VAGINAL BIOCENOSIS IN PREGNANT WOMEN

Abstract

Bacterial vaginosis developing in pregnancy is associated with abnormal vaginal flora and with an imbalance of cytokines and antimicrobial peptides. The aim of this research was to study the bacterial, cytokine and antimicrobial components of the vaginal nonspecific immune system in the second and third trimesters of pregnancy among patients with recurrent bacterial vaginosis. Materials and methods . The study included 40 pregnant women with recurrent bacterial vaginosis (Group 1), and 40 healthy pregnant women with no signs of vaginosis (Group 2). At the onset of this study, the average gestational age among the selected women was 14.8 ± 2.0 weeks. We analyzed clinical and laboratory parameters of bacterial vaginosis, qualitative and quantitative characteristics of the vaginal flora, the levels of β-defensin-2 (HBD-2), interleukin-1β (IL-1β), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), and interferon-γ (INF-γ) in vaginal washouts. Results. The pregnant women with recurrent bacterial vaginosis tested at the 30th week of gestation, had moderate vaginal dysbiosis caused by an increased number of anaerobic microorganisms. Along with that, at the beginning of the third trimester, the number of lactobacillus bacteria increased in both Group 1 and Group 2. Notably, the predominant species in the healthy women samples was L. crispatus whereas in patients with recurrent bacterial vaginosis that was L. iners. There were no changes in the levels of cytokines and antimicrobial peptide between the second and third trimester in women with recurrent bacterial vaginosis. In this group (Group 1), however, the levels of HBD-2, IL-1β, IL-6, IL-10, INF-γ were lower in comparison with healthy pregnant women (Group 2), which can be seen as a risk factor of further returns of the disease. Conclusion. Pregnant women with recurrent bacterial vaginosis as well as women with normal course of gestation have an increased presence of lactobacilli bacteria in their vagina during the third trimester of gestation. No other changes in the bacterial, antimicrobial and cytokine components of the nonspecific immune system in the female reproductive tract were found.