Placental inflammatory changes and their association with the vaginal microbiota before delivery

2021 ◽  
Vol 70 (1) ◽  
pp. 59-68
Author(s):  
Dzhamilya G. Dadayeva ◽  
Alexandra K. Sosnina ◽  
Tatyana G. Tral ◽  
Gulrukhsor Kh. Tolibova ◽  
Olga V. Budilovskaya ◽  
...  
Keyword(s):  
Histological Examination ◽  
Vaginal Discharge ◽  
Vaginal Microbiota ◽  
Amniotic Cavity ◽  
Membrane Rupture ◽  
Opportunistic Bacteria ◽  
Prolonged Labor ◽  
Adverse Pregnancy ◽  
Prelabor Rupture Of Membranes ◽  
Inflammatory Changes

Hypothesis/aims of study: Infection of the amniotic cavity and placenta is one of the leading causes of adverse pregnancy outcomes. In the majority of cases, intra-amniotic infection is associated with the normal microbiota of the lower urogenital tract. The aim of the study was to explore the relationships between the placental inflammatory changes, vaginal microbiota and labor course. Study design, materials and methods: We examined 124 women at 37-41 weeks of gestation. The vaginal discharge at admission was taken for microbiological evaluation, with the delivered placenta sent for histological examination. Results: In 17.7% of cases, histological examination of the placenta revealed inflammatory changes. A statistically significant correlation was noted between the placental inflammatory changes and Staphylocossus spp. presence in the vaginal discharge at admission (р = 0.0004). The placental inflammatory changes were associated with the membrane rupture to delivery interval more than 6 hours (р = 0.01) and the labor duration more than 7 hours (р = 0.0004). Prelabor rupture of membranes did not significantly affect the placental inflammatory changes (p = 1.0). Conclusion: Predisposing factors for the development of ascending bacterial infection of the placenta are an abnormal vaginal microbiota with the presence of opportunistic bacteria before delivery, a long membrane rupture to delivery interval, and a prolonged labor.

scholarly journals Microbial burden and inflammasome activation in amniotic fluid of patients with preterm prelabor rupture of membranes

2020 ◽  
Vol 48 (2) ◽  
pp. 115-131 ◽  
Author(s):  
Kevin R. Theis ◽  
Roberto Romero ◽  
Kenichiro Motomura ◽  
Jose Galaz ◽  
Andrew D. Winters ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Ribosomal Rna ◽  
Preterm Labor ◽  
Rrna Gene ◽  
Inflammasome Activation ◽  
Amniotic Cavity ◽  
Valuable Complement ◽  
Polymerase Chain ◽  
Adverse Pregnancy ◽  
Prelabor Rupture Of Membranes

Abstract Background Intra-amniotic inflammation, which is associated with adverse pregnancy outcomes, can occur in the presence or absence of detectable microorganisms, and involves activation of the inflammasome. Intra-amniotic inflammasome activation has been reported in clinical chorioamnionitis at term and preterm labor with intact membranes, but it has not yet been investigated in women with preterm prelabor rupture of membranes (preterm PROM) in the presence/absence of detectable microorganisms. The aim of this study was to determine whether, among women with preterm PROM, there is an association between detectable microorganisms in amniotic fluid and intra-amniotic inflammation, and whether intra-amniotic inflammasome activation correlates with microbial burden. Methods Amniotic fluids from 59 cases of preterm PROM were examined for the presence/absence of microorganisms through culture and 16S ribosomal RNA (rRNA) gene quantitative real-time polymerase chain reaction (qPCR), and concentrations of interleukin-6 (IL-6) and ASC [apoptosis-associated spec-like protein containing a caspase recruitment domain (CARD)], an indicator of inflammasome activation, were determined. Results qPCR identified more microbe-positive amniotic fluids than culture. Greater than 50% of patients with a negative culture and high IL-6 concentration in amniotic fluid yielded a positive qPCR signal. ASC concentrations were greatest in patients with high qPCR signals and elevated IL-6 concentrations in amniotic fluid (i.e. intra-amniotic infection). ASC concentrations tended to increase in patients without detectable microorganisms but yet with elevated IL-6 concentrations (i.e. sterile intra-amniotic inflammation) compared to those without intra-amniotic inflammation. Conclusion qPCR is a valuable complement to microbiological culture for the detection of microorganisms in the amniotic cavity in women with preterm PROM, and microbial burden is associated with the severity of intra-amniotic inflammatory response, including inflammasome activation.

