Complex therapy of bacterial vaginosis during pregnancy

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective: To present own experience of complex treatment of bacterial vaginosis during pregnancy.

Materials and methods: The study included 46 patients with a pregnancy at 22–36 weeks’ gestation with confirmed bacterial vaginosis. All patients were divided into two equal groups: women of group 1 received treatment with an antibiotic in com-bination with the immunomodulatory medication Superlymph, patients of group 2 received only antibiotic therapy. Efficacy was evaluated by the analysis of clinical manifestations, microbiological and microscopic examination of vaginal dis-charge, vaginal pH, pro-inflammatory cytokines.

Results: In both groups there was a decrease in the number of epithelial cells and leukocytes during the treatment, key cells were not detected after the treatment; however, the improvement was more significant in group 1. There was also a de-crease of the titer in both groups. But despite the treatment, the average titer of Gardnerella vaginalis was >104 CFU/ml in 17.4% (n=4). The growth of Lactoba-cillus spp. in both groups was evidence of the effectiveness of the therapy while the value of this microorganism was higher in group 1. Moreover, there was a statisti-cally significant decrease of pro-inflammatory cytokines to normal values in the main group. The most favorable results for obstetric and perinatal outcomes (preterm rupture of membranes, preterm labor, asphyxia, intrauterine infection of newborns, etc.) were obtained in group 1.

Conclusion: Immunomodulatory medication Superlymph combined with antibacte-rial drugs improves the effectiveness of the treatment for bacterial vaginosis during pregnancy.

Full Text

Restricted Access

About the authors

Victor L. Tyutyunnik

Academician V.I. Kulakov National Medical Research Centre of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Author for correspondence.
Email: tioutiounnik@mail.ru
ORCID iD: 0000-0002-5830-5099
SPIN-code: 1963-1359
Scopus Author ID: 56190621500
ResearcherId: B-2364-2015

Professor, MD, PhD, Leading Researcher of Research and Development Service

Russian Federation, 117997, Moscow, Ac. Oparina str., 4

Olga I. Mikhailova

Academician V.I. Kulakov National Medical Research Centre of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: omikhaylova@gmail.com
ORCID iD: 0000-0001-7569-8704

PhD, Researcher, 2 Maternity Department

Russian Federation, 117997, Moscow, Ac. Oparina str., 4

Natalia E. Kan

Academician V.I. Kulakov National Medical Research Centre of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: kan-med@mail.ru
ORCID iD: 0000-0001-5087-5946
SPIN-code: 5378-8437
Scopus Author ID: 57008835600
ResearcherId: B-2370-2015

MD, PhD, Deputy Director of Science

Russian Federation, 117997, Moscow, Ac. Oparina str., 4

Dzhamilia D. Mirzabekova

Academician V.I. Kulakov National Medical Research Centre of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: Jamilya1705@yandex.ru
ORCID iD: 0000-0002-2391-3334

