Uterine microbiome in women with uterine scar defect after cesarean section: Prospective cohort study

Abstract

Aim. To evaluate the endometrial microbiota in patients with uterine scar defect after cesarean section.
 Materials and methods. The study included 80 women of reproductive age. The main group included 50 patients with a uterus scar defect due to cesarean section; the comparison group included 30 women with a competent uterus scar due to cesarean section. Patients underwent a Pipelle endometrial biopsy on days 2022 of the menstrual cycle using a double-lumen catheter that excludes sample contamination with vaginal and cervical microflora. A molecular genetic study of the endometrium was performed by real-time polymerase chain reaction using the Femoflor 16 reagent kit (DNA-Technology
 Moscow). The DNA content in the specimen was measured using software and expressed in genome equivalent (GE) proportional to the number of microorganisms. The statistical data were processed using the Exсel software package and SPSS Statistics 22.0.
 Results. The study showed the following statistically significant differences: lower count of Lactobacillus spp. 2.600 (1.4303.600) GE/mL vs 3.550 (2.8004.700) GE/mL in patients of the comparison group (p=0.02); higher count of Streptococcus and Staphylococcus spp. 3.270 (3.0003.700) GE/mL and 3.450 (3.2003.600) GE/mL vs 1.030 (0.7601.700) GE/mL and 0.560 (0.1201.200) GE/mL in the comparison group, respectively (p0.00001); higher count of Enterobacteriaceae 2.700 (1.7003.300) GE/mL vs 0.950 (0.6601.120) GE/mL in the comparison group (p0.00001); higher count of Gardnerella/Prevotellabivia/Porphyromonas spp. 2.310 (0.9303.480) GE/mL vs 1.000 (0.0001.860) GE/mL (p=0.003); higher count of Peptostreptococcus spp. 0.195 (0.0001.560) GE/mL vs 0.000 (0.000-0.000) GE/mL (p=0.032); Eubacterium spp. 1.355 (0.1002.460) GE/mL vs 0.000 (0.0001.560) GE/mL (p=0.040).
 Conclusion. Endometrial dysbiosis in patients with a uterus scar defect after cesarean section due to the possible effects of microorganisms can be considered one of the leading causes of the formation of a uterus scar defect in the postoperative period.