Gardnerella vaginalis chorioamnionitis: A report of two cases and a review of the pathogenic role of G. Vaginalis in obstetrics

Lee, Wesley; Phillips, Lou Ellen; Carpenter, Robert J.; Martens, Mark G.; Faro, Sebastian

doi:10.1016/0732-8893(87)90157-x

Cited by 12 publications

(6 citation statements)

References 7 publications

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“…Gardnerella vaginalis stimulates the production of interleukin (IL)‐1β, tumour necrosis factor (TNF)‐α, IL‐6, and Human β defensins 1/2/3 by choriodecidua in vitro . It has been found to colonise the vagina in 16% of PTB cases compared with 3% of term pregnancies, has previously been associated with PTB following emergency cerclage in culture‐dependent studies, and is associated with chorioamnionitis . Gardnerella vaginalis also forms biofilms, making it resistant to antibiotic treatment, which may account for the poor outcomes in this study when the fetal membranes were exposed to the vagina despite antibiotic treatment …”

Section: Discussionmentioning

confidence: 99%

Prospective observational study of vaginal microbiota pre‐ and post‐rescue cervical cerclage

Chan

Terzidou

et al. 2019

BJOG

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Objective To investigate the relation between vaginal microbiota composition and outcome of rescue cervical cerclage. Design Prospective observational study. Setting Queen Charlotte's and Chelsea Hospital, London. Population Twenty singleton pregnancies undergoing a rescue cervical cerclage. Methods Vaginal microbiota composition was analysed in women presenting with a dilated cervix and exposed fetal membranes before and 10 days following rescue cervical cerclage and was correlated with clinical outcomes. Main outcome measures Composition of vaginal bacteria was characterised by culture‐independent next generation sequencing. Successful cerclage was defined as that resulting in the birth of a neonate discharged from hospital without morbidity. Unsuccessful cerclage was defined as procedures culminating in miscarriage, intrauterine death, neonatal death or significant neonatal morbidity. Results Reduced Lactobacillus spp. relative abundance was observed in 40% of cases prior to rescue cerclage compared with 10% of gestation age‐matched controls (8/20, 40% versus 3/30, 10%, P = 0.017). Gardnerella vaginalis was over‐represented in women presenting with symptoms (3/7, 43% versus 0/13, 0%, P = 0.03, linear discriminant analysis, LDA (log 10) and cases culminating in miscarriage (3/6, 50% versus 0/14, 0%, P = 0.017). In the majority of cases (10/14, 71%) bacterial composition was unchanged following cerclage insertion and perioperative interventions. Conclusions Reduced relative abundance of Lactobacillus spp. is associated with premature cervical dilation, whereas high levels of G. vaginalis are associated with unsuccessful rescue cerclage cases. The insertion of a rescue cerclage does not affect the underlying bacterial composition in the majority of cases. Tweetable abstract Preterm cervical dilatation associates with reduced Lactobacillus spp. Presence of Gardnerella vaginalis predicts rescue cerclage failure.

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Section: Discussionmentioning

confidence: 99%

Prospective observational study of vaginal microbiota pre‐ and post‐rescue cervical cerclage

Chan

Terzidou

et al. 2019

BJOG

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“…27 It has been found to colonise the vagina in 16% of PTB cases compared with 3% of term pregnancies, 28 has previously been associated with PTB following emergency cerclage in culture-dependent studies, 17 and is associated with chorioamnionitis. 29,30 Gardnerella vaginalis also forms biofilms, making it resistant to antibiotic treatment, which may account for the poor outcomes in this study when the fetal membranes were exposed to the vagina despite antibiotic treatment. 31 Interestingly, two of the control samples also contained G. vaginalis, albeit at a lower abundance.…”

Section: Discussionmentioning

confidence: 91%

Faculty Opinions recommendation of Prospective observational study of vaginal microbiota pre- and post-rescue cervical cerclage.

Larsen

Lowe

2019

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature

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“…Commonly accepted methods to diagnose bacterial vaginosis include the Amsel criteria, which define bacterial vaginosis in the presence of four criteria: 1) a thin homogeneous vaginal discharge, 2) the presence of a fishy vaginal odor after alkalinization of the vaginal discharge with a 10% potassium hydroxide solution (positive ''whiff'' test), 3) vaginal pH greater than 4.5, and 4) the identification of clue cells or a predominance of coccobacilli in wet mounts of vaginal fluid with few or absent lactobacilli. 10,13 Alternatively, bacterial vaginosis may be defined by patterns of altered vaginal flora on Gram stain.…”

Section: Discussionmentioning

confidence: 99%

“…There is increasing evidence that preterm labor and delivery are associated with infection of the amniotic fluid and/or the chorioamnion, as well as with alterations in vaginal flora. [1][2][3] Bacterial vaginosis is a syndrome associated with altered vaginal flora, rather than infection with a single microorganism. A number of organisms have been associated with bacterial vaginosis; the two most commonly identified are Mycoplasma hominis 4 and Gardnerella vaginalis.…”

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confidence: 99%

Association between a shift in vaginal flora on papanicolaou smear and acute chorioamnionitis and preterm delivery

et al. 1999

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Bacterial vaginosis has been implicated as a cause of acute chorioamnionitis and preterm delivery. This study was designed to determine any association between the detection of bacterial vaginosis on a prenatal Papanicolaou (Pap) smear, defined as a shift in vaginal flora, and the subsequent occurrence of acute chorioamnionitis or preterm labor. A 47‐mo retrospective case‐control analysis comparing 186 patients with histologically‐proven acute chorioamnionitis (cases) and 186 controls was performed. Initial prenatal Pap smears were evaluated for the presence of altered vaginal flora. Pap smears from women with acute chorioamnionitis were more likely to have altered vaginal flora than those without chorioamnionitis (P < 0.01). Preterm delivery was also more common among women with a shift in vaginal flora (P < 0.01). In conclusion, women at risk for chorioamnionitis and/or preterm delivery may be able to be identified by the results of their prenatal Pap smear. Diagn. Cytopathol. 1999;21:7–9. © 1999 Wiley‐Liss, Inc.

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Gardnerella vaginalis chorioamnionitis: A report of two cases and a review of the pathogenic role of G. Vaginalis in obstetrics

Cited by 12 publications

References 7 publications

Prospective observational study of vaginal microbiota pre‐ and post‐rescue cervical cerclage

Prospective observational study of vaginal microbiota pre‐ and post‐rescue cervical cerclage

Faculty Opinions recommendation of Prospective observational study of vaginal microbiota pre- and post-rescue cervical cerclage.

Association between a shift in vaginal flora on papanicolaou smear and acute chorioamnionitis and preterm delivery

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