Abstract
Hypothesis/aims of study. To date, there have been some publications on the possible role of systemic endotoxinemia resulting from intestinal dysbiosis in the pathogenesis of miscarriage. The aim of this study was to compare the state of intestinal microbiocenosis and the level of endotoxinemia in women with threatened abortion and normal pregnancy.
 Study design, materials and methods. The study involved 50 women aged 18 to 35 years (mean age 28.1 0.6 years) in pregnancy from 6 to 18 weeks. The main group consisted of 30 women with threatened abortion. The control group included 20 women with normal pregnancy. Patients of the main and control groups were examined in accordance with the order of the Ministry of Health of the Russian Federation No. 572n. In addition, a qualitative and quantitative microbiological analysis of feces was performed using the real-time PCR method. The level of endotoxinemia was studied to assess the possible systemic effect of intestinal dysbacteriosis on a pregnant woman.
 Results. 23.3% of patients of the main group were diagnosed with intestinal dysbiosis of degree I, 60% of degree II, and 16.6% of degree III. In patients of the control group, dysbiotic changes corresponded mainly to degree I (75%) and degree II (25%). Degree III was not detected. Microbiological disorders in the main group were characterized by a decrease in the number of members of intestinal normal flora and a high concentration of opportunistic microorganisms. Microbiological disorders in the control group were characterized by a decrease in the intensity of colonization of the large intestine by lactobacilli and bifidobacteria. The average level of endotoxinemia in patients of the main group was 0.52 0.05 nmol/ml and was classified as elevated, significantly exceeding that in patients of the control group 0.34 0.05 nmol/ml.
 Conclusion. In patients with threatened abortion, intestinal microflora was characterized by a decrease in normal flora and a high concentration of opportunistic microorganisms with high a pathogenic potential and their associations. During normal pregnancy, microbiological disorders in the intestinal biocenosis were characterized by a decrease in the intensity of colonization of the large intestine by lactobacilli and bifidobacteria. The level of endotoxemia was directly proportional to the degree of dysbacteriosis of the intestine and was significantly higher in women of the main group.
Highlights
The aim of this study was to compare the state of intestinal microbiocenosis and the level of endotoxinemia in women with threatened abortion and normal pregnancy
23.3% of patients of the main group were diagnosed with intestinal dysbiosis of degree I, 60% of degree II, and 16.6% of degree III
In patients of the control group, dysbiotic changes corresponded mainly to degree I (75%) and degree II (25%)
Summary
Цель — провести сравнительную оценку состояния микробиоценоза кишечника и уровня эндотоксинемии у женщин с угрозой прерывания беременности и с физиологически протекающей беременностью. У 23,3 % пациенток основной группы был диагностирован дисбактериоз кишечника I степени, у 60 % — II степени, у 16,6 % — III степени. У пациенток контрольной группы преимущественно выявлено снижение интенсивности колонизации толстой кишки лактобактериями и бифидобактериями. Микробиологические нарушения в составе кишечного биоценоза у пациенток с угрозой прерывания беременности были обусловлены достоверным снижением количества нормофлоры на фоне увеличенного содержания условно-патогенных микроорганизмов с высоким патогенным потенциалом и их ассоциаций. Микрофлора кишечника при нормально протекающей беременности характеризовалась преимущественно снижением интенсивности колонизации толстой кишки лакто- и бифидобактериями. Уровень эндотоксинемии имел прямую пропорциональную зависимость от степени дисбактериоза кишечника и был достоверно выше у женщин основ ной группы. ■■ Ключевые слова: невынашивание беременности; дисбактериоз кишечника; эндотоксин; эндотоксин-индуцированный аборт
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