graduate student

Russian Federation, 117997, Moscow, Ac. Oparina str., 4

References

  1. Coudray M.S., Madhivanan P. Bacterial vaginosis-A brief synopsis of the literature. Eur. J. Obstet. Gynecol. Reprod. Biol. 2020; 245: 143-8. https://dx.doi.org/10.1016/j.ejogrb.2019.12.035.
  2. Российское общество дерматовенерологов и косметологов. Федеральные клинические рекомендации. Дерматовенерология. 2015: Болезни кожи. Инфекции, передаваемые половым путем. 5-е изд. М.: Деловой экспресс; 2016: 645-54. [Russian Society of Dermatovenerologists and Cosmetologists. Federal clinical guidelines. Dermatovenerology 2015: Skin diseases. Sexually transmitted infections. Moscow; 2016: 645-54. (in Russian)].
  3. Vazquez F., Fernández-Blázquez A., García B. Vaginosis. Vaginal microbiota. Enferm. Infecc. Microbiol. Clin. (Engl. Ed). 2019; 37(9): 592-601. https://dx.doi.org/10.1016/j.eimc.2018.11.009.
  4. Reiter S., Kellogg Spadt S. Bacterial vaginosis: a primer for clinicians. Postgrad. Med. 2019; 131(1): 8-18. https://dx.doi.org/10.1080/00325481.2019.1546534.
  5. Chen X., Lu Y., Chen T., Li R. The female vaginal microbiome in health and bacterial vaginosis. Front. Cell. Infect. Microbiol. 2021; 11: 631972. https://dx.doi.org/10.3389/fcimb.2021.631972.
  6. Chee W.J.Y., Chew S.Y., Than L.T.L. Vaginal microbiota and the potential of Lactobacillus derivatives in maintaining vaginal health. Microb. Cell Fact. 2020; 19(1): 203. https://dx.doi.org/10.1186/s12934-020-01464-4.
  7. Bagnall P., Rizzolo D. Bacterial vaginosis: a practical review. JAAPA. 2017; 30(12): 15-21. https://dx.doi.org/10.1097/01.JAA.0000526770.60197.fa.
  8. Jayaram P.M., Mohan M.K., Konje J. Bacterial vaginosis in pregnancy - a storm in the cup of tea. Eur. J. Obstet. Gynecol. Reprod. Biol. 2020; 253: 220-4. https://dx.doi.org/10.1016/j.ejogrb.2020.08.009.
  9. Дикке Г.Б. Бактериальный вагиноз: новые аспекты этиопатогенеза и выбора терапевтических стратегий. Русский медицинский журнал. Мать и дитя. 2019; 2(4): 307-13. [Dicke G.B. Bacterial vaginosis: new aspects of etiopathogenesis and choice of therapeutic strategies. Russian Medical Journal. Mother and Child. 2019; 2(4): 307-13. (in Russian)]. https://dx.doi.org/10.32364/2618-8430-2019-2-4-307- 313.
  10. Yudin M.H., Money D.M. No. 211-screening and management of bacterial vaginosis in pregnancy. J. Obstet. Gynaecol. Can. 2017; 39(8): e184-e191. https://dx.doi.org/10.1016/j.jogc.2017.04.018.
  11. Kahwati L.C., Clark R., Berkman N., Urrutia R., Patel S.V., Zeng J., Viswanathan M. Screening for Bacterial Vaginosis in Pregnant Adolescents and Women to Prevent Preterm Delivery: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2020; 323(13): 1293-309. https://dx.doi.org/10.1001/jama.2020.0233.
  12. Haahr T., Ersbøll A.S., Karlsen M.A., Svare J., Sneider K., Hee L. et al. Appreciable uncertainty regarding benefits and risks in the treatment of bacterial vaginosis to prevent preterm birth. Acta Obstet. Gynecol. Scand. 2017; 96(2): 251-2. https://dx.doi.org/10.1111/aogs.13076.
  13. Чилова Р.А., Проклова Г.Ф., Гончаренко Н.В. Проблемы дифференциальной диагностики и лечения бактериального вагиноза. Русский медицинский журнал. Мать и дитя. 2020; 3(1): 39-43. [Chilova R.A., Proklova G.F., Goncharenko N.V. Problems of differential diagnosis and treatment of bacterial vaginosis. Russian Medical Journal. Mother and Child. 2020; 3(1): 39-43. (in Russian)]. https://dx.doi.org/10.32364/2618- 8430-2020-3-1-39-43.
