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

Tapilskaya, Natalia I.; Игоревна, Тапильская Наталья; Savicheva, Alevtina; Михайловна, Савичева Алевтина; Shipitsyna, Elena; Васильевна, Шипицына Елена

doi:10.17816/jowd65689-95

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…Vagina preparation in all patients before the operation was performed using drug product containing a lyophilized culture of lactobacteria L. casei rhamnosus Doderlein, which are Gram-positive anaerobic non-sporeforming bacteria exhibiting antagonistic activity against a broad range of pathogenic and conditionally pathogenic bacteria (including Staphylococcus spp., Proteus spp., and enteropathogenic Escherichia coli), and at the same time not affecting the natural vaginal microbiocenosis [9]. Particular attention was paid to the quality of hand treatment by the medical personnel involved in the operation, as well as strict adherence to asepsis and antiseptic rules in the operating ward.…”

Section: Study Materials and Methodsmentioning

confidence: 99%

Is It Necessary to Perform a Routine Antibiotic Prophylaxis before an Elective Surgery of Cesarean Section?

Belyaev

Nazarenko

Dubrova

et al. 2021

Open Access Maced J Med Sci

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INTRODUCTION: According to the data by World Health Organization, the broad and often insufficiently substantiated prescription of antibiotics, including for prophylactic purposes, has led to the growth of antibiotic-resistant microflora, which is a dangerous and intractable problem of modern medicine. Despite the undoubted benefits of antibiotics in the management of wound infection and endometritis after cesarean section, the routine prophylactic administration of antibacterial drugs can not only carry the risk of growth of resistant nosocomial microflora, but also have doubtful effects on the health of a newborn. PURPOSE OF THE STUDY: The purpose of the study was to justify the possibility of carrying out elective cesarean section operations without routine antibiotic prophylaxis. MATERIALS AND METHODS: An analysis of 333 cases of elective cesarean section operations carried out in the obstetric department in the period from 2017 to 2019 was performed. Routine antibiotic prophylaxis before surgery was not prescribed in 118 healthy patients with an uncomplicated history and a smooth course of the gestational process. The remaining 215 women received a single intravenous injection of 1 g of cefazolin sodium intraoperatively, after extraction of the fetus. A comparative analysis of the clinical groups was carried out according to the following criteria: vaginal microbiocenosis before surgical delivery, duration, and features of the operation, clinical blood count on days 1 and 5 of the post-operative period, condition of postoperative sutures, the presence of discharge from the wound, signs of infectious complications from the uterus or other organs, uterine involution rate, duration of hospital stay before and after surgery, follow-up history for 1 month after discharge from the maternity ward. The data obtained were subjected to statistical processing. RESULTS: We have found no significant differences in the course and number of complications in the postpartum period in the compared clinical groups. The statistically significant transient leukocytosis observed on the 1st day of the postoperative period in patients who did not undergo antibiotic prophylaxis before the surgery seems to be associated with a more pronounced adaptive reaction and was not combined with any clinical symptoms of development of infection. CONCLUSION: No relationship has been identified between the routine prescription of antibiotics before or during an elective cesarean section and the risk of developing infectious complications in the post-operative period. Antibiotic prophylaxis before surgery should be carried out differentially, taking into account the history and features of the course of this pregnancy.

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Section: Study Materials and Methodsmentioning

confidence: 99%

Is It Necessary to Perform a Routine Antibiotic Prophylaxis before an Elective Surgery of Cesarean Section?

Belyaev

Nazarenko

Dubrova

et al. 2021

Open Access Maced J Med Sci

View full text Add to dashboard Cite

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Impact of Vaginal Microbiota on Gestation and Labour

Karakhalis

Ivantsiv

2020

Kuban. nauсh. med. vestnik

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Background. Imbalances of vagina microbiota in pregnant women entail the development of bacterial vaginosis and candidal vulvovaginitis. Lactobacterial strains modulate pro-inﬂammatory epithelium responses to enhance resistance, which renders lactobacteria promising agents in pregnant women with elevated pH.Objectives. Assessment of the lactobacterial impact on vaginal microbiota and the course of gestation and labour.Methods. A total of 261 pregnant women were examined and separated by cohorts according to pH of vaginal ﬂuid: ≥4.5 in cohort 1 (n = 147), <4.5 in cohort 2 (n = 114). Cohort 1 had age 29.9 (4.6) years, cohort 2 — 29.0 (4.6) years, p = 0.55. Screening: at weeks 11–14, 18–21, 30–34 and 36–41 of gestation we performed vaginal pH-metry, cervicometry, determined opportunistic pathogens and lactobacteria with mass spectrometry. Cohort 1 received lactobacteria. Statistical analyses were performed with Statistica 10.Results. In cohort 1 receiving lactobacteria, the number of women devoid of opportunistic ﬂora increased from 31.29 to 43.53%. In cohort 2 not receiving lactobacteria, this number decreased from 53.51 to 35.09%. In cohort 1, L. jensenii (correlates with bacterial vaginosis rate) was primarily isolated in 9.52% women, and in 14.91% — in cohort 2. The rate of L. jensenii increased to 14.96% in cohort 1 (receiving lactobacteria) and decreased to 3.51% in cohort 2 (not receiving lactobacteria). A higher L. jensenii rate correlated with absent growth of opportunistic pathogens. Increasing the rate of L. crispatus (suppresses opportunistic pathogens) to 14.96% in cohort 1 lead to a 1.9-fold diminishing of active opportunistic ﬂora. An increase of L. crispatus from 7.02 to 30.7% in cohort 2 supressed active opportunistic growth 3.9-fold at a normal baseline pH. Cervicometry values were invariant between the cohorts. Pregnancy complications were not observed under abundant lactobacterial growth. The risk of gestation loss occurred in 1.4% of women in cohort 1 and in 10.5% — in cohort 2. Abnormal labour and premature rupture of foetal membranes were more frequent in cohort 2.Conclusion. With a less favourable premorbid condition in cohort 1, vaginal changes with background lactobacterial therapy facilitate gestational health in pregnancy. Many “sterile” niches, especially the maternal generative passages, represent active low biomass environments inhabited by unique typical maternal microﬂora. Most remarkable is the correlation between health of vaginal microbiota and abnormal labour.

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

Cited by 2 publications

References 28 publications

Is It Necessary to Perform a Routine Antibiotic Prophylaxis before an Elective Surgery of Cesarean Section?

Is It Necessary to Perform a Routine Antibiotic Prophylaxis before an Elective Surgery of Cesarean Section?

Impact of Vaginal Microbiota on Gestation and Labour

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