Lactoginal for correction of abnormal vaginal microbiocenosis in pregnant woman with cervical cerclage: clinical case and literature review

Cover Page


The present paper describes for the first time a case of using the preparation of vaginal lactobacilli Lactoginal (strain Lactobacillus rhamnosus Lcr35) for correction of vaginal microflora disturbance, associated with cervical cerclage in pregnant woman with a history of pregnancy miscarriage. Administration of the probiotic lactobacilli preparation up to the delivery resulted in steady normalization of the vaginal miсrobiocenosis, which might have, to a certain extent, contributed to its normal course and delivery. The obtained results are discussed in the context of literature data.

Natalia I Tapilskaya

St Petersburg State Pediatric Medical University

Author for correspondence.

Russian Federation MD, Professor of the Department of Obstetrics and Gynecology

Alevtina M Savicheva

FSBSI “The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott”


Russian Federation MD, Professor, Head of Laboratory of Microbiology

Elena V Shipitsyna

FSBSI “The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott”


Russian Federation PhD, Senior Researcher, Laboratory of Microbiology

  1. Shennan A, Jones B. The cervix and prematurity: aetiology, prediction and prevention. Semin Fetal Neonatal Med. 2004;9:471-9. doi: 10.1016/j.siny.2004.09.001.
  2. Lee SE, Romero R, Park CW, et al. The frequency and significance of intraamniotic inflammation in patients with cervical insufficiency. Am J Obstet Gynecol. 2008;198:633e1-e8. doi: 10.1016/j.ajog.2007.11.047.
  3. Alfirevic Z, Stampalija T, Roberts D, Jorgensen AL. Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy. Cochrane Database Syst Rev. 2012;18;(4): CD008991. doi: 10.1002/14651858.CD008991.pub2.
  4. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No.142: Cerclage for the management of cervical insufficiency. Obstet Gynecol. 2014;123(2 Pt 1):372-9. doi: 10.1097/01.AOG.
  5. Brown R, Gagnon R, Delisle MF, et al. Cervical insufficiency and cervical cerclage. J Obstet Gynaecol Can. 2013;35(12):1115-27.
  6. Petrova M, Lievens E, Malik S, et al. Lactobacillus species as biomarkers and agents that can promote various aspects of vaginal health. Front Physiol. 2015;6:81. doi: 10.3389/fphys.2015.00081.
  7. Annells MF, Hart PH, Mullighan CG, et al. Interleukins-1, -4, -6, -10, tumor necrosis factor, transforming growth factor-beta, FAS, and mannose-binding protein C gene polymorphisms in Australian women: Risk of preterm birth. Am J Obstet Gynecol. 2004;191(6):2056-67.
  8. Abdel-Aleem H, Shaaban OM, Abdel-Aleem MA. Cervical pessary for preventing preterm birth. Cochrane Database Syst Rev. 2013;(5):CD007873. doi: 10.1002/14651858.CD007873.pub3.
  9. Romero R, Nicolaides KH, Conde-Agudelo A, et al. Vaginal progesterone decreases preterm birth ≤ 34 weeks of gestation in women with a singleton pregnancy and a short cervix: an updated meta-analysis including data from the OPPTIMUM study. Ultrasound Obstet Gynecol. 2016;48(3):308-17. doi: 10.1002/uog.15953.
  10. Di Renzo GC, Roura LC, Facchinetti F, et al. Guidelines for the management of spontaneous preterm labor: identification of spontaneous preterm labor, diagnosis of preterm premature rupture of membranes, and preventive toolsfor preterm birth. J Matern Fetal Neonatal Med. 2011;24(5):659-67. doi: 10.3109/14767058.2011.553694.
  11. Final report of the Medical Research Council/Royal College of Obstetricians and Gynaecologists multicentre randomised trial of cervical cerclage. MRC/RCOG Working Party on Cervical Cerclage. Br J Obstet Gynaecol. 1993;100:516-23.
  12. Melamed N, Ben-Haroush A, Chen R, et al. Intrapartum cervical lacerations: characteristics, risk factors, and effects on subsequent pregnancies. Am J Obstet Gynecol. 2009;200:388 e1-e4. doi: 10.1016/j.ajog.2008.10.034.