scholarly journals Neonatal Survivability following Previable PPROM after Hospital Readmission for Intervention

2020 ◽  
Vol 10 (04) ◽  
pp. e395-e402
Author(s):  
Felicia LeMoine ◽  
Robert C. Moore ◽  
Andrew Chapple ◽  
Ferney A. Moore ◽  
Elizabeth Sutton
Keyword(s):  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Intensive Care Unit Discharge ◽  
Expectant Management ◽  
Antibiotic Administration ◽  
Tertiary Referral Center ◽  
Membrane Rupture ◽  
South Central ◽  
Prelabor Rupture Of Membranes ◽  
Latency Duration

Abstract Objective To describe our hospital's experience following expectant management of previable preterm prelabor rupture of membranes (pPPROM). Study Design Retrospective review of neonatal survival and maternal and neonatal outcomes of pPPROM cases between 2012 and 2019 at a tertiary referral center in South Central Louisiana. Regression analyses were performed to identify predictors of neonatal survival. Results Of 81 cases of pPPROM prior to 23 weeks gestational age (WGA), 23 survived to neonatal intensive care unit discharge (28.3%) with gestational age at rupture ranging from 180/7 to 226/7 WGA. Increased latency (adjusted odds ratio [aOR] = 1.30, 95% confidence interval [CI] = 1.11, 1.52) and increased gestational age at rupture (aOR = 1.62, 95% CI = 1.19, 2.21) increased the probability of neonatal survival. Antibiotics prior to delivery were associated with increased latency duration (adjusted hazard ratio = 0.55, 95% CI = 0.42, 0.74). Conclusion Neonatal survival rate following pPPROM was 28.3%. Later gestational age at membrane rupture and increased latency periods are associated with increased neonatal survivability. Antibiotic administration following pPPROM increased latency duration.

scholarly journals CONDITION OF FETOPLACENTIAL COMPLEX IN PATIENTS AFTER APPLICATION OF ART

2020 ◽  
pp. 7-13
Author(s):  
S.Sh. Issenova ◽  
G.Zh. Bodykov ◽  
A.S. Shukirbaeva ◽  
M.O. Kubesova ◽  
L. Ziyat ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiac Surgery ◽  
Retrospective Analysis ◽  
Histological Examination ◽  
The State ◽  
Placental Insufficiency ◽  
Archival Material ◽  
Spontaneous Pregnancy ◽  
Comparative Group ◽  
Inflammatory Changes

A retrospective analysis was carried out according to the archival material of the center of perinatology and pediatric cardiac surgery in Almaty for 2017-2018. The analysis was carried out in 2 groups: the main group - 250 histories of women giving birth after IVF and the comparative group - 250 histories of women giving birth to spontaneous pregnancy. The condition of the feto-placental complex was assessed by studying the data of ultrasound, Dopplerometry, CTG, histological examination. The study shows that in women after the use of ART, the absence of pronounced blood flow disorders in the mother-placenta-fetus system according to Dopple-rometry is important and significant, which contributes to the favorable course of pregnancy and the state of the fetus, as well as the presence of morphological signs of placental insufficiency in 68% of cases inflammatory changes in the placenta in 57% of cases of varying severity.

The value of vaginal lactobacilli in the restoration of vaginal microbiocenosis in women in the early postpartum period, depending on the method of delivery

2021 ◽  
Vol 70 (4) ◽  
pp. 15-23
Author(s):  
Dzhamilya G. Dadayeva ◽  
Olga V. Budilovskaya ◽  
Anna A. Krysanova ◽  
Tatyana A. Khusnutdinova ◽  
Alevtina M. Savicheva ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Postpartum Period ◽  
Vaginal Discharge ◽  
Vaginal Microbiota ◽  
Clinical Material ◽  
Birth Canal ◽  
Early Postpartum Period ◽  
Vaginal Microflora ◽  
Early Postpartum ◽  
Before And After

