Changes in the microbiota of the genital tract in women during the first month after extremely early premature birth

Abstract

Background. The problem of extremely early premature birth (ERP) is one of the most urgent in obstetrics due to the unfavorable perinatal prognosis and consequences for the mother’s body. At the same time, in the postpartum period, the patient is threatened with infectious and inflammatory complications due to infection prior to childbirth, a decrease in uterine contractility, and prolonged inpatient stay in connection with the care of an extremely premature newborn. Objective. Assessment of changes in the microbiota of the vagina and cervical canal in women in the dynamics of the first month after extremely early premature birth. Materials and methods. The main group consisted of women who delivered at 22-27/6 weeks gestation (N=50).The control group consisted of 50 patients who were delivered during full-term pregnancy. The patients underwent bacteriological studies of the contents of the cervical canal and studies of the biocenosis of the vagina by PCR (Femoflor-16). The studies were conducted on the 3rd and 30th days after childbirth. Results. The microbiota of the lower genital tract of women after extremely early premature birth undergoes the following changes: by the 30th day of the postpartum period, there was a statistically significant increase in the proportion of conditionally pathogenic microflora, mainly represented by gram-positive flora (Staphylococcus spp, Streptococcus spp, Enterococcus faecalis), however, with the development of infectious and inflammatory complications, the proportion of gram-negative microflora increases (Escherichia coli). In the study of vaginal biocenosis, it was found that in the dynamics of the postpartum period in patients after extremely early premature birth, the proportion of aerobic dysbiotic disorders decreases, and the proportion of moderate and pronounced anaerobic dysbiosis increases more than twice.Conclusion. It is necessary to search for effective methods of preventing postpartum complications of bacterial nature in patients after extremely early premature birth, taking into account the transformation of the microbiota of the lower parts during the first month after childbirth.