Email this article The efficiency of treatment of vaginal infections in women with a history of miscarriage
- Authors: Siniakova A.A.1, Shipitsyna E.V.1,2, Budilovskaya O.V.1,2, Bolotskikh V.M.2,3,4, Savicheva A.M.1,2
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Affiliations:
- The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
- Saint Petersburg State Pediatric Medical University
- Maternity Hospital No. 9
- Saint Petersburg State University
- Issue: Vol 68, No 5 (2019)
- Pages: 63-74
- Section: Original Research
- URL: https://journals.rcsi.science/jowd/article/view/15812
- DOI: https://doi.org/10.17816/JOWD68563-74
- ID: 15812
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Abstract
Hypothesis/aims of study. The problem of vaginal infections during pregnancy is of high importance in obstetric practice. To predict the risks and reduce the frequency of pregnancy and childbirth complications, it is necessary to dynamically assess the vaginal microflora and treat its disorders. The aim of the study was to investigate the vaginal microflora and evaluate the effectiveness of treating vaginal infections in pregnant women with a history of miscarriage.
Study design, materials and methods. The study included 153 pregnant women in the first trimester. The main group (group I) consisted of 99 women with a history of miscarriage, 35 of whom had signs of threatened abortion (subgroup IA) and 64 did not (subgroup IB). The control group (group II) comprised 54 women without a history of miscarriage and signs of threatened abortion. The vaginal microflora was examined using microscopic, bacteriological and quantitative real-time PCR methods. All patients with an established vaginal infection (bacterial vaginosis, aerobic vaginitis, and vulvovaginal candidiasis) received etiotropic therapy, depending on the microorganisms identified and their sensitivity to antimicrobial drugs. After treatment, in order to assess the effectiveness of the therapy, the vaginal microflora was examined in the second trimester and the outcomes and complications of present pregnancy were evaluated.
Results. In women of subgroup IA, vulvovaginitis and bacterial vaginosis were detected 3.5 times more often compared to the control group, and 1.6 times more often compared to subgroup IB (66% and 19%, respectively, p < 0.001; 66% and 42%, respectively, p < 0.05). Aerobic vaginitis was the most frequent vaginal infection in the first trimester of pregnancy in women of the main group (p < 0.05). After treatment, the frequency of the vaginal infections in the second trimester in women of the main group significantly decreased: by 1.9 times in subgroup IA and by 1.5 times in subgroup IB (p < 0.05). There were no significant differences in the frequency of adverse pregnancy outcomes in women with bacterial vaginosis or vulvovaginitis as compared to women with normal vaginal microflora. Nevertheless, pregnancy and childbirth complications were diagnosed 4 times more frequently in the main group (23% and 6%, respectively, p < 0.05), with the complications occurring significantly more often in the cases of vulvovaginitis or bacterial vaginosis and signs of threatened abortion in the first trimester (p < 0.05).
Conclusion. Etiotropic therapy of vaginal infections diagnosed in the first trimester of pregnancy in women with a history of miscarriage was highly effective. In 40% of women, vaginal microbiocenosis normalized, and the clinical symptoms of vaginosis/vaginitis disappeared. Differences in the frequency of adverse pregnancy outcomes in women with vulvovaginitis or bacterial vaginosis in the first trimester and in women with normal vaginal microbiocenosis were not significant. However, the treatment of vaginal infections in the group of pregnant women with a history of miscarriage did not significantly affect the frequency of pregnancy and childbirth complications.
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##article.viewOnOriginalSite##About the authors
Anna A. Siniakova
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Author for correspondence.
Email: annakizeeva@yandex.ru
ORCID iD: 0000-0003-3094-665X
SPIN-code: 7795-8364
MD
Russian Federation, Saint PetersburgElena V. Shipitsyna
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott; Saint Petersburg State Pediatric Medical University
Email: shipitsyna@inbox.ru
ORCID iD: 0000-0002-2309-3604
SPIN-code: 7660-7068
PhD, DSci (Biology), Leading Researcher. The Laboratory of Microbiology
Russian Federation, Saint PetersburgOlga V. Budilovskaya
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott; Saint Petersburg State Pediatric Medical University
Email: o.budilovskaya@gmail.com
ORCID iD: 0000-0001-7673-6274
SPIN-code: 7603-6982
Researcher. The Laboratory of Microbiology
Russian Federation, Saint PetersburgVyacheslav M. Bolotskikh
Saint Petersburg State Pediatric Medical University; Maternity Hospital No. 9; Saint Petersburg State University
Email: docgin@yandex.ru
ORCID iD: 0000-0001-9846-0408
SPIN-code: 3143-5405
MD, PhD, DSci (Medicine), Associate Professor; Chief Physician; Associate Professor. The Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty
Russian Federation, Saint PetersburgAlevtina M. Savicheva
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott; Saint Petersburg State Pediatric Medical University
Email: savitcheva@mail.ru
ORCID iD: 0000-0003-3870-5930
SPIN-code: 8007-2630
д-р мед. наук, профессор, заслуженный деятель науки РФ, заведующая лабораторией микробиологии; заведующая кафедрой клинической лабораторной диагностики факультета послевузовского и дополнительного профессионального образования
Russian Federation, Saint PetersburgReferences
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