Lactobacilli in Papanicolaou Smears, Genital Infections, and Pregnancy

Donders, Gilbert; Wet, H.G. De; Hooft, P.; Desmyter, Jan

doi:10.1055/s-2007-994761

Cited by 49 publications

(52 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…6 Donders also records abnormal status of lactobacilli, that is, their absence, which is a negative factor and enables development of infection, especially in pregnancy. [7][8][9][10][11] In our study most common organism is the E. Coli amounting 34% followed by Candidial spp. 21%.…”

Section: Discussionsupporting

confidence: 50%

Isolation and characterization of organisms in high vaginal swab culture in preterm pregnancy (28-37 week)

Singh

Swain

Das

et al. 2016

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 50%

Isolation and characterization of organisms in high vaginal swab culture in preterm pregnancy (28-37 week)

Singh

Swain

Das

et al. 2016

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

“…Severe complications such as mid-trimester pregnancy losses, chorioamnionitis and even first trimester abortions were linked to the latter flora and mycoplasmata 8,17,18 . McDonald et al 9 found E. coli and group B streptococci to be important pathogens alongside the classical bacterial vaginosis organisms, and we reported that abnormal flora, but not full-blown bacterial vaginosis, was associated with preterm birth 11,19 . We hence suggested that a second abnormality of the vaginal flora should be considered, now termed 'aerobic vaginitis' 1 .…”

Section: Vaginal Fluid Constituentsmentioning

confidence: 54%

“…Treatment with metronidazole was highly unsuccessful in women with aerobic vaginitis (unpublished data) and is the subject of an ongoing treatment trial. The independent relationships of Trichomonas and abnormal flora with preterm birth have been studied in a population with high prevalence of both conditions 19 . Chlamydia and gonorrhoea cervicitis were excluded in the current series.…”

Section: Vaginal Fluid Constituents No Infection Candida Vaginitis Bamentioning

confidence: 99%

Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis

Donders

2002

BJOG: An International Journal of Obstetrics and Gynaecology

121

View full text Add to dashboard Cite

Objective To define an entity of abnormal vaginal flora: aerobic vaginitis.Design Observational study.Setting University Hospital Gasthuisberg, Leuven, Belgium.Sample 631 women attending for routine prenatal care or attending vaginitis clinic.Methods Samples were taken for fresh wet mount microscopy of vaginal fluid, vaginal cultures and measurement of lactate, succinate and cytokine levels in vaginal fluid. Smears deficient in lactobacilli and positive for clue cells were considered to indicate a diagnosis of bacterial vaginosis. Aerobic vaginitis was diagnosed if smears were deficient in lactobacilli, positive for cocci or coarse bacilli, positive for parabasal epithelial cells, and/or positive for vaginal leucocytes (plus their granular aspect). Results Genital complaints include red inflammation, yellow discharge, vaginal dyspareunia. Group B streptococci, escherichia coli, staphylococcus aureus and trichomonas vaginalis are frequently cultured.Vaginal lactate concentration is severely depressed in women with aerobic vaginitis, as in bacterial vaginosis, but vaginal succinate is not produced. Also in contrast to bacterial vaginosis, aerobic vaginitis produces a host immune response that leads to high production of interleukin-6, interleukin-1-b and leukaemia inhibitory factor in the vaginal fluid. Conclusion Aerobic vaginitis is associated with aerobic micro-organisms, mainly group B streptococci and E. coli. Its characteristics are different from those of bacterial vaginosis and elicit an important host response. The most severe form of aerobic vaginitis equals desquamative inflammatory vaginitis. In theory, aerobic vaginitis may be a better candidate than bacterial vaginosis as the cause of pregnancy complications, such as ascending chorioamnionitis, preterm rupture of the membranes and preterm delivery.

show abstract

“…Using the lactobacillary grading of the vaginal microflora in a population with high prevalence of genital infection [4,5], we previously demonstrated the link between nonspecific disturbance of the vaginal flora early in pregnancy and first trimester miscarriage, preterm birth and low birth weight [6][7][8][9][10]. The association of (anaerobic) bacterial vaginosis and preterm birth has been repeatedly confirmed [11][12][13][14][15], and treatment with oral clindamycin [12,14], or oral metronidazole [16] has proven to be effective in delaying delivery.…”

Section: Introductionmentioning

confidence: 99%

The Ecology of the Vaginal Flora at First Prenatal Visit is Associated with Preterm Delivery and Low Birth Weight

Donders¹,

Spitz²,

Vereecken³

et al. 2008

TOIDJ

View full text Add to dashboard Cite

Abstract:Objective: Can assessment of vaginal microbial flora at first prenatal visit predict the outcome of pregnancy?Material and methods: Pap smears and vaginal cultures were taken from 222 pregnant women at their first prenatal visit. Lactobacillary grades (LBG I-III) on Pap smears were used as a basis for the scoring. Points were added or subtracted according to the morphotypes of the lactobacilli, the presence of abnormal cellular morphology, increased vaginal leukocytosis, visible pathogens or red blood cells, or the finding of cytolysis of epithelial cells. The total score, reflecting the health of the vaginal microflora, was termed "Vaginal Ecology Score (VECO score)" and compared with pregnancy outcome.Results: A strong correlation was found between the vaginal eco-score (VECO) at first prenatal visit and the birth weight (r 2 0.85, p = 0.003), and between the VECO score and the number of days before term delivery took place (r 0.57, p = 0.048). This association persisted after multivariate analysis. After standardization for positive vaginal culture, a VECO score of 4 or more at first visit was associated with lower birth weight, earlier delivery and smaller fetal head circumference, but not with histological chorioamnionitis. Chorioamnionitis, on the other hand, was found more often in the group with positive vaginal cultures at first prenatal visit.Discussion: Vaginal micro-ecology can be scored at the first antenatal visit to predict delivery before 40 weeks and lowered birth weight, even in the absence of overt or detectable infectious disease. To assess prematurity below 37 weeks, larger studies are needed. This assessment of the vaginal ecology could also easily be applied on fresh wet mounts or gram stained specimens of vaginal fluid.

show abstract

Lactobacilli in Papanicolaou Smears, Genital Infections, and Pregnancy

Cited by 49 publications

References 7 publications

Isolation and characterization of organisms in high vaginal swab culture in preterm pregnancy (28-37 week)

Isolation and characterization of organisms in high vaginal swab culture in preterm pregnancy (28-37 week)

Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis

The Ecology of the Vaginal Flora at First Prenatal Visit is Associated with Preterm Delivery and Low Birth Weight

Contact Info

Product

Resources

About