AEROBIC VAGINITIS AND PREGNANCY

Objective. To determine the frequency of aerobic vaginitis (AV) and their etiologic pattern in a group of pregnant women at high risk for infection. Subject and methods. 312 women in different periods of pregnancy were examined. Acute sexually transmitted and virus infections were excluded in all the women. The microbiological diagnosis of vaginal infections was made on the basis of integral evaluation of the vaginal microbiota by microscopy and culture results. AV included vaginitis with the facultative anaerobic bacteria being found in a high titer (more than 104-5CFU/ml) in the absence of lactobacilli or in the presence of their low titer, a significant leukocyte reaction, and parabasal epithelial cells (severe forms). Results. AV was identified in 11.9% of the pregnant women on their primary referral. Moreover, the high titers (>10 5CFU/ml)) of facultative anaerobic bacteria were detected in 17.0% of the patients with bacterial vaginitis (BV) and in 16.4% of the pregnant women with Candida vaginitis (CV). Thus, the problems associated with facultative anaerobic bacteria could be seen in 63 (36.4%) of the 176 pregnant women with abnormal vaginal microbiota. The AV pathogens showed a preponderance of Group B streptococci (62.2%), enterococci (48.7%), and Escherichia (40.5%), which were isolated in both monoculture and more frequently in associations. The same species were predominant in BV and CV cases with high titers of opportunistic microorganisms (OM). Conclusion. AVs which are mixed infections caused by OM and their development readiness (high titers of OM as a risk factor for ping-pong vaginitis in BV and CV) were found in every 3 pregnant women with abnormal vaginal microbiota. Imperfect primary microbiological diagnosis of vaginal infections leads to inadequate etiotropic treatment for vaginal infections, which frequently results in its inefficiency, recurrent vaginitis, and complicated pregnancy.

aerobic vaginitis, pregnancy, opportunistic infections