Vagina Of Pregnant Women Research Articles

Вплив вітаміну D на мікробіоценоз статевих шляхів у жінок із багатоплідною вагітністю

Insufficiency of vitamin D during pregnancy was and remains one of the urgent problems of modern obstetric practice, which focuses on itself the attention of researchers from different countries. The importance of the issue of multiple pregnancy (МР) is determined by the significant number of complications that may arise during pregnancy, childbirth and the postpartum period. Possessing an immunomodulatory and anti-inflammatory effect, vitamin D ensures not only implantation, placentation, but also the course of the entire multiple pregnancy. Microbiocenosis of the female genital tract is a marker of the overall health of the female body, the issue of its disruption under the influence of vitamin D deficiency is of particular scientific interest. Purpose - to study the peculiarities of the genital tract microbiocenosis in women with multiple pregnancies and vitamin D deficiency. Materials and methods. Were examined 120 pregnant women, 90 of whom had multiple pregnancies and vitamin D deficiency, and were divided into two groups depending on the onset of pregnancy: the Group I consisted of 48 women with multiple births as a result of assisted reproductive technologies, and the Group II consisted of 42 pregnant women with spontaneous multiple births. The control group consisted of 30 healthy women with a singleton pregnancy and a normal level of 25(OH)D. The content of vitamin D in blood serum was studied by the immunoenzymatic method in the first and second trimesters of pregnancy. Microbiocenosis of the vagina of examined pregnant women was studied on the basis of bacterioscopic and bacteriological research. Results. A deviation in the ratio between cocci and bacilli flora was found in the I and II trimesters of pregnancy. The predominance of cocci flora was observed in women with multifertility due to the use of assisted reproductive technologies (55.9%), compared to women of the Group II (22.6%) and the control group (18.4%), which indicates the presence of inflammatory processes caused by vitamin D deficiency in this contingent of pregnant women, both in the first and second trimesters of pregnancy. The high activity of pro-inflammatory cytokines, which activate proteolytic enzymes in the vagina of pregnant women under the influence of vitamin D deficiency, causes the inflammatory process, thereby disrupting the vaginal microbiocenosis of pregnant women with MP. Conclusions. Violations of the microbiocenosis of the genital tract in women with MP in the early stages of pregnancy indicate that vitamin D deficiency plays a leading role in the genesis of inflammatory changes in the vaginal ecosystem. Early detection and timely treatment of vitamin D deficiency will contribute to reducing the number of violations of vaginal microbiocenosis and, as a result, prolongation of multiple pregnancies due to the use of assisted reproductive technologies. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.

The role of bacterial vaginosis in the development of inflammatory diseases of the female genital organs and the formation of disorders of the placental complex in the early stages of pregnancy

ABSTRACT. This paper presents some features of microbiocenosis of the vulva and vagina in pregnant women against the background of inflammatory diseases of the female genital organs and the role of bacterial vaginosis in the development of primary placental dysfunction during the formation of the placental complex. Goal. To determine the species composition of the microflora of vaginal contents in pregnant women by means of bacterioscopic, bacteriological research methods, polymerase chain reaction, pH-metry of vaginal discharge. Materials and methods. We used bacterioscopic, bacteriological, ultrasound research methods, polymerase chain reaction, and pH-metry of vaginal secretions. Studies of uteroplacental blood circulation were carried out on the ultrasonic diagnostic device "SonoAce 8000 Life". According to the set goal, a study was conducted on 87 women at 6-7 and 12-14 weeks of gestation. The main group consisted of 47 women with signs of bacterial vaginosis, the control group consisted of 40 practically healthy women. The results. In the women of the main group, the growth of contamination of the mucous membrane of the vulva and vagina with vaginal gardnerella is characteristic - 53.9%. To diagnose the formation of primary placental dysfunction, a dopplerometric study of blood flow indicators in uterine arteries revealed a significant increase in vascular resistance indices in 34 (46.7%) (p>0.05) pregnant women of the main observation group. Conclusions. The revealed features of the microbiocenosis of the genital tract in pregnant women in the early stages of guttation of patients with inflammatory diseases of the female genital organs indicate that the leading role in the development of inflammatory diseases of the female genital organs is played by the violation of the ecosystem of the vagina. These diagnostic criteria will make it possible to detect the insufficiency of the placental bed, to diagnose primary placental dysfunction at the preclinical stage (at 8-12 weeks of pregnancy).