BACKGROUND: Despite numerous studies of the vaginal microbiota, there is still a lack of knowledge regarding its restoring dynamics in the early postpartum period. The condition of the vaginal microflora during pregnancy plays a key role in maintaining the physiological microbiocenosis of the birth canal and creating conditions for the normal course of pregnancy, the establishment of an infants intestinal microbiota, and the further development of the child. AIM: The aim of this study was to estimate the role of certain types of lactobacilli in restoring the vaginal microbiota in women in the early postpartum period, depending on the method of delivery. MATERIALS AND METHODS: We examined 150 women at 38-41 weeks of gestation. The clinical material for the study was vaginal discharge before and after delivery. To determine the species of lactobacilli and other microorganisms in the clinical material, we used quantitative real-time PCR. RESULTS: Before delivery, lactobacilli were found in vaginal discharge in 144 out of 150 women (96.0%), their number in the majority being more than 106 GE. In the postpartum period, lactobacilli were found in 66/128 (51.5%) cases, while prevailing in women after vaginal delivery in 50/65 (76.9%) cases (4.61.6, p = 0.000000). Among the dominant species of lactobacilli was L. crispatus, found in vaginal discharge before delivery, which most often affects the recovery of the vaginal microbiota in the postpartum period (29 out of 61 women, 47.5%). L. iners detected in the lochia predisposes to the violation of uterine involution in the early postpartum period (p = 0.03). CONCLUSIONS: Normal vaginal microbiota in the postpartum period is restored more quickly in women after vaginal delivery. Our study confirms that L. crispatus and L. iners play a major role in restoring the vaginal microbiota in the postpartum period.

scholarly journals Lactobacillus iners Is Associated with Vaginal Dysbiosis in Healthy Pregnant Women: A Preliminary Study

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Nengneng Zheng ◽  
Renyong Guo ◽  
Yinyu Yao ◽  
Meiyuan Jin ◽  
Yiwen Cheng ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Vaginal Microbiota ◽  
Second Trimester ◽  
Premature Rupture Of Membranes ◽  
Third Trimester ◽  
Premature Rupture ◽  
Significant Difference ◽  
Bacterial Marker ◽  
Preliminary Study ◽  
Adverse Pregnancy

Vaginal dysbiosis has been identified to be associated with adverse pregnancy outcomes, such as preterm delivery and premature rupture of membranes. However, the overall structure and composition of vaginal microbiota in different trimesters of the pregnant women has not been fully elucidated. In this study, the physiological changes of the vaginal microbiota in healthy pregnant women were investigated. A total of 83 healthy pregnant participants were enrolled, who are in the first, second, or third pregnancy trimester. Quantitative real-time PCR was used to explore the abundant bacteria in the vaginal microbiota. No significant difference in the abundance of Gardnerella, Atopobium, Megasphaera, Eggerthella, Leptotrichia/Sneathia, or Prevotella was found among different trimesters, except Lactobacillus. Compared with the first pregnancy trimester, the abundance of L. iners decreased in the second and third trimester while the abundance of L. crispatus was increased in the second trimester. Moreover, we also found that vaginal cleanliness is correlated with the present of Lactobacillus, Atopobium, and Prevotella and leukocyte esterase is associated with Lactobacillus, Atopobium, Gardnerella, Eggerthella, Leptotrichia/Sneathia, and Prevotella. For those whose vaginal cleanliness raised or leukocyte esterase became positive, the richness of L. iners increased, while that of L. crispatus decreased significantly. Our present data indicated that the altered vaginal microbiota, mainly Lactobacillus, could be observed among different trimesters of pregnancy and L. iners could be considered as a potential bacterial marker for evaluating vaginal cleanliness and leukocyte esterase.

scholarly journals Efficacy of Rifaximin Vaginal Tablets in Treatment of Bacterial Vaginosis: a Molecular Characterization of the Vaginal Microbiota

2012 ◽  
Vol 56 (8) ◽  
pp. 4062-4070 ◽  
Author(s):  
Federica Cruciani ◽  
Patrizia Brigidi ◽  
Fiorella Calanni ◽  
Vittoria Lauro ◽  
Raffaella Tacchi ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Denaturing Gradient Gel Electrophoresis ◽  
Vaginal Microbiota ◽  
Controlled Study ◽  
Double Blind ◽  
Content Type ◽  
Sexually Transmitted ◽  
Gradient Gel Electrophoresis ◽  
Adverse Pregnancy ◽  
The Impact