  13. Kindinger LM, MacIntyre DA, Lee YS, et al. Relationship between vaginal microbial dysbiosis, inflammation, and pregnancy outcomes in cervical cerclage. Sci Transl Med. 2016;8(350):350ra102. doi: 10.1126/scitranslmed.aag1026.
  14. Carey JC, Klebanov MA. Is a change in the vaginal flora associated with an increased risk of preterm birth? Am J Obstet Gynecol. 2005;192(4):1341–6. doi: 10.1016/j.ajog.2004.12.069.
  15. Donders GG, Van Calsteren K, Bellen G, et al. Predictive value for preterm birth of abnormal vaginal flora, bacterial vaginosis and aerobic vaginitis during the first trimester of pregnancy. BJOG: Int J Obstet Gynecol. 2009;116:1315-24. doi: 10.1111/j.1471-0528.2009.02237.x.
  16. Leitich H, Kiss H. Asymptomatic bacterial vaginosis and intermediate flora as risk factors for adverse pregnancy outcome. Best Pract Res Clin Obstet Gynaecol. 2007;21(3):375-90. doi: 10.1016/j.bpobgyn.2006.12.005.
  17. Keelan JA, Blumenstein M, Helliwel RJ. Cytokines, prostaglandins and parturition – a review. Placenta. 2003;24(SupplA):S33-46.
  18. Mancuso MS, Figueroa D, Szychowski JM, et al. Midtrimester bacterial vaginosis and cervical length in women at risk for preterm birth. Am J Obstet Gynecol. 2011;204:342. doi: 10.1016/j.ajog.2010.11.003.
  19. Stojanović N, Plećaš D, Plešinac S. Normal vaginal flora, disorders and application of probiotics in pregnancy. Arch Gynecol Obstet. 2012;286(2):325-32. doi: 10.1007/s00404-012-2293-7.
  20. McGregor JA, French JI, Jones W, et al. Bacterial vaginosis is associated with prematurity and vaginal fluid mucinase and sialidase: results of a controlled trial of topical clindamycin cream. Am J Obstet Gynecol. 1994;170:1048-1059.
  21. Kavak SB, Kavak E, Ilhan R, et al. The efficacy of ampicillin and Lactobacillus casei rhamnosus in the active management of pretermpremature rupture of membranes remote from term. Drug Des Devel Ther. 2014;8:1169-73. doi: 10.2147/DDDT.S68552.
  22. Krauss-Silva L, Moreira ME, Alves MB, et al A randomized controlled trial of probiotics for the prevention of spontaneous preterm delivery associated with bacterial vaginosis: preliminary results. Trials. 2011;12:239. doi: 10.1186/1745-6215-12-239.
  23. Othman M, Alfirevic Z, Neilson JP. Probiotics for preventing preterm labour. Cochrane Database Syst Rev. 2007; 24(1): CD005941. doi: 10.1002/14651858.cd005941.pub2.
  24. Reid JN, Bisanz JE, Monachese M, et al. The rationale for probiotics improving reproductive health and pregnancy outcome. Am J Reprod Immunol. 2013;69(6):558-66. doi: 10.1111/aji.12086.
  25. Petricevic L, Witt A. The role of Lactobacillus casei rhamnosus Lcr35 in restoring the normal vaginal flora after antibiotic treatment of bacterial vaginosis. BJOG. 2008;115(11):1369-74. doi: 10.1111/j.1471-0528.2008.01882.x.
  26. Coudeyras S, Jugie G, Vermerie M, Forestier C. Adhesion of human probiotic Lactobacillus rhamnosus to cervical and vaginal cells and interaction with vaginosis-associated pathogens. Infect Dis Obstet Gynecol. 2008:549640. doi: 10.1155/2008/549640.
  27. De Champs C, Maroncle N, Balestrino D, et al. 2003. Persistence of colonization of intestinal mucosa by a probiotics strain, Lactobacillus casei subsp. rhamnosus Lcr35, after oral consumption. J Clin Microbio. 2003;41(3):1270-73.
  28. Nivoliez A, Camares O, Paquet-Gachinat M, et al. Influence of manufacturing processes on in vitro properties of the probiotic strain Lactobacillus rhamnosus Lcr35®. J Biotechnol. 2012;160(3–4):236-41. doi: 10.1016/j.jbiotec.2012.04.005.
  29. Савичева А.М., Рыбина Е.В. Исследование in vitro роста, размножения, антибиотикорезистентности, конкурентных взаимоотношений штамма Lactobacillus casei rhamnosus // Акушерство и гинекология. – 2014. – № 7. – С. 79–83. [Savicheva AM, Rybina EV. Issledovanie in vitro rosta, razmnozheniya, antibiotikorezistentnosti, konkurentnyh vzaimootnoshenij shtamma Lactobacillus casei rhamnosus. Akusherstvo i ginekologiya. 2014;(7):79-83. (In Russ.)]


Abstract - 903

PDF (Russian) - 290


Copyright (c) 2016 Tapilskaya N.I., Savicheva A.M., Shipitsyna E.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.