Correlation between Group B Streptococcus Infection in The Vagina with Maternal Serum C-Reactive Protein Levels in Preterm Labor

For decades GBS has been the most common cause of early-onset of neonatal infection. Ascending route infection with Group B Streptococcus bacteria increases the risk of preterm premature rupture of membranes, fetus infection, sepsis, preterm birth, and meningitis in infants. C-Reactive Protein is a sensitive marker of systemic inflammation where an increase in CRP can also be triggered by GBS infection. Objective of this study is to determine the relationship between Group B Streptococcus infection in the vagina of pregnant women and maternal serum C-Reactive Protein levels in preterm labor. The design of this study was cross-sectional in the preterm delivery population. This study was conducted in the obstetrics delivery room at Sanglah Hospital from January 2021 to January 2022. A total of 31 samples met the inclusion criteria, each of which was examined for vaginal swab culture and maternal serum CRP levels. Vaginal swab samples were processed at the Microbiology Laboratory of Sanglah Hospital, Denpasar. Maternal serum CRP samples were processed at the Clinical Pathology Laboratory of Sanglah Hospital, Denpasar. Bivariate analysis using Chi-square test. The relationship between GBS infection and maternal serum CRP levels using the Prevalence Ratio. The growth of Streptococcus agalactiae from vaginal swab culture was 7 samples (22.58%). Positive GBS in the group of high maternal serum CRP levels were found in 6 patients (19.4%) and the group of low maternal serum CRP levels as many as 1 patient (3.2%) while negative GBS in the group of high maternal serum CRP levels were found in 5 patients (16.1%) and 19 patients (61.3%) in the group of low maternal serum CRP levels. The Prevalence Ratio value obtained was 4.1 (1.78-9.49, 95% CI; p = 0.002). There is a positive relationship between GBS infection and maternal CRP serum levels in preterm labor where positive GBS is a risk factor that increases maternal CRP serum levels in preterm labor.

Torquetenovirus in pregnancy: Correlation with vaginal microbiome, metabolome and pro-inflammatory cytokines.

Torquetenovirus (TTV) is a negative sense, single-stranded DNA virus present in many body fluids of apparently healthy individuals. At present, it is considered a non-pathogenic endogenous virus. TTV can be detected in the vagina of pregnant women, its abundance being modulated with the extent of immune system activation. Until now, there is only scarce information regarding the association between TTV and the composition of the vaginal environment. Therefore, this study aimed to assess the presence of TTV in the vaginal ecosystem of a cohort of white women with a normal pregnancy (n = 60) at different gestational stages (first, second and third trimester) and in 9 subjects suffering a first trimester miscarriage. For each woman, we determined (i) the presence and titer of TTV, (ii) the vaginal bacterial composition by means of Nugent score and 16S rRNA gene sequencing, (iii) the vaginal metabolic profiles through 1H-NMR spectroscopy, and (iv) the vaginal concentration of two pro-inflammatory cytokines (IL-6 and IL-8). More than one third of women were found negative for TTV at all gestational stages. Although not statistically significant, the positivity for TTV dropped from 53.3% in the first to 36.6% in the third trimester. TTV loads varied greatly among vaginal samples, ranging between 2 × 101 and 2 × 105 copies/reaction. No difference in TTV prevalence and loads was observed between women with normal pregnancies and miscarriages. The presence of TTV was more common in women with a higher vaginal leucocyte count (p = 0.02). The levels of IL-6 (p = 0.02), IL-8 (p = 0.03), propionate (p = 0.001) and cadaverine (p = 0.006) were significantly higher in TTV-positive samples. TTV titer was positively correlated with the concentrations of 4-hydroxyphenyllactate (p < 0.0001), isoleucine (p = 0.01) and phenylalanine (p = 0.04). TTV-positive samples were characterized by a higher relative abundance of Sneathia (p = 0.04) and Shuttleworthia (p = 0.0009). In addition, a trend toward a decrease of Lactobacillus crispatus and Lactobacillus jensenii, and an increase of Lactobacillus iners was observed for TTV-positive samples. In conclusion, we found that TTV is quite common in women with normal pregnancy outcomes, representing a possible predictor of local immune status.

