scholarly journals Features of the vaginal microbiota and ways of correction of its disorders in case of full-term pregnancy

2020 ◽  
pp. 38-43
Author(s):  
Z. S. Zaydiyeva ◽  
M. K. Medzhidova
Keyword(s):  
Pregnant Women ◽  
Treatment Method ◽  
Full Term ◽  
Vaginal Microbiota ◽  
Vaginal Candidiasis ◽  
Good Effect ◽  
Term Pregnancy ◽  
Quick Method ◽  
Vaginal Microflora ◽  
Wide Range

Introduction. The vaginal microflora has a direct impact on the health of a newborn child, as well as during the postpartum period in new mothers. The composition of the vaginal microflora of a new mother determines the microflora of her conjunctiva, gastrointestinal tract, and the skin of the newborn, which are identical to the microflora of the mother’s birth canal, and the risk of infection in newborns is directly related to the degree of amniotic fluid insemination. At least half of women have some kind of vaginal microcenosis disorder during pregnancy. In the course of the study, the peculiarities of vaginal microbiota in a full-term pregnancy were studied and the effectiveness of correction of vaginal microcenosis abnormalities when applying the preparation Gaynomax was assessed.Aim of the study. To study the peculiarities of the vaginal microbiota in case of full-term pregnancy and to evaluate the effectiveness of correction of its abnormalities when applying the preparation Gaynomax.Materials and methods. On the basis of City Clinical Hospital No. 40, separate subdivision “Maternity hospital“, clinical and diagnostic department 72 pregnant women in the gestation period of 37-39 weeks the analysis of microscopic examination of vaginal swabs culture and sensitivity test was performed. The analysis included the results of a microscopic study of vaginal and cervical swabs stained using the Gram method. Bacteriological analysis of the vaginal content by cultivating aerobic and anaerobic microorganisms on special nutrient media. PCR method with real-time detection of results (Femoflor 16), including the determination of a wide range of microorganisms. To obtain adequate results, only samples with a sufficient number of cells caught in the test tube with the analyzed sample and sufficient total bacterial mass were used. Samples in which the number of DNA of human cells was more than 104 genome equivalents (GE) in the sample were taken into account, this is a swab quality indicator (SQI).The results: In pregnant women with high frequency infectious risk group, vaginal dysbitoic conditions were revealed with development of bacterial vaginosis, vaginal candidiasis and nonspecific vaginitis. Vaginal sanitation was carried out in patients. Excellent effect was obtained in 33/72 (49,2%) women, good effect in 21/72 (31,4%) patients, satisfactory in 13/72 (19,4%), which indicates fully justified expectations from the chosen treatment method. Conclusion: The use of Gaynomax vaginal suppositories is a reasonable and quick method of vaginal sanitation before delivery.

scholarly journals Efficacy of normalization of vaginal microbiota after antimicrobial treatment for bacterial vaginosis and bacterial vaginosis in pregnant women (results of the multicenter prospective non-interventional comparative study)

2021 ◽  
Vol 4 (3) ◽  
pp. 192-200
Author(s):  
V.E. Radzinskiy ◽  
◽  
I.B. Manukhin ◽  
I.M. Ordiyants ◽  
V.E. Balan ◽  
...  
Keyword(s):  
Comparative Study ◽  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Antimicrobial Treatment ◽  
Vulvovaginal Candidiasis ◽  
Vaginal Microbiota ◽  
Vaginal Microflora ◽  
Key Indicator

ABSTRACT Aim: to assess the efficacy and safety of Lactogynal® to normalize vaginal microflora after antimicrobial treatment for bacterial vaginosis (BV) and to prevent recurrences of vulvovaginal candidiasis (VVC) during pregnancy. Patients and Methods: this multicenter prospective non-interventional comparative study included 100 women in the 3rd trimester of pregnancy diagnosed with acute BV (n=50) or acute VVC (n=50). 25 women of each group received standard antimicrobial treatment only. 25 women of each group received Lactogynal® as the second step of antimicrobial treatment. Women were followed up until delivery and discharge. The rate of BV and VVC recurrences before delivery was considered the key indicator of treatment efficacy. In addition, obstetrical and perinatal outcomes, compliance, the type and duration of antimicrobial treatment for BV and VVC were evaluated. Results: in women with BV and VVC who received Lactogynal®, no recurrences during the follow-up were reported (p<0.05). In women who received standard antimicrobial treatment only, the rate of recurrences of BV and VVC was 40% and 28%, respectively. As to the complications of pregnancy, delivery, and the postpartum period, women with BV who received probiotic therapy were less often diagnosed with anemia (p<0.05) while women with VVC who received probiotic therapy were less often diagnosed with the premature rupture of membranes (p<0.05). Conclusions: Lactogynal® is an effective and safe tool to normalize vaginal microflora after antimicrobial treatment for BV and to prevent VVC recurrences during the 3rd trimester of pregnancy. This drug (as a part of complex treatment for BV and VVC) reduces the risk of recurrences and promotes a more favorable pregnancy course until delivery. KEYWORDS: lactobacilli, bacterial vaginosis, vulvovaginal candidiasis, pregnancy, vaginal microflora. FOR CITATION: Radzinskiy V.E., Manukhin I.B., Ordiyants I.M. et al. Efficacy of normalization of vaginal microbiota after antimicrobial treatment for bacterial vaginosis and bacterial vaginosis in pregnant women (results of the multicenter prospective non-interventional comparative study). Russian Journal of Woman and Child Health. 2021;4(3):192–200 (in Russ.). DOI: 10.32364/2618-8430-2021-4-3-192-200.

scholarly journals Microbiota of fetal membranes in intact amniotic sac and full-term pregnancy

2021 ◽  
pp. 4-11
Author(s):  
M.A. Kaganova ◽  
◽  
N.V Spiridonova ◽  
E.A. Makhlina ◽  
◽  
...  
Keyword(s):  
Pregnant Women ◽  
Ureaplasma Urealyticum ◽  
Bacterial Load ◽  
Full Term ◽  
Gardnerella Vaginalis ◽  
Elective Cesarean Section ◽  
Fetal Membrane ◽  
Fetal Membranes ◽  
Term Pregnancy ◽  
Candida Spp

Aim of research. To study the microbial landscape of intact fetal membranes in full-term pregnancy. Materials and methods. In 19 pregnant women (mean age — 31.0 ± 5.3 years, mean gestational age — 39.3 ± 0.65 weeks) with intact fetal membranes, the fetal membrane tissue was collected during elective cesarean section to detect by polymerase chain reaction the following microorganisms: Lactobacillus spp., Enterobacteriaceae, Streptococcus spp., Staphylococcus spp., Gardnerella vaginalis/Prevotella bivia/Porphyromonas spp., Eubacterium spp., Sneathia spp./Leptotrihia spp./ Fusobacterium spp., Megasphaera spp./Veillonella spp./ Dialister spp., Lachnobacterium spp./Clostridium spp., Mobiluncus spp./Corynebacterium spp., Peptostreptococcus spp., Atopobium vaginae, Mycoplasma hominis, Ureaplasma (urealyticum + parvum), Candida spp., Mycoplasma genitalium. Results. Sterile membranes were found in 5 pregnant women (26.3%), in the remaining cases, the total bacterial load (TBL) was 104.5 (103.5–105.8) genome equivalents (GE) per sample. Representatives of the Enterobacteriaceae family prevailed — 104.5 GE per sample on average, only in one case Candida spp. were detected. In 42.1% of cases, when determining TBL, specific types of microorganisms were not identified. Conclusion. On the fetal membranes in full-term pregnancy, the average TBL corresponding to 104.5 (103.5–105.8) GE per sample, in which Enterobacteriaceae prevail in the amount of 104.5 GE per sample on average, is acceptable.

scholarly journals THE INFLUENCE OF OSTEOPATHIC CORRECTION OF PELVIS DYSFUNCTIONS IN WOMEN IN LABOR WITH PRETERM AMNIORRHEA IN CASE OF FULL-TERM PREGNANCYON THE LABOR COURSE AND RESULT

2021 ◽  
Vol 83 (3) ◽  
pp. 24-36
Author(s):  
Natalia Noritsyna ◽  
Svyatoslav Novoseltsev
Keyword(s):  
Pregnant Women ◽  
Main Group ◽  
Full Term ◽  
Control Group ◽  
Term Pregnancy ◽  
Labor Management ◽  
Management Protocol ◽  
Cesarian Section

The eff ectiveness of applying osteopathic methods to patients with amniorrhea in case of full-term pregnancy was evaluated. 40 pregnant women with singleton full-term pregnancy without severe somatic and obstetric pathologies, with preterm amniorrheaunder the absence of regular labor activity were included into the study. The main group (n = 20) included women who underwent treatmentwith osteopathic methods. In the control group (n = 20) the labor was managed in accordance with the labor management protocol in case of amniorrhea. The osteopathic examination, which was performed in the course of the study, showed that all patients had biomechanical disorders at the pelvis level. The women in labor, who underwent osteopathic correction, started to deliver on their own in a greater percentage of cases as compared with the control group; there was a signifi cant decrease of frequency of labor anomalies and the total number of complications in labor and, as a consequence, a signifi cant decrease of obstetric aids and frequency of the emergency deliveryby cesarian section. A decrease in the frequency of episiotomy was noted. A decrease in the duration of the rupture-to-delivery interval was also noted.

Establishment of the Normal Reference Range of Thrombelas-togram among the Healthy Population and Pregnants in China

2019 ◽  
Author(s):  
Rong GU ◽  
Xueyuan HUANG ◽  
Ming ZHOU ◽  
Shujuan OUYANG ◽  
Yunfeng FU ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Healthy Volunteers ◽  
Blood Group ◽  
Reference Range ◽  
Full Term ◽  
Blood Type ◽  
Coagulation Disorder ◽  
Term Pregnancy ◽  
Normal Ranges ◽  
Central South

Background: We aimed to establish the reference range of thrombelastogram (TEG) for Chinese healthy volunteers and pregnant women and analyze the influence factors. Methods: Blood samples were collected from healthy volunteers and pregnant women at five tertiary hospitals (the Third Xiangya Hospital of Central South University, the Second Xiangya Hospital of Central South University, Hunan Provincial People's Hospital, Hunan Cancer Hospital and Changsha Central Hospital) in 2016. The effects of age, gender, blood type, and full-term pregnancy on the reference range of normal TEG for healthy volunteers and pregnant women were studied. The specificity of TEG in detecting coagulation disorder. Results: For healthy volunteers, the normal ranges of TEG parameters were as follows: R, 4.3-9.3 min; K, 1.2-3.2 min; α, 50.2-71.2°; MA, 54.1-71.3 mm; LY30: 0%-2.2%; CI, -3.8-2.4. At least one parameter exceeded the normal range specified by the manufacturer in 20.3% of the healthy volunteers; about 7.6% healthy volunteers were diagnosed as coagulation disorder by the above standards; the specificity of detection was 79.7%. There were significant differences in R, K, α, MA and CI between males and females (P<0.01). For pregnant women, the normal ranges of TEG were as follows: R, 3.9-7.5 min; K, 1.0-2.4 min; α, 57.6-74.9°; MA, 55.7-75.7 mm; LY30, 0%-0.56%; CI, -0.97-3.6. Pregnant women having O blood group had a dramatically prolonged R. Full-term pregnancy had no significant impact on TEG results. Conclusion: Compared with pregnant women having non-O blood group, those having O blood group had a dramatically prolonged R and showed greater tendency to hemorrhage during and after parturition.

COMPARATIVE MORPHOLOGICAL ANALYSIS OF THE PLACENTA IN WOMEN WITH HYPERTENSIVE CONDITIONS

2020 ◽  
Vol 93 (1) ◽  
pp. 38-41
Author(s):  
Bakhodir Kurbanov
Keyword(s):  
Comparative Analysis ◽  
Pregnant Women ◽  
Morphological Analysis ◽  
Full Term ◽  
Term Pregnancy ◽  
Functional Changes ◽  
Comparative Morphological Analysis ◽  
Placental Site

This article presents a comparative analysis of morphological and functional changes in the placenta and placental site in pregnant women with various types of hypertensive conditions. The modern ultrastructural methods for the study of the placenta in women with preeclampsia and with a physiological full-term pregnancy have been carried out.

scholarly journals Primary results of a prospective comparative non-interventional study for the treatment of asymptomatic bacteriuria in pregnant women

2021 ◽  
Vol 14 (1) ◽  
pp. 124-128
Author(s):  
S.V. Shkodkin ◽  
◽  
N.A. Fliginskikh ◽  
N.V. Zhdanovskaya ◽  
L.F. Li ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Methodological Quality ◽  
Randomized Clinical Trials ◽  
Urine Analysis ◽  
Asymptomatic Bacteriuria ◽  
Herbal Medicines ◽  
Evidence Base ◽  
Vaginal Microbiota ◽  
Vaginal Candidiasis ◽  
Vaginal Smears

Introduction. Over the past three decades, the views on the diagnosis and treatment of asymptomatic bacteriuria in pregnant women have not undergone any changes. However, the majority of randomized clinical trials concerning the treatment of pathients with this nosology are of low methodological quality and date back to the 60-80s. Since then, diagnostic and treatment protocols have changed dramatically, so the quality of the evidence base is low. In a recent Scandinavian study of higher methodological quality, there was no clear benefit of antibiotic therapy in pregnant women with asymptomatic bacteriuria. Material and methods. This publication is devoted to the interim results of a study that analyzed the efficacy and safety of herbal medicinal product Canephron® N in the treatment of asymptomatic bacteriuria in 29 pregnant women aged 22 to 34 years at a gestation period of 14-28 weeks. When included in the study, as well as on days 14, 30 and 60, the following laboratory control was performed: general urine analysis, urine bacteriological examination, clinical analysis of vaginal smears, analysis of vaginal microbiota by quantitative PCR Results. In the group of our patients, the distributions by age and gestational age differed from normal, the mean values are presented by the median and were 29 years and 14 weeks, respectively. Already had children – 13 (44.8%) women. In total, 35 microorganisms were isolated in a diagnostically significant titer. Most of the representatives of the Enterococcaceae family were traditionally 57.1%. At the time of inclusion, the median pyuria was 2.5 μl and exceeded the reference values only in 10.3% of patients. Clinical examination of vaginal smears revealed no inflammatory changes. However, an assessment of the vaginal microbiota showed the presence of dysbiosis due to an increase in the amount of obligate-anaerobic microflora in 58.6% and vaginal candidiasis in 10.3% of pregnant women. After 2 months, the 28 pregnant women remaining in the study had no episodes of symptomatic urinary infection. During the herbal drug therapy, there was a decrease in diagnostically significant bacteriuria and signs of the inflammatory process in all patients. The frequency of vaginal dysbiosis was recorded in 10.7% of pregnant women (р>0,05). Conclusion. Thus, our preliminary results shows that the use of Canephron N in pregnant women with asymptomatic bacteriuria (ABU) may be an effective alternative approach comparing the use of antibiotics. The treatment with Canephron N promotes the normalization of the urinary tract microflora and save the intactness of the saprophytic flora, in contrast to antibacterial drugs, and this is especially important in the paradigm of the antibiotics stewardship and the fight against growing antibiotic resistance. Comparative results of the use of antibacterial agents and Canephron N will be analyzed in the next publication, on the basis of which final conclusions will be drawn about the advisability of using herbal medicines to control bacteriuria in pregnant women Conclusion. We have obtained encouraging results from the use of Canephron-N® in patients with asymptomatic bacteriuria in pregnant. To obtain an evidence base of a recommendatory level, it is advisable to increase the number of observations.

scholarly journals CHARACTERISTICS OF LABOUR PROGRESSION IN PREGNANT OBESE WOMEN

2020 ◽  
Vol 115 (1) ◽  
pp. 9-17
Author(s):  
Kateryna Tyshko ◽  
Olena Gnatko
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Full Term ◽  
Obese Women ◽  
Term Pregnancy ◽  
Obesity Class ◽  
Term Delivery ◽  
Group 2 ◽  
Term Labour ◽  
Group 1

