The role of abnormal vaginal microbiocenosis in increasing the risk of adverse reproductive outcome

DOI: https://doi.org/10.29296/25877305-2023-01-11
Issue: 
1
Year: 
2023

A. Megrabyan(1), Professor I. Ignatko(1), MD, Corresponding Member of the Russian Academy of Sciences ; D. Yakubova(1),Sh. Baibulatova(2)
1-I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
2-Clinical Hospital Four, Groznyi

Objective. To study vaginal microbiocenosis in pregnant women with poor perinatal outcome to determine the relationship between different types of perinatal infections and stillbirths. Subjects and methods. A retrospective study was conducted in 154 pregnant women divided into groups: a study group of 114 patients with antenatal fetal death at 22 weeks’ gestation; a control group of 40 patients with physiological pregnancy at the same time. Results. The patients in both groups were found to have statistically significant abnormal vaginal flora: coagulase-negative Staphylococcus (41.2%), Enterococcus faecalis (29.4%), Escherichia coli (44.1%), Staphylococcus aureus (11.1%), Klebsiella pneumoniae (12.9%), and Candida albicans (28.8%). At the same time, these abnormalities statistically significantly more commonly occurred in the study group. Conclusion. Of great importance is the determination of vaginal opportunistic pathogens in the prevention of adverse perinatal outcomes.

Keywords: 
obstetrics and gynecology
intrauterine infections
antenatal fetal death
adverse perinatal outcomes.



References: 
  1. Liu L., Johnson H.L., Cousens S. et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 2012; 379 (9832): 2151–61. DOI: 10.1016/S0140-6736(12)60560-1
  2. Oestergaard M.Z., Inoue M., Yoshida S. et al. Neonatal mortality levels for 193 countries in 2009 with trends since 1990: a systematic analysis of progress, projections, and priorities. PLoS Med. 2011; 8 (8): e1001080. DOI: 10.1371/journal.pmed.1001080
  3. World Health Organization (2012) Global Burden of Disease Regions used for WHO-CHOICE Analyses. Available: http://www.who.int/choice/demography/regions/en/
  4. Синякова А.А., Шипицына Е.В., Будиловская О.В. и др. Клинико-анамнестические и микробиологические предикторы невынашивания беременности. Журнал акушерства и женских болезней. 2019; 68 (2): 59–70 [Sinyakova A.A., Shipitsyna E.V., Budilovskaya O.V. et al. Anamnestic and microbiological predictors of miscarriage. Journal of Obstetrics and Women's Diseases. 2019; 68 (2): 59–70 (in Russ.)]. DOI: 10.17816/JOWD68259-70
  5. Canadian Guidelines on Sexually Transmitted Infections – Management and treatment of specific syndromes – Pelvic Inflammatory Disease (PID), 2016.
  6. Workowski K.A., Berman S. Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010; 59: 1–110.
  7. Etyang A.K., Omuse G., Mukaindo A.M. et al. Maternal inflammatory markers for chorioamnionitis in preterm prelabour rupture of membranes: a systematic review and meta-analysis of diagnostic test accuracy studies. Syst Rev. 2020; 9 (1): 141. DOI: 10.1186/s13643-020-01389-4
  8. Tyutyunnik V.L., Kan N.E., Lomova N.A. et al. Role of innate immunity in pregnant patients with vulvovaginal infections in the development of intrauterine infection in the newborn. Bull Exp Biol Med. 2014; 158 (1): 74–6. DOI: 10.1007/s10517-014-2695-6
  9. Радзинский В.Е., Петров Ю.А., Полина М.Л. Хронический эндометрит: современные аспекты. Кубанский научный медицинский вестник. 2017; 5: 69–74 [Radzinsky V.E., Petrov Yu.A., Pоlina M.L. Chronic endometritis: current aspects. Kuban Scientific Medical Bulletin. 2017; 5: 69–74 (in Russ.)]. DOI: 10.25207/1608-6228-2017-24-5-69-74
  10. Hitti J., Garcia P., Totten P. et al. Correlates of cervical Mycoplasma genitalium and risk of preterm birth among Peruvian women. Sex Transm Dis. 2010; 37 (2): 81–5. DOI: 10.1097/OLQ.0b013e3181bf5441
  11. Houben M.L., Nikkels P.G.J., van Bleek G.M. et al. The association between intrauterine inflammation and spontaneous vaginal delivery at term: a cross-sectional study. PLoS One. 2009; 4 (8): e6572. DOI: 10.1371/journal.pone.0006572
  12. Kacerovský M. and Boudyš L. Preterm premature rupture of membranes and Ureaplasma urealyticum. Ceska Gynekol. 2008; 73 (3): 154–9.
  13. Oh K.J., Lee S.E., Jung H. et al. Detection of Ureaplasmas by the polymerase chain reaction in the amniotic fluid of patients with cervical insufficiency. J Perinat Med. 2010; 38 (3): 261–8. DOI: 10.1515/jpm.2010.040
  14. Kacerovský M., Pavlovský M., Tosner J. Preterm premature rupture of the membranes and genital mycoplasmas. Acta Medica (Hradec Kralove). 2009; 52 (3): 117–20. DOI: 10.14712/18059694.2016.115
  15. Kapatais-Zoumbos K., Chandler D.K.F., Barile M.F. Survey of immunoglobulin A protease activity among selected species of Ureaplasma and mycoplasma: specificity for host immunoglobulin A. Infect Immun. 1985; 47 (3): 704–9. DOI: 10.1128/iai.47.3.704-709.1985
  16. Kasper D.C., Mechtler T.P., Reischer G.H. et al. The bacterial load of Ureaplasma parvum in amniotic fluid is correlated with an increased intrauterine inflammatory response. Diagn Microbiol Infect Dis. 2010; 67 (2): 117–21. DOI: 10.1016/j.diagmicrobio.2009.12.023
  17. Lee S.E., Romero R., Kim E.-C. et al. A high Nugent score but not a positive culture for genital mycoplasmas is a risk factor for spontaneous preterm birth. J Matern Fetal Neonatal Med. 2009; 22 (3): 212–7. DOI: 10.1080/14767050802616994
  18. McGowin C.L., Spagnuolo R.A., Pyles R.B. Mycoplasma genitalium rapidly disseminates to the upper reproductive tracts and knees of female mice following vaginal inoculation. Infect Immun. 2010; 78 (2): 726–36. DOI: 10.1128/IAI.00840-09
  19. Kataoka S., Yamada T., Chou K. et al. Association between preterm birth and vaginal colonization by mycoplasmas in early pregnancy. J Clin Microbiol. 2006; 44 (1): 51–5. DOI: 10.1128/JCM.44.1.51-55.2006