Complex therapy of vaginal viral and bacterial infections in female patients with recurrent miscarriage

Objective. To evaluate efficacy of complex therapy for vaginal viral and bacterial disorders in female patients with recurrent miscarriage using activated glycyrrhizinic acid. Materials and methods. The study has included 36 female patients of 101 women who presented with recurrent miscarriage in the period 2016-2018 in the medical center «Arbatclinic». Disorders of vaginal biocenosis of viral and bacterial nature have been found in the cohort of 36 (35.6 %) women. In order to investigate the state of biocenosis of the lower genital tract, smears were taken to test microflora, gonococci and trichomonas; PCR was performed to test STD and real-time PCR, qualitative and quantitative characteristics of normal and opportunistic flora of vaginal secretions. Herpes simplex virus (HSV) and cytomegaloviruses (CMV) in the vaginal contents were tested by culture method. Results. Bacterial vaginosis (BV) has been found predominantly in 28 (77.8%) women, combination of BV+HSV has been present in 24 (66.7%) patients and BV+CMV+HSV in 4 (11.1%) female patients. Aerobic vaginitis has been found in 8 (22.2%) women. It was associated with CMV+HSV in 2 (5.6%) female patients, and it was associated with HSV in 6 (16.7 %) women. Activated glycyrrhizinic acid (Epigen Intim spray) in 2 doses intravaginally 3-4 times a day for 2 weeks has been administered after antimicrobial therapy. Complex therapy for vaginal viral and bacterial infections using activated glycyrrhizinic acid in female patients with recurrent miscarriage led to de-escalation of HSV and CMV in the vaginal discharge. Conclusion. Impaired vaginal biocenosis in women with recurrent miscarriage (in 35.6%) is related to combined viral and bacterial infection. Use of activated glycyrrhizinic acid after antimicrobial therapy leads to de-escalation of HSV and CMV and recovery of vaginal biotope with domination of lactic bacteria. Activated glycyrrhizinic acid may be recommended to women with viral infections of the genital tract, including women with recurrent miscarriage.

viral and bacterial infection, recurrent miscarriage, activated glycyrrhizinic acid