Obesity of pregnant women is a current global problem. The urgency is determined by numerous complications in obese pregnant women, which can affect the labour course, the maternal and foetal condition, require surgical delivery, and involve postpartum complications. The purpose was to study the characteristics of labour in obese pregnant women. The study methods included retrospective analysis of labour in 100 pregnant women with obesity, which were divided into 3 subgroups, depending on the obesity class (I, II, III), determined by BMI at the time of pregnancy registration. Labours of 100 pregnant women without obesity were used as the reference group. According to the medical records, the analysis included the estimation of gestational age (full-term, with tendency to post-term, early) and labour term (term, pre-term, late) and the cervical maturity according to Bishop Score (mature, under-mature, immature), the nature of the labour onset (spontaneous, induced) and their course (physiological, pathological). Statistical analysis of the results was carried out in EZR v.1.35 (R statistical software version 3.4.3, R Foundation for Statistical Computing, Vienna, Austria) (Kanda, 2013). Results. Comparative evaluation of the results of labour in women of Groups 1 and 2 showed that term labour accounts for the vast majority in both groups (80.0% in Group 1 and 91.0% in Group 2, respectively). The incidence of preterm and post-term labour is higher in obese women: pre-term labour by 1.7 times and late labour by 4 times. In pregnant women with obesity, early gestational age (˂ 37 weeks) was observed in 12.0% versus 7.0% among women in Group 2. In patients of Group 1, full-term pregnancy was reported in 56.0%, with a tendency to post-term labour - in 24.0%, while in pregnant women of Group 2, full-term pregnancies were observed in 85.0% of women, and with a tendency to post-term delivery - in 6.0%. Among patients with full-term pregnancy, "mature" cervix was observed in a large percentage of women both in Group 1 (70.0%) and Group 2 (94.0%) with predominance among pregnant women without obesity. Analysis of the results of the cervical maturity in the subgroups according to the obesity class showed that 68.4% of pregnant women with obesity class I and II at admission had "mature" cervix, the difference from the control Group was statistically significant, p<0.05. In patients with obesity class III compared with Group 2, "immature" or "under-mature" cervix was more common, 25% and 6%, respectively (p<0.001), which required the preparation (maturation) of the cervix with subsequent labour induction.  In general, women in Group 1 with term pregnancy had spontaneous onset of labour in 56.0%, versus 86.0% in patients of Group 2, and induced onset of labour in 10.0% versus 4.0% in pregnant women in Group 2. Among pregnant women with a tendency to post-term delivery, the onset of labour was spontaneous in 15.0% versus 3.0% in patients in Group 2 and induced in 6.0% versus 2.0% in pregnant women in Group 2. Surgical delivery more often occurred in pregnant women with obesity (33.0%) compared with pregnant women without obesity (10.0%) In general, physiological labour occurred in women of Group 1 in 77.0%, and pathological labour in 33.0%. In Group 2, physiological labour was observed in 90.0%, pathological labour in 10.0%, respectively. Conclusion. Labour in obese women has certain specific patterns, which depend on changes in the labour structure, in gestational age, the degree of the cervical maturity, the need for pre-induction and induction of labour. The identified changes depend on the obesity class and require timely evaluation and prediction for optimal management.

scholarly journals Application of COOK ok Cervical Ripening Balloon Combined With Artificial Rupture of Membranes and Oxytocin in Labor Induction for Full-term Pregnancy

2020 ◽  
Author(s):  
Ying Dong ◽  
Chuyu Li ◽  
Xin Zhao ◽  
Lin Zhang ◽  
Xiaojun Jia ◽  
...  
Keyword(s):  
Adverse Events ◽  
Pregnant Women ◽  
Infant Health ◽  
Mode Of Delivery ◽  
Balloon Dilation ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Full Term ◽  
Cervical Ripening ◽  
Term Pregnancy

