About
The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
ArchiveEthical StandardsSubscription
For authors
InstructionsInformed consent policyContract offerEASE GuidelinesICJME CriteriaWAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications
Reviewing
About
The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
ArchiveEthical StandardsSubscription
For authors
InstructionsInformed consent policyContract offerEASE GuidelinesICJME CriteriaWAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications
Reviewing
Logout
Obstetrics and Gynegology2019№2
Risk for miscarriage and premature...

Risk for miscarriage and premature birth in women with HPV infection and recurrent vaginal dysbiosis

DOI
https://dx.doi.org/10.18565/aig.2019.2.135-142

Bebneva T.N., Dikke G.B.

1 Peoples’ Friendship University of Russia, Ministry of Education and Science, Moscow, Russia; 2 F.I. Inozemtsev Academy of Medical Education, Saint Petersburg, Russia
Objective. To determine the rate and risk of miscarriage and preterm birth (PB) and to evalute the effect of progesterone in reducing the risk of PB in women with human papillomavirus (HPV) and recurrent dysbiosis.
Subjects and methods. The investigation enrolled 170 pregnant women (145 of them had HPV and recurrent vaginal dysbiosis). Group 1 (n = 36) took an antiseptic; Group 2 (n = 41) received an antiseptic and a probiotic. A control group (n = 25) had neither HPV nor dysbiosis. Sixty-eight patients used micronized progesterone. The strength of an association between variables (Cramer’s V coefficient) was analyzed.
Results. The rate of PB and late miscarriages was 24.7% and was strongly associated with the absence of effect of treatment for dysbiosis (VC = 0.7) and with the presence of recurrences (VC = 0.5). Micronized progesterone could reduce the rate of PB by 70% (OR = 0.3; 95% CI, 0.07-0.8; p = 0.02).
Conclusion. Pregnancy in the presence of HPV and recurrent dysbiosis is associated with a high risk of miscarriage and PB. The use of micronized progesterone reduces the rate of PB.

Keywords

human papillomavirus
dysbiosis
premature birth
spontaneous miscarriages
antiseptics
probiotics
progesterone
Full text (in Russian)