ABSTRACTBacterial vaginosis (BV) is a common vaginal disorder characterized by an alteration of the vaginal bacterial morphotypes, associated with sexually transmitted infections and adverse pregnancy outcomes. The purpose of the present study was to evaluate the impact of different doses of rifaximin vaginal tablets (100 mg/day for 5 days, 25 mg/day for 5 days, and 100 mg/day for 2 days) on the vaginal microbiota of 102 European patients with BV enrolled in a multicenter, double-blind, randomized, placebo-controlled study. An integrated molecular approach based on quantitative PCR (qPCR) and PCR-denaturing gradient gel electrophoresis (PCR-DGGE) was used to investigate the effects of vaginal tablets containing the antibiotic. An increase in members of the genusLactobacillusand a decrease in the BV-related bacterial groups after the antibiotic treatment were demonstrated by qPCR. PCR-DGGE profiles confirmed the capability of rifaximin to modulate the composition of the vaginal microbial communities and to reduce their complexity. This molecular analysis supported the clinical observation that rifaximin at 25 mg/day for 5 days represents an effective treatment to be used in future pivotal studies for the treatment of BV.

scholarly journals Oligohydramnios in Women with Preterm Prelabor Rupture of Membranes and Adverse Pregnancy and Neonatal Outcomes

PLoS ONE ◽  
2014 ◽  
Vol 9 (8) ◽  
pp. e105882 ◽  
Author(s):  
Marian Kacerovsky ◽  
Ivana Musilova ◽  
Ctirad Andrys ◽  
Marcela Drahosova ◽  
Helena Hornychova ◽  
...  
Keyword(s):  
Neonatal Outcomes ◽  
Adverse Pregnancy ◽  
Prelabor Rupture Of Membranes

scholarly journals Criteria for diagnosis of bacterial vaginosis using the test Femoflor-16

2017 ◽  
Vol 66 (4) ◽  
pp. 57-67 ◽  
Author(s):  
Veronika V. Nazarova ◽  
Elena V. Shipitsyna ◽  
Ekaterina N. Gerasimova ◽  
Alevtina M. Savicheva
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Bacterial Load ◽  
Anaerobic Bacteria ◽  
Microscopic Investigation ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Nugent Score ◽  
Adverse Pregnancy ◽  
Amsel Criteria

Background. Bacterial vaginosis is disturbance of the balance of the vaginal microflora, associated with a number of infectious diseases of the urogenital tract and adverse pregnancy outcomes. In this country, for the detection of vaginal dysbiotic conditions, the test Femoflor-16 (DNA-Technology, Moscow) is widely used, however interpretation algorithms of this test do not include the category of BV. Aim. The study aimed to elaborate diagnostic criteria for the detection of BV using Femoflor-16 test. Materials and methods. Women of reproductive age addressing a gynecologist with vaginal discharge were enrolled in the study. For clinical diagnosis of BV, the Amsel criteria were used, laboratory analysis for BV was performed via microscopic investigation of vaginal discharge using the Nugent score. Samples of vaginal discharge from all women were analyzed with the test Femoflor-16, intended for characterizing vaginal microbiocenosis using multiplex quantitative real-time PCR. Results. A total of 280 women were included in the study. BV was diagnosed in 86 women (31%) using the Amsel criteria, and in 81 women (29%) using the Nugent score. All groups of anaerobic bacteria included in Femoflor-16 test were shown to be associated with BV, with the exception of bacteria of the genus Mobiluncus, which are detected together with phylogenetically related but not BV-associated bacteria of the genus Corynebacterium. A low amount of lactobacilli (< 10% of total bacterial load) coupled with an elevated amount of Gardnerella vaginalis/Prevotella bivia/Porphyromonas (> 1%) and/or Eubacterium (> 2%) and/or Sneathia/Leptotrichia/Fusobacterium (> 0.1%) and/or Megasphaera/Veillonella/Dialister (> 0.1%) and/or Lachnobacterium/Clostridium (> 0.1%) and/or Peptostreptococcus (> 0.1%) and/or Atopobium vaginae (> 0.2%) detected BV with a sensitivity of 99% and specificity of 93%. Conclusions. Criteria for BV diagnosis using the test Femoflor-16 have been elaborated, which enable to detect BV or exclude it with a sensitivity of 99% and specificity of 93%. These criteria for BV and criteria of the test manufacturers for severe anaerobic dysbiosis determine to a large extent the same category of the vaginal microbiocenosis.

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