Abstract Background The use of COOK balloon in the process of induction of labor is gradually promoted. This study was conducted to investigate the safety and efficacy of COOK double balloon dilation for pre-induction cervical maturation and induction of labor. Methods A total of 343 pregnant women with full-term pregnancy in Shanghai Putuo Maternity & Infant Health Hospital from January 1st to September 30th of 2016 were enrolled. Of all the pregnant women, 166 had labor induction, which included the use of a COOK balloon, the implementation of artificial rupture of membranes (AROM) and oxytocin intravenous (IV) drip (COOK group). The other 177 pregnant women with spontaneous rupture of membranes (SROM) and mature cervix only administrated with oxytocin IV drip to promote regular uterus contraction (oxytocin group). Maternal adverse reactions, mode of delivery and delivery outcomes of two groups were subsequently compared between the two groups. Results There were significant differences of maternal age (28.29 ± 3.34 vs. 29.25 ± 3.62 years, P = 0.02), gestational age (283.49 ± 4.53 vs. 274.71 ± 7.04 years, P < 0.001) and birth weight (3435.27 ± 340.29 vs. 3354.63 ± 387.96 g, P = 0.02) between the COOK group and the oxytocin group. There were no significant differences in terms of gravidity, parity, mode of delivery, analgesia, 1 min and 5 min Apgar score, labor time, postpartum hemorrhage, and adverse events. Conclusion Use of a COOK balloon may help full-term pregnancy women with immature cervix obtain the same pregnancy results as those with mature cervix, without extra occurrence of adverse events.Trial registration This is an observational study and no registration is required.

scholarly journals Vaginal microbiocenosis in the prenatal and postnatal periods

2019 ◽  
Vol 68 (4) ◽  
pp. 35-45
Author(s):  
Dzhamilya G. Dadayeva
Keyword(s):  
Postpartum Period ◽  
Full Term ◽  
Vaginal Microbiota ◽  
Main Topic ◽  
Lactobacillus Species ◽  
Term Pregnancy ◽  
Obstetric Practice

The article presents literature data on vaginal microbiota status during full-term pregnancy, placental microbiota status, and the characteristics of the vaginal microbiocenosis in the postpartum period. The main topic of the publication is the role of the prevailing Lactobacillus species and conditionally pathogenic microflora of the vagina and placenta in obstetric practice.

Clinical and microbiological aspects of vaginal microbiota at pregnant with threat of late miscarriages during treatment with vaginal gestagens forms

2017 ◽  
pp. 68-73
Author(s):  
I.P. Polishchuk ◽  
Keyword(s):  
Pregnant Women ◽  
Therapeutic Effect ◽  
Local Treatment ◽  
Vaginal Microbiota ◽  
Control Group ◽  
Before And After ◽  
Low Efficiency ◽  
Late Miscarriage ◽  
Microbiological Aspects ◽  
Micronized Progesterone

The objective: was to examine the effectiveness of treatment of late miscarriage threat by micronized form of progesterone for 100 mg – 3 times a day in the form of gelatin pills and vaginal tablets with lactose. Patients and methods. Under our supervision there were 70 pregnant women with normocenosis of vagina (NCV) without extragenital pathology, which were not performed systemic or local treatment with antibacterial drugs in the last 4 weeks. Among them 25 pregnant women with TLSM treated by gelatin tablets of micronized progesterone (GTP) (group 1); 25 pregnant women with TLSM, treated by vaginal micronized progesterone tablets (VPT) (2nd group) and 20 healthy women with physiological pregnancy – PV (control group). The distribution of women in the group adhered to the principles of randomization. The age of examined women ranged from 19 to 32 years, most pregnant women were aged under 30 years (89.02%). General clinical examination was carried out according to the standard scheme according to the Order MH of Ukraine № 620. Results. During the research we have determined the colpocytologcal dynamics and state of vaginal microbiota in pregnant women with threatened late miscarriage with initial vaginal normocenosis before and after treatment whit vaginal forms of progesterone. Conclusion. The received results showed low efficiency of micronized progesterone gelatin dragee at threat of the late miscarriage that at small therapeutic effect has led to the development of vaginal dysbiosis in all surveyed. In contrast, the use of micronized progesterone vaginal tablets – the maximally rapid therapeutic effect without disturbance of vaginal normocenosis. Key words: the threat of a late miscarriage, vaginal micronized forms of progesterone.

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