  14. Hoffman M.K., Bellad M.B., Charantimath U.S., Kavi A., Nagmoti J.M., Nagmoti M.B. et al. A comparison of colorimetric assessment of vaginal pH with nugent score for the detection of bacterial vaginosis. Infect. Dis. Obstet. Gyne-col. 2017; 2017: 1040984. https://dx.doi.org/10.1155/2017/1040984.
  15. Jin J. Screening for bacterial vaginosis during pregnancy. JAMA. 2020; 323(13): 1324. https://dx.doi.org/10.1001/jama.2020.3690.
  16. Летяева О.И. Бактериальный вагиноз: современные возможности и перспективы длительного контроля. Российский вестник акушера-гинеколога. 2019; 19(2): 100-4. [Letyaeva O.I. Bacterial vaginosis: current possibilities and prospects for long-term control. Russian Bulletin of Obstetrician-Gynecologist. 2019; 19(2): 100-4. (in Russian)]. https://dx.doi.org/10.17116/rosakush201919021100.
  17. Redelinghuys M.J., Geldenhuys J., Jung H., Kock M.M. Bacterial vaginosis: current diagnostic avenues and future opportunities. Front. Cell. Infect. Microbiol. 2020; 10: 354. https://dx.doi.org/10.3389/fcimb.2020.00354.
  18. Ибрагимова Д.М., Доброхотова Ю.Э. Подходы к лечению бактериального вагиноза. Русский медицинский журнал. Мать и дитя. 2018; 2: 174-7. [Ibragimova D.M., Dobrokhotova Yu.E. Approaches to the treatment of bacterial vaginosis. Russian Medical Journal. Mother and Child. 2018; (2): 174-7. (in Rus-sian)]. https://dx.doi.org/10.32364/2618-8430-2018-1-2-174-177.
  19. Subtil D., Brabant G., Tilloy E., Devos P., Canis F., Fruchart A. et al. Early clindamycin for bacterial vaginosis in pregnancy (PREMEVA): a multicentre, double-blind, randomised controlled trial. Lancet. 2018; 392(10160): 2171-9. https://dx.doi.org/10.1016/S0140-6736(18)31617-9.
  20. Hu C.Y., Li F.L., Hua X.G., Jiang W., Zhang X.J. Longitudinal trajectory of vulvovaginal candidiasis, trichomoniasis, and bacterial vaginosis during pregnancy as well as the impact on pregnancy outcomes: a preliminary study. J. Matern. Fetal Neonatal Med. 2019; 32(21): 3612-7. https://dx.doi.org/ 10.1080/14767058.2018.1469125.
  21. Карапетян Т.Э., Арзуманян В.Г., Тютюнник В.Л., Кан Н.Е., Ло-мова Н.А., Канюкина А.А. Бактериальный вагиноз и антимикробная активность во время беременности. Акушерство и гинекология. 2018; 8: 85-90. [Karapetyan T.E., Arzumanyan V.G., Tyutyunnik V.L., Kan N.E., Lomova N.A., Kanyukina A.A. Bacterial vaginosis and antimicrobial activity during pregnancy. Obstetrics and Gynecology. 2018; (8): 85-90. (in Russian)]. https://dx.doi.org/10.18565/aig.2018.8.85-90.
  22. Боровкова Е.И., Залесская С.А., Степанянц И.В. Сравнительная эффективность влагалищного и ректального применения цитокинотерапии у беременных с дисплазией шейки матки. Русский медицинский журнал. Мать и дитя. 2019; 2(3):173-6. [Borovkova E.I., Zalesskaya S.A., Stepanyants I.V. Comparative efficacy of vaginal and rectal cytokine therapy in pregnant women with cervical dysplasia. Russian medical journal. Mother and Child. 2019; 2(3): 173-6. (in Russian)]. https://dx.doi.org/10.32364/ 2618-8430-2019-2-3-173-176.
  23. Аполихина И.А., Саидова А.С., Тетерина Т.А. Эффективность применения локальной цитокинотерапии в комплексном лечении пациенток с хроническим циститом. Акушерство и гинекология. 2019; 12: 167-72. [Apolikhina I.A., Saidova A.S., Teterina T.A. Efficiency of local cytokine therapy used in the combination treatment of female patients with chronic cystitis. Obstetrics and Gynecology. 2019; (12): 167-72. (in Russian)]. https://dx.doi.org/10.18565/aig.2019.12.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies