Bacterial vaginosis in the first trimester of pregnancy: microbiological and immunological indicators in the evaluation of therapy efficiency

Objective. To investigate defensin production in pregnant women with bacterial vaginosis. Subjects and methods. Seventy pregnant women with bacterial vaginosis (according to the Amsel criteria) were examined and treated. The investigators formed a study group of 40 patients receiving Tergynan for 10 days and a control one of 30 patients taking Hexicon for 10 days; the patients’ median age was 29.3 years. They performed a culture study of vaginal microbiocenosis, an immunological study of the expression of defensin genes by real-time reverse transcription PCR, and statistical processing. Results. The course of the first and second trimesters was not different in the groups. The control group of patients in the third trimester more often developed a threat of preterm labor and urinary tract infection. Delivery at term occurred in 97.5% of the pregnant women in the study group; preterm labor was seen in 10% in the control group. Recurrent bacterial vaginosis developed in 10 and 43.3% in the study and control groups, respectively. In the study group, the normocenosis persisted at day 30 after treatment and at weeks 34-36. Conclusion. The expression of defensin was substantially increased in the presence of bacterial vaginosis. Following 10 days, the level of defensin in the study group decreased 1.7-fold and persisted at day 30 and at weeks 34-36; that in the control group declined 1.4-fold; at day 30, the expression of the factor returned to the baseline values and remained until the end of pregnancy.

bacterial vaginosis, pregnancy, preterm labor, mucosal immunity, defensin, Tergynan, chlorhexidine