S.S., Alvi S., Bongiovanni A.M., Linhares I.M., Ledger D.J. Lactic acid stimulates interleukin-23 production by peripheral blood mononuclear cells exposed to bacterial lipopolysaccharide. FEMS Immunol. Med. Microbiol. 2011; 61(2):153-8. https://dx.doi.org/10.1111/j.1574-695X.2010.00757.x.
Received 30.12.2019
Accepted 07.02.2020
About the Authors
Valentina F. Dolgushina, MD, professor, Head of Obstetrics and Gynaecology Department, South Ural State Medical University.Tel.: +7(351)232-74-82, E-mail: dolgushinavf@yandex.ru. 64 Vorovskogo str., Chelyabinsk, 454092, Russian Federation.
Yulia S. Shishkova, MD, Associate professor, professor in Microbiology, Virology, Immunology and Clinical Laboratory Diagnostics Department, South Ural State Medical University. Tel.: +7(351)232-74-82, E-mail: shishkova_yulia@mail.ru.
64 Vorovskogo str., Chelyabinsk, 454092, Russian Federation.
Elena D. Grafova, assistant in Obstetrics and Gynecology Department, South Ural State Medical University.
Tel.: +7(909)075-31-18. E-mail: grafovaed@yandex.ru.
64 Vorovskogo str., Chelyabinsk, 454092, Russian Federation.
Ilona V. Kurnosenko, MD, Associate professor, professor in Obstetrics and Gynecology Department, South Ural State Medical University.
Tel.: +7(351)232-74-82. E-mail: kurnosenlo_ilona@mail.ru. 64 Vorovskogo str., Chelyabinsk, 454092, Russian Federation.
For reference: Dolgushina V.F., Shishkova Yu.S., Grafov E.D., Kurnosenko I.V. Differentiated correction of vaginal microbiocenosis in women with nonspecific
cervicovaginitis in the first pregnancy trimester
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 5: 139-143 (In Russian).
https://dx.doi.org/10.18565/aig.2020.5.139-143
Similar Articles
