Микробиологическая и биохимическая характеристика амниотической жидкости при доношенной беременности, осложнившейся преждевременным излитием околоплодных вод

Abstract

Objective. To study the connection between the microbial landscape and biochemical composition of amniotic fluid (AF) in fullterm pregnancy and premature rupture of membranes (PROM). Patients and methods. The biochemical (glucose, total protein, urea, creatinine, calcium, potassium, sodium, chlorine, C-reactive protein) and microbial compositions of AF at 37–41 weeks’ gestation were examined in 39 pregnant women who delivered by cesarean section. The main group included 20 patients with PROM (the latency period <6 h), the control group – 19 patients with intact amniotic membranes. The microbial composition was evaluated using a real-time polymerase chain reaction (Femoflor-16). Results. The total bacterial load was 103.02 GE/mL in the main group of patients with PROM and 103.06 GE/mL in the control group, with predominant Enterobacteriaceae spp. – 15 and 21%, respectively; facultative and obligate anaerobic bacteria were identified in rare cases. In the biochemical analysis of AF, the levels of total protein and C-reactive protein were higher in patients with PROM, whereas the levels of creatinine, calcium, and potassium were lower. A weak positive correlation between creatinine levels with the presence of Gardnerella vaginalis in AF (r = 0.399, p = 0.032), potassium levels with Enterobacteriaceae spp. (r = 0.378, p = 0.043), and sodium levels with Streptococcus spp. (r = 0.383, p = 0.040) was observed. Conclusion. The presence of Enterobacteriaceae spp. is typical for AF. According to biochemical parameters in PROM, there is an increase in the levels of total protein and a decrease in the levels of creatinine and ions. Key words: amniotic fluid, pregnancy, biochemical analysis, microbiota, premature rupture of membranes, polymerase chain reaction, femoflor