Untargeted metabolite profiling of Enterococcus villorum SB2, isolated from the vagina of pregnant women, by HR-LCMS.

Enterococcus bacteria are studied in various sectors including fermentation, food and dairy industries,as well as studied for their probiotic properties but have limited use due to their possible pathogenic behavior. The present report talks about the metabolites produced, by the previously isolated Enterococcus strain, E.villorum SB2 (accession number KX830968), from the vaginal source. The growth of the bacteria in three types of media (M17, MRS and LAPTg) was compared, where the M17 media gave better bacterial colonies, also maximum growth rate was observed in M17 media (Td = 1.6h & k = 0.4h-1), and thus was selected as the metabolite production media. Further, the studied bacteria did not show any hemolytic activity, making it safe for industrial applications. The HR-LCMS results showed the production of various amino acids, organic acids, peptides, and other metabolites like flavonoids (Quercetin 3-O-Manoglucoside), terpenoids (7',8',Dihydro-8'-hydroxycitraniaxanthin, O-Methylganoderic acid O, Thalicsessine, Austinol, Valdiate), indole derivatives produced by tryptophan metabolism (5-hydroxykynurenamine, 2S,4R)-4-(9H-Pyrido[3,4-b]indol-1-yl)-1,2,4-butanetriol, Indoleacrylic acid), antimicrobial compounds (Fortimicin A) and fatty acids (Stearic acid, Myristic acid), which were earlier unreported form Enterococcus species opening new scope for discovering new industrial applications of the strain. As the studied bacteria has been reported to be a potential probiotic, the detection of these industrially important metabolites can be studied further in future studies to reveal the potential industrial applications of the strain.

Status of biocenosis of vagina in pregnant women living in the Khanty-Mansi Autonomous Okrug–Yugra

Introduction. The intensive development of the mining industry led to a rapid growth in the population, large-scale migration processes to cities, the construction of numerous industrial facilities, which was accompanied by changes in the ecological, socioeconomic and cultural foundations of the local indigenous population (Khanty and Mansi) caused by the disruption of the usual rhythm of life that exists here. over the centuriesAim. The study of mass and growth parameters, the state of the biocenosis of the vagina and gastrointestinal tract in pregnant women living in the village and in the city in the Khanty-Mansi Autonomous Okrug-Yugra and correction of violations with metronidazole and miconazole.Materials and methods. A prospective analysis of complaints, anamnestic, anthropometric, as well as an assessment of the state of the biocenosis of the vagina and intestines in patients selected by the method of continuous sampling was carried out. We examined women from among the indigenous small-numbered peoples of the north (indigenous peoples of the North) – the Khanty and Mansi, living in the urban-type settlement. Berezovo, in camps and in the city of Khanty-Mansiysk. The comparison group included women from the migrant population (Russians) living in the city of Khanty-Mansiysk.Results. It was found that the greatest number of violations of the biocenosis of the vagina and intestines was in pregnant women living in the city, both from the indigenous minorities and the migrant population. Half of pregnant women, 50% of women, had normocenosis. Every second had inflammatory changes – nonspecific vaginitis occurred in 9.1%, vulvovaginal candidiasis in 13.6% and mixed pathogenic flora (bacterial vaginosis and vulvovaginal candidiasis) were in 31.8% of women. Monitoring of the state of the vaginal biocenosis was carried out after 4–5 weeks and at the end of the postpartum period (40–44 days), normobiocenosis was determined. Relapses both before and after childbirth within 42 days were not observed in this contingent.Conclusion. The use of metronidazole and miconazole intravaginally is an effective trea for bacterial vaginosis in combination with vulvovaginal candidiasis with rapid relief of symptoms and no side effects.

The vaginal Torquetenovirus titer varies with vaginal microbiota composition in pregnant women.

