Genital Micro-Organisms in Pregnancy

Abstract

The microbiome of the female genital tract may undergo changes in pregnancy due to metabolic, endocrinological, and immunological alterations. These dysbiotic states may cause infections which may ascend upwards to the feto-placental unit or may be seeded hematogenously. These low grade and often low virulent infectious states lead to chronic inflammatory states and maybe associated with adverse maternal and neonatal outcome. Organisms have been isolated from amniotic fluid and placentae from women delivering pre-term; however the possibility of contamination cannot be conclusively ruled out. Common vaginal dysbiotic states often cause symptoms that are overlooked and often untreated. Vulvovaginal Candidiasis (VVC), Bacterial Vaginosis (BV), and Trichomonas Vaginitis (TV) are the commonly occurring dysbiotic states leading to vaginal infective states in pregnancy. With the advent of novel technologies like Next Generation sequencing (NGS), it will soon be possible to comprehensively map the vaginal microbiome and assess the interplay of each microbial state with their effects in pregnancy. This may open new avenues for antibiotic recommendations, probiotics and potential alternate therapies for dysbiotic states leading to pregnancy complications.

Vaginal Probiotics for Reproductive Health and Related Dysbiosis: Systematic Review and Meta-Analysis

“…were the dominant colonizers in reproductive sites [ 38 ] and defended these sites against abnormal or pathogenic microorganisms [ 61 ]. Accordingly, more probiotic interventional studies have been conducted on reproductive failures with lactobacilli imbalance, such as adverse pregnancy outcomes [ 16 ], a significant decrease in endometrial implantation [ 36 ], and altered IVF outcomes [ 62 , 63 ]. The Lactobacillus genus has optimal probiotic properties, including high hydrophobicity and self-regulation, adhesion to epithelial cells and acid production [ 64 ], and restoration of healthy urogenital microbiota [ 65 , 66 , 67 ].…”

Next-Generation Sequencing as a Tool to Detect Vaginal Microbiota Disturbances during Pregnancy

“…Studies on the human microbiome with the application of this method have definitely shown more richness in the microbiota (both aerobic and anaerobic) than those identified using culturing methods [ 12 ]. For this reason, the implementation of the NGS seems to be an appropriate method to monitor the changes in the vaginal composition of bacteria during pregnancy and its relationship with susceptibility to infection, the possibility of premature birth, and postpartum complications [ 3 , 6 , 13 , 14 ].…”

Current and Future Trends in the Laboratory Diagnosis of Sexually Transmitted Infections

“…Furthermore, changes in microbial communities which are potentially associated with disease can be studied. A dysbiotic vaginal environment, like the one observed in bacterial vaginosis (BV), is interlinked with an augmented risk of contracting STIs [109] and adverse pregnancy outcomes [6].…”

“…The two most common bacterial STIs, CT and NG, not only cause pelvic inflammatory disease and chronic pelvic pain in women, but also result in ectopic pregnancies and miscarriages, preterm labor, increased risk of mother-to-child HIV transmission, conjunctivitis, and pneumonia in neonates [5]. Although the evidence is inconclusive, MG and TV infection in pregnancy have also been associated with preterm birth [6]. Neonates can become infected with HSV at birth from an infected mother, with potential involvement of the central nervous system and fatal consequences [7].…”