References

  1. Domža G., Gudlevičienė Z., Didžiapetrienė J., Valuckas K.P., Kazbarienė B., Drąsutienė G. Human papillomavirus infection in pregnant women. Arch. Gynecol. Obstet. 2011; 284(5): 1105-12. doi: 10.1007/S00404-010-1787-4.
  2. Xiong Y.Q., Mo Y., Luo Xiong Q.M., Huo S.T., He W.Q., Chen Q. The risk of human papillomavirus infection for spontaneous abortion, spontaneous preterm birth, and pregnancy rate of assisted reproductive technologies: a systematic review and meta-analysis. Gynecol. Obstet. Invest. 2018; 83(5): 417-27. doi: 10.1159/000482008.
  3. Дикке Г.Б. Полимикробные ассоциации в этиологии воспалительных заболеваний половых органов у женщин. Акушерство и гинекология. 2017; 6: 151-8. [Dikke G.B. Polymicrobial associations in the etiology of inflammatory diseases of the genital organs in women. Akusherstvo i ginekologiya / Obstetrics and Gynecology. 2017; 6: 151-8 (in Russian)].
  4. Хрянин А.А., Решетников О.В. Бактериальный вагиноз. Новые представления о микробном биосоциуме и возможности лечения. Медицинский совет. 2014; 17: 128-32. [Khryanin A.A., Reshetnikov O.V. Bacterial vaginosis. New ideas about the microbial biosocial and treatment options. Meditsinskiy sovet / Medical advice. 2014; 17: 128-32 (in Russian)]. DOI: 10.21518/2079-701X-2014-17-128-133.
  5. Jain R. Role of bacterial vaginosis in preterm labor - a prospective study. Int. J. Med. Res. Rev. 2016; 4(4): 543-9. doi: 10.17511/ijmrr.2016.i04.12.
  6. Donders G., Van Calsteren C., Bellen G., Reybrouck R., Van den Bosch T., Riphagen I., Van Lierde S. Association between abnormal vaginal flora and cervical length as risk factors for preterm birth. Ultrasound Obstet. Gynecol. 2010; Jan 26. doi: 10.1002/uog.7568.
  7. Nygren P., Fu R., Freeman M., Bougatsos C., Klebanoff M., Guise J.M. Evidence on the benefits and harms of screening and treating pregnant women who are asymptomatic for bacterial vaginosis: an update review for the U.S. Preventive Services Task Force. Ann. Intern. Med. 2008; 148(3): 220-33.
  8. Серов В.Н., Сухорукова О.И. Профилактика преждевременных родов. РМЖ. 2014; 22(1): 3-6. [Serov V.N., Sukhorukova O.I. Prevention of preterm labor. Rus honey. journals Mother and Child. 2014; 22 (1): 3-6. (in Russian)].
  9. Государственный реестр лекарственных средств. Инструкции по медицинскому применению препаратов. [State Register of Medicines. Instructions for the medical use of the drugss (in Russian)]. Available at: https://grls.rosminzdrav.ru/grls.aspx
  10. Nayar R., Wilbur D.С., eds. The Bethesda system for reporting cervical cytology, definitions, criteria, and explanatory notes. 3rd ed. Springer; 2015. 321р. doi: 10.1007/978-3-319-11074-5.
  11. Gupta A., Garg P., Nigam S. Bacterial vaginosis in pregnancy (<28weeks) and its effect on pregnancy outcome: a study from a western up city. Ind. J. Clin. Pract. 2013; 23(11): 740-4. doi: 10.5958/2394-2754.2016.00021.7.
  12. Кузьмин В.Н., Мурриева Г.А. Роль неспецифических урогенитальных инфекций в патогенезе самопроизвольных преждевременных родов. Лечащий врач. 2013; 6: 60-2. [Kuzmin V.N., Murrieva G.A. The role of non-specific urogenital infections in the pathogenesis of spontaneous preterm labor. Attending doctor. 2013; 6: 60-2. (in Russian)].
  13. Савельева Г.М., Шалина Р.И. Преждевременные роды (диагностика, тактика ведения). Акушерство и гинекология. Новости, мнения, обучения. 2015; 1: 31-9. [Savelieva G.M., Shalina R.I. Preterm labor (diagnosis, management tactics). Obstetrics and Gynecology: News. Opinions. Learning 2015; 1 (7): 31-9. (in Russian)].
  14. Савельева Г.М., Шалина Р.И., Курцер М.А., Клименко П.А., Сичинава Л.Г., Панина О.Б., Плеханова Е.Р., Выхристюк Ю.В., Лебедев Е.В. Преждевременные роды как важнейшая проблема современного акушерства. Акушерство и гинекология. 2012; 8-2: 4-10. [Savelyeva G.M., Shalina R.I., Kurtser M.A., Klymenko P.A., Sichinava L.G., Panina O.B. and others. Preterm birth as the most important problem of modern obstetrics. Obstetrics and gynecology. 2012; 8-2: 4-10.(in Russian)].
  15. Badshaw C.S., Brotman R.M. Making inroads into improving treatment of bacterial vaginosis – striving for long-term cure. BMC Infectious Diseases. 2015; 15: 292. doi: 10.1186/s12879-015-1027-4.
  16. Tielsch J.M. Global incidence of preterm birth. Nestle Nutr. Inst. Workshop Ser. 2015; 81: 9-15. doi: 10.1159/000365798.
  17. McNamee K.M., Dawood F., Farquharson R.G. Mid-trimester pregnancy loss. Obstet. Gynecol. Clin. North Am. 2014; 41(1): 87-102. doi: 10.1016/j.ogc.2013.10.007.
  18. Romero R., Nicolaides K., Conde-Agudelo A., Tabor A., O’Brien J.M., Cetingoz E. et al. Vaginal progesterone in women with an asymptomatic sonographic shot cervix in the midtrimester deceases preterm delivery and neonatal morbidity: a systematic review and meta-analysis of individual patient data. Am. J. Obstet. Gynecol. 2012; 206(2): 124. e1-19. doi: 10.1016/j.ajog.2011.12.003.
  19. Brocklehurst P., Gordon A., Heatley E., Milan S.J. Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database Syst. Rev. 2013; (1): CD000262. doi: 10.1002/14651858.CD000262.pub4.
  20. Niyibizi J., Zanré N., Mayrand M.H., Trottier H. The association between adverse pregnancy outcomes and maternal human papillomavirus infection: a systematic review protocol. Syst. Rev. 2017; 6(1): 53. doi: 10.1186/s13643-017-0443-5.