Torquetenovirus (TTV) is a nonpathogenic endogenous virus whose abundance varies with the extent of immune system activation. We determined if the TTV titer in the vagina of pregnant women was associated with vaginal microbiota composition and levels of compounds in vaginal secretions. Vaginal TTV and microbiota composition in 494 second trimester pregnant women were identified by gene amplification and analysis. Vaginal matrix metalloproteinases (MMPs), tissue inhibitors of MMP (TIMP) and lactic acid isomers were measured by ELISA. Dominance was defined as the relative abundance of a specific bacterium or species at >50% of the total number of bacteria identified. Clinical data were obtained by chart review. The median log10 TTV titer was lowest when Lactobacillus species other than L. iners were dominant (<1.0) as compared to when L. iners (4.1, p = 0.0001), bacteria other than lactobacilli (4.5, p = 0.0016) or no bacterium (4.7, p = 0.0009) dominated. The TTV titer was inversely proportional to L. crispatus abundance (p<0.0001) and directly proportional to levels of G. vaginalis (p = 0.0008) and L. iners (p = 0.0010). The TTV titer was proportional to TIMP-1, TIMP-2, MMP-8 and MMP-9 abundance (p≤0.0002) and inversely proportional to the level of D-lactic acid (p = 0.0024). We conclude that the association between variations in the TTV titer and the relative abundance of specific bacterial species and vaginal compounds indicates that local changes in immune status likely influence vaginal fluid composition.

The use of betadine for the treatment of dysbiotic and fungal diseases of the vagina in pregnant women

Betadine can be recommended for the treatment of vaginitis in pregnant women in order to improve the microbiocenosis before childbirth and for the prevention of postpartum infectious complications.

Using of Procalcitonin Level in Differentiation between Bacterial Vaginitis Due to Pathogenic Bacteria and Normal Flora

This study conducted to view the role of PCT level in initial finding of bacterial vaginitis in pregnantwomen. A total of 150 deep vaginal swabs (100 pregnant women and 50 pregnant women as controlgroup) were collected from the beginning of February 2019 to the end of May 2019 from inpatients andoutpatients women attended to Al-Fallujah teaching hospital. Media were organized &amp; purified according toproducer’s guidance. The ready media were utilized for segregation , definition of the viable enumeration, identifying &amp; sensibility workout these media were achieved in the wake of being solidified. Swabs wasinoculated bacteriological agars for isolation of causative bacterial types . Blood samples collected by veinpuncture for determination of PCT by using ELISA technique. The study showed that that 57% of pregnantwomen have vaginal swab for culture as compared with 48 of the control group (non- pregnant women). Theresults demonstrated that, 54.39% of pathogenic bacteria isolated from vagina of pregnant women was G-vebacteria and 45.61% was G+ve bacteria. S. aureus represented the highest rate of pathogenic isolates 45.61%in cases (43.86%) while 29.17 of the control group were infected equally by E coli and K. pneumonia.Thehighest rate of antibiotic sensitivity toward S. aureus isolates was occurred in levofloxacin (88.46%) whileit was completely resistant to ampicillin and lincomycin, 94.11% of E. coli isolates was sensitive to each oflevofloxacin and cefotaxime and 100% resistant to lincomycin, 92.85% of Klebsiella isolates was sensitive toamoxicalve while it was 100% resistant to ampicillin, erythromycin and lincomycin. Procalcitonin level washighly elevated among pregnant ones followed by healthy ones (26.79±9.4 v.s 9.236±0.6 pg/ml) at P value&lt;0.01. The highest mean of Procalcitoninlevel is found among pregnant women with pathogenic bacteriaisolates of HVS culture (30.15±9.84 pg/ml) and the lowest mean is recorded among pregnant women withnormal flora isolates (23.72±7.25 pg/ml).Conclusions: Serum PCT was highly elevated in pregnant womenwith vaginitis especially who diagnosed with pathogenic bacteria.

Identification of bacteriophages in the vagina of pregnant women: a descriptive study.

