Biography:
To be updated
Abstract:
Statement of the Problem: Preterm birth (PB) is one of the main causes of perinatal morbidity and mortality in newborns. The cause of PB is multietiologic, however, it is considered that one of the main risk factors is a disturbance of the vaginal microbiocenosis in a pregnant woman. Some studies have shown an interaction between vaginal microbiota in early pregnancy and the risk of PB.
Purpose of this study was to assess the morphological features of the placenta and the microflora of the vagina and placenta in women with preterm birth.
Methodology & Theoretical Orientation: This was retrospective, case-control study. The study was conducted during 2018 and included 150 women who gave birth at the Reshetova L.A. Kemerovo Regional Clinical Perinatal Center (Kemerovo, Russia). Group I included 50 women with preterm vaginal birth; Group II consisted of 100 women with term vaginal birth. We used morphological investigations of the placenta, bacteriological examination of the contents of the vagina, scrape from the surface of the placenta.
The results of the study showed that the features of the histological structure of the placenta in women with PB is a high incidence of ascending infection (54%), especially Grade II-III (16% and 10%) with a predominance of choriodeciditis (40%) and intervillusitis (32%), as well as a higher frequency of placental insufficiency (54% vs 35% in the control group) and placental villous immaturity (100%). In patients with premature birth in the early pregnancy, a high frequency of vaginal disbiosis was recorded (75%). There is no established relationship between the microbiocenosis of the vagina in early pregnancy, placenta microbiocenosis, and the placenta infection. Microflora were isolated from vagina in 97% and 61% of women (p<0.001), from placenta – in 61% and 50% of women (p>0.05). The main vaginal microflora were St. haemolyticus (30.6%), C. albicans (20.2%), Corynbacterium spp (19.4%). Lactobacilli were isolated in early pregnancy only in 5.6% of women with PB. The main placenta microflora were E.Coli (22.2%) and Ent.Faecalis (14.3%). The coincidence of the microbiocenosis of the vagina and the placenta (E. coli and St. haemolyticus) was observed just in two patients.
Conclusion & Significance: Patients with preterm birth had a high incidence of vaginal microbiocinosis disorders in early pregnancy, placental infection, and placental insufficiency.