  21. Kwon J.Y., Romero R., Mor G. New insights into the relationship between viral infection and pregnancy complications. Am. J. Reprod. Immunol. 2014; 71(5): 387-90. doi: 10.1111/aji.12243.
  22. Zuo Z., Goel S., Carter J.E. Association of cervical cytology and HPV DNA status during pregnancy with placental abnormalities and preterm birth. Am. J. Clin. Pathol. 2011; 136(2): 260-5. doi: 10.1309/AJCP93JMIUEKRPIW.
  23. Gomez-Lopez N., StLouis D., Lehr M.A., Sanchez-Rodriguez E.N., Arenas-Hernandez M. Immune cells in term and preterm labor. Cell. Mol. Immunol. 2014; 11(6): 571-81. doi: 10.1038/cmi.2014.46.
  24. Ходжаева З.С., Федотовская О.И., Донников А.Е. Клинико-анамнестические особенности женщин с идиопатическими преждевременными родами на примере славянской популяции. Акушерство и гинекология. 2014; 3: 28-32. [Khodjaeva Z.S., Fedotovskaya OI, Donnikov A.E. Clinical and anamnestic features of women with idiopathic preterm labor using the example of the Slavic population. Obstetrics and gynecology. 2014; 3: 28-32.(in Russian)].
  25. Assefa N.E., Berhe H., Girma F., Berhe K., Berhe Y.Z., Gebreheat G. et al. Risk factors of premature rupture of membranes in public hospitals at Mekele city, Tigray, a case control study. BMC Pregnancy Childbirth. 2018; 18(1): 386. doi: 10.1186/s12884-018-2016-6.
  26. Choudhary M., Rathore S.B., Chowdhary J., Garg S. Pre and post conception risk factors in PROM. Int. J. Res. Med. Sci. 2017; 3(10): 2594-8. doi: 10.18203/2320-6012.ijrms20150797.
  27. Сухих Г.Т., Серов В.Н., Адамян Л.В., Филиппов О.С., Баев О.Р., Клименченко Н.И., Тетруашвили Н.К., Тютюнник В.Л., Ходжаева З.С., Холин А.М. Преждевременные роды. Клинические рекомендации (протокол). М.; 2014. 35с. [Preterm birth. Clinical recommendations (protocol). The team of authors. M., 2014. 35 p. (in Russian)].
  28. Workowski K.A., Berman S.; Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm. Rep. 2010; 59(RR-12): 1-110. Available at:http://www.cdc.gov
  29. Dodd J.M., Flenady V., Cincotta R., Crowther C.A. Prenatal administration of progesterone for preventing PTB. Cochrane Database Syst. Rev. 2006; (1): CD004947. doi: 10.1002/14651858.CD004947.pub2.
  30. Vaginal Micronized Progesterone Capsules for the Prevention of Miscarriage and Preterm Birth: A Review of the Clinical Evidence. Rapid Response Report: Summary with Critical Appraisal Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2014; Apr 28.
  31. Ходжаева З.С., Дембовская С.В., Доброхотова Ю.Э., Сичинава Л.Г., Юзько А.М., Мальцева Л.И., Серова О.Ф., Макаров И.О., Ахмадеева Э.Н., Башмакова Н.В., Шмаков Р.Г., Клименченко Н.И., Муминова К.Т., Талибов О.Б., Сухих Г.Т. Медикаментозная профилактика преждевременных родов (результаты международного многоцентрового открытого исследования МИСТЕРИ). Акушерство и гинекология. 2016; 8: 37-43. doi: 10.18565/aig.2016.8.37-43
  32. Савельева Г.М., Аксененко В.А., Андреева М.Д., Базина М.И., Башмакова Н.В., Боровкова Л.В., Брюхина Е.В., Буштырева И.О., Волков В.Г., Гурьев Д.Л., Данькова И.В., Доброхотова Ю.Э., Егорова А.Т., Иванова Т.В., Константинова О.Д., Коротких И.Н., Кравченко Е.Н., Крамарский В.А., Кулешов В.М., Лебеденко Е.Ю. и др. Исходы второй половины беременности у пациенток с привычным выкидышем в анамнезе (результаты многоцентрового исследования ТИРСТАН-2). Акушерство и гинекология. 2018; 8: 111-20. [Savelieva G.M., Aksenenko V.A., Andreeva M.D., Bazina M.I., Bashmakova N.V., Borovkova L.V. and others. Outcomes of the second half of pregnancy in patients with a habitual miscarriage in the anamnesis (the results of a multicenter study TIRSTAN-2). Obstetrics and gynecology. 2018; 8: 111-20. (in Russian)]. DOI: 10.18565/aig.2018.8.111-121.
  33. Hassan S.S., Romero R., Vidyadhari D., Fusey S., Baxter J.K., Khandelwal M. et al. Vaginal progesterone reduces the rate of preterm birth in omen with a sonographic short cervix: a multicenter, randomized, double-blind, placebo-controlled trial. Ultrasound Obstet. Gynecol. 2011; 38(1): 18-31. doi: 10.1002/uog.9017.
  34. Choi S.J. Use of progesterone supplement therapy for prevention of preterm birth: review of literatures. Obstet. Gynecol. Sci. 2017; 60(5): 405-20. doi: 10.5468/ogs.2017.60.5.405.

Received 27.12.2018

Accepted 22.02.2019

About the Authors

Bebneva, Tamara N., PhD, associate professor, Department of Obstetrics, Gynecology and Reproductive Medicine, Faculty of Advanced Training for Medical Professionals
of the Medical Institute, Peoples’ Friendship University of Russia; doctor, National Medical Research Center of Endocrinology of the Ministry of Health of Russia.
117198, Russia, Moscow, Miklukho-Maklaya str. 21, bldg. 3.Tel.: +79165181964. E-mail: bebn@mail.ru. ORCID.org/0000-0003-1095-2008.
Dikke, Galina B., MD, associate professor, professor of the Department of Obstetrics and Gynecology with a course of reproductive medicine,
Private Educational Institution «Academy of Medical Education named F.I. Inozemtsev», St. Petersburg.
190013, Russia, St. Petersburg, Moscow Ave str. 22, letter M. Tel.: +78123347650. E-mail: galadikke@yandex.ru. ORCID.org 0000-0001-9524-8962.

For reference: Bebneva T.N., Dikke G.B. Risk for miscarriage and premature birth in women with HPV infection and recurrent vaginal dysbiosis. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2019; (2): (in Russian)
http://dx.doi.org/10.18565/aig.2019.2.
By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.