To determine the presence and identity of extracellular bacteriophage (phage) families, genera and species in the vagina of pregnant women. Descriptive, observational cohort study. São Paulo, Brazil. Pregnant women at 21-24weeks' gestation. Vaginal samples from 107 women whose vaginal microbiome and pregnancy outcomes were previously determined were analysed for phages by metagenomic sequencing. Identification of phage families, genera and species. Phages were detected in 96 (89.7%) of the samples. Six different phage families were identified: Siphoviridae in 69.2%, Myoviridae in 49.5%, Microviridae in 37.4%, Podoviridae in 20.6%, Herelleviridae in 10.3% and Inviridae in 1.9% of the women. Four different phage families were present in 14 women (13.1%), three families in 20 women (18.7%), two families in 31 women (29.1%) and one family in 31 women (29.1%). The most common phage species detected were Bacillus phages in 48 (43.6%), Escherichia phages in 45 (40.9%), Staphylococcus phages in 40 (36.4%), Gokushovirus in 33 (30.0%) and Lactobacillus phages in 29 (26.4%) women. In a preliminary exploratory analysis, there were no associations between a particular phage family, the number of phage families present in the vagina or any particular phage species and either gestational age at delivery or the bacterial community state type present in the vagina. Multiple phages are present in the vagina of most mid-trimester pregnant women. Bacteriophages are present in the vagina of most pregnant women.

Distribution of Pilus island and antibiotic resistance genes in Streptococcus agalactiae obtained from vagina of pregnant women in Yazd, Iran.

Background and Objectives:Due to the important role of Streptococcus agalactiae, Group B streptococci (GBS), in production of invasive disease in neonates, investigation regarding the pathogenicity and antibiotic resistance factors is necessary in selecting the appropriate therapeutic agents. Beside capsule, the pilus has been currently recognized as an important factor in enhancing the pathogenicity of GBS. Resistance of GBS to selected antibiotics is noticeably increasing which is mainly due to the anomalous use of these drugs for treatment. The aim of this study was to determine the prevalence of pili genes followed by antibiotic susceptibility of GBS, previously serotyped, isolated from pregnant women in the city of Yazd, Iran.Materials and Methods:Fifty seven GBS from pregnant women were subjected to multiplex PCR for determination of PI-1, PI-2a and PI-2b pilus-islands and simultaneously, the phenotype of antibiotic resistance to penicillin, tetracycline, erythromycin, clindamycin, gentamycin and levofloxacin was determined. Antibiotic resistance genes (ermA, ermB, mefA, tetM, int-Tn) were further diagnosed using PCR and multiplex PCR.Results:PI-1+PI-2a with 71.9%; followed by PI-2a (21.1%) and PI-2b (7%) were observed. PI-1+PI-2a in serotype III was (73.2%), serotype II, Ia, Ib and V were 12.2%, 9.8%, 2.4% and 2.4% respectively. GBS penicillin sensitive was 89.5% and 96.5% resistance to tetracycline. The frequency of resistance genes were as follows: tetM (93%), ermA (33.3%), ermB (8.8%), int-Tn (80.7%) and mefA (0).Conclusion:Majority of GBS contained PI-1+PI-2a. Hence presence of this pilus stabilizes the colonization, therefore designing a program for diagnosing and treatment of infected pregnant women seems to be necessary.

Identification of bacteriophages in the vagina of pregnant women: a descriptive study

Identification of bacteriophages in the vagina of pregnant women: a descriptive study

Krönig. - Ueber die Natur der Scheidenkeime, speciell über das Vorkommen anaerober Streptokokken im Scheidensekret Schwangerer. (Centralbl. F. Gynäk., 1895, No. 16). On the nature of vaginal microbes, mainly in anaerobic renal cocci in the vaginal discharge in pregnant women

The author informs the further results of his observations (Centralbl. F. Gynaek., 1894, No. 1). Not finding at that time in the separated vagina of pregnant women microbes that would grow aerobically, he, having put the secret of the vagina (in pregnant women) in the conditions of anaerobic life on nutrient media, received cocci, located in groups of 12-20, microscopically indistinguishable from encountered in childbirth fever, renal cocci.

Krönig. Scheidensecretuntersuchungen bei 100 Schwangeren. Aseptik in der Geburtshilfe. (Centralblatt für Gynäkologie, No. 1, 1894). Study of the secret of the sleeve in 100 pregnant women. Asepsis in obstetrics

In view of the abrupt contradiction of the frequent finding of staphylococcus pyogenes albus in the vagina of pregnant women, and the extremely rare finding of it in childbirth fever, the author raises the question whether the previous opinion was not the result of our constantly being examined by this almost constantly on the surface of the body.

THE STATE OF VAGINAL MICROBIOCENOSIS AFTER THE INFLUENZA IN THE EARLY PERIOD OF PREGNANCY

The aim of the study was to assess the state of the vaginal microbiocenosis in pregnant women after influenza in the early stages of pregnancy.Materials and research methods. We examined 120 women who had had influenza in the first trimester of pregnancy: the main group - 68 patients with placental dysfunction, the comparison group - 52 pregnant women without signs of placental insufficiency. Cultural, microscopic, auxiliary and clinical research methods were used.Research results. The microbial landscape of the vagina in pregnant women of the main group in terms of the frequency of detection of microorganisms with CFU 104 and above is characterized by an increased frequency of detection of pathogenic microflora: Staphylococcus epidermidis (22,1 %), Staphylococcus aureus (14,7 %), Staphylococcus haemolyticus (26,5 %), Streptococcus group В (26,5 %), Gardnerella vaginalis (27,9 %), Escherichia coli (33,8 %), Klebsiella (14,7 %), Chlamydia (32,4 %), Ureaplasma urealyticum (23,5 %) and Mycoplasma hominis (26.5%) ). The highest detection rate of fungi of the genus Candida (39.7%). The revealed violations occur against the background of suppression of normal microflora: Bifidobacterium were observed only in 17.6% of women, Lactobacterium in 25.0%. In most of the examined, vaginal contamination is associative in nature. In 64.7% of pregnant women, an inflammatory type of smear was detected, due to a variety of pathogenic microflora with a large number of leukocytes (41.2%) against the background of the absence of Dederlein sticks (Lactobacterium). 32.4% of patients report complaints of varying intensity, which may be caused by vaginal dysbiosis (excessive vaginal discharge, itching, edema and hyperemia of the mucous membrane), the pH of the vaginal contents is more than 4.5 - in 35.3% of patients, a positive amino test - in 23 1 %. Only in 14.7% of women the state of the vagina according to Kira’s classification is assessed as normocenosis, in 25.0% - moderate dysbiosis and in 27.9% - pronounced vaginal dysbiosis.Conclusions. Physiological immunosuppression during pregnancy in association with the immunosuppressive effect of influenza, changes in the acidity of the environment under the influence of gestational hormones disrupt the microbial balance of the biocenoses of the mucous membranes of the pregnant woman. Obstetric and perinatal complications in women after influenza may be partially mediated by abnormalities in the vaginal microbiome.

Prevalence and capsular type distribution of group B Streptococcus isolated from vagina of pregnant women in Nghe An province, Vietnam

Identification of GBS serotypes provides helpful information for appropriate the development of suitable vaccines; however, no reports from Vietnam have been published. This study has been performed to find the prevalence and serotypes of group B Streptococcus isolated from vagina of pregnant women in Nghe An province, Vietnam. Vaginal swabs were collected from pregnant women at 35-37 weeks of gestation at the Nghe An Obstetrics and Pediatrics Hospital, Vietnam between May 2018 and July 2019. The swabs were cultured on 5% sheep blood agar for isolation of GBS. All isolates were identified using the Gram staining, CAMP test and specific PCR. GBS strains were serotyped using the multiplex PCR assays. The prevalence of vaginal GBS colonization was 9.20% of 750 participants. Among the isolates, serotypes III (39.13%) and V (31.89%) were the most frequent, followed by serotypes Ia (11.59%), VI (11.59%), Ib (2.90%), II (1.45%) and VII (1.45%), respectively. Serotypes IV, VIII and IX were not found. The prevalence of GBS in the Nghe An province of central Vietnam was similar to reports from other parts of the world. The predominat GBS serotypes (III, V, Ia and VI) were slightly different from those previously described from other regions around the world. The high frequency of serotype VI was a notable feature of the strains from pregnant women in Vietnam.

Comparing the effect of some plant extracts and commercial washes against some isolated Microorganisms from vagina of pregnant women

Comparing the effect of some plant extracts and commercial washes against some isolated Microorganisms from vagina of pregnant women

POLA MIKROORGANISME PADA LIANG VAGINA WANITA HAMIL DI RSU DR. SOETOMO SURABAYA

In pregnant women especially in the third trimester, it is seldom that attention is paid to microorganism in the vagina. Many studies have reported about microorganism in the vagina which possibly can infect the foetus. This is due to the migration of bacterial colonization in the vagina to the foetus during labour, causing infection or sepsis in the foetus after delivery. To study the microorganism pattern in the vagina of pregnant women, pathogenic as well as normal flora of the vagina. If the microorganism is known, prevention or treatment before and after delivery can be applied. Population was recruited from pregnant women in the third trimester who visited The Maternity Outpatient Clinic, Dr. Soetomo Hospital from September until October 2005. Specimens from ostium of the cervix and posterior fornix of the vagina were collected in Amies media and examined in the Department of Clinical Pathology, Airlangga University/ Dr. Soetomo Hospital to detect any bacteria, fungi and parasites using direct method and culture. The microorganism pattern from 30 pregnant women consisted of non-haemolytic Streptococcus 25%, Escherichia coli 25%, Lactobacillus 35%, Staphylococcus aureus 10%, and Staphylococcus coagulase negative 5%. The result of fungi examination showed 14 (47%) samples with negative result and 16 (53%) samples with positive result (Candida sp). The pattern of microorganism was dominated by Lactobacillus and Candida sp but no parasites in the vagina were found.

Parallel detection of lactobacillus and bacterial vaginosis-associated bacterial DNA in the chorioamnion and vagina of pregnant women at term

Background: The majority of early preterm births are associated with intrauterine infections, which are thought to occur when microbes traffic into the uterus from the lower genital tract and seed the placenta. Bacterial vaginosis (BV) is associated with heterogeneous bacterial communities in the vagina and is linked to preterm birth. The extent to which trafficking into the uterus of normal and BV-associated vaginal bacteria occurs is unknown. The study objective was to characterize in parallel the distribution and quantities of bacteria in the vagina, uterus, and placental compartments.Methods: Pregnant women at term (≥37 weeks) presenting for delivery were recruited prospectively. Swabs were collected in parallel from the vagina, chorioamnion. Choriodecidual swabs were collected if a cesarean section was performed. Samples were analyzed by culture, broad-range 16S rRNA gene PCR, and bacterial species-specific quantitative PCR (qPCR) for DNA from Lactobacillus and a panel of BV-associated bacteria. Results were correlated with placental histopathology.Results: Of the 23 women enrolled, 15 were delivered by cesarean section (N = 10 without labor; N = 5 in labor) and eight were delivered vaginally. BV was diagnosed in two women not in labor. Placental histopathology identified chorioamnionitis or funisitis in six cases [1/10 (10%) not in labor; 5/13 (38%) in labor]. Among non-laboring women, broad-range 16S qPCR detected bacteria in the chorioamnion and the choriodecidua (4/10; 40%). Among laboring women, Lactobacillus species were frequently detected in the chorioamnion by qPCR (4/13; 31%). In one case, mild chorioamnionitis was associated with qPCR detection of similar microbes in the chorioamnion and vagina (e.g. Leptotrichia/Sneathia, Megasphaera), along a quantitative gradient.Conclusions: Microbial trafficking of lactobacilli and fastidious bacteria into the chorioamniotic membranes and choriodecidua occurs at term in normal pregnancies. In one case, we demonstrated a quantitative gradient between multiple bacterial species in the lower genital tract and placenta. Not all bacterial colonization is associated with placental inflammation and clinical sequelae. Further studies of the role of placental colonization with Lactobacillus in normal pregnancy and fastidious bacteria in chorioamnionitis may improve prevention and treatment approaches for preterm labor.

Progress on influencing factors regarding the neonatal group B streptococcal infectious diseases

Group B streptococcus (GBS) is one of the severe pathogenic bacteria during the perinatal period, both on pregnant women and newborns. GBS infection may lead to pneumonia, septicemia, meningitis or other severe disease, even death in neonates. Although only 1%-2% infections will develop into GBS disease among the neonates, the etiological mechanism of which is worth researching. This review summarizes the possible factors related to GBS infection or occurrence of the disease, including the risk in gestation period (for example, colonization of GBS on vagina of pregnant women, preterm birth or premature rupture of fetal membranes and so on), related pathogens (bacteria strains, loads or virulence), immune level (inflammatory factor or neutralizing anticytokine auto-Abs), gene defect or primary immunodeficiencies of the hosts.