Vaginal microbiocenosis in patients with cervical insufficiency
https://doi.org/10.51523/2708-6011.2026-23-1-08
Abstract
Objective. To determine features of the vaginal microbiocenosis in pregnant women with cervical insufficiency. Materials and methods. The prospective study included 69 pregnant women between 16 and 24 weeks of gestation, aged 34 (32; 36) years old. The patients were divided into two groups. The main group consisted of 39 pregnant women with cervical insufficiency. The comparison group included 30 women without cervical insufficiency. Condition of the vaginal microbiome was assessed using microscopy and bacteriology of vaginal fluid, vaginal fluid pH testing, and the Femoflor-16 method.
Results. Diseases associated with disturbances in the vaginal microbiocenosis according to a set of microscopic criteria were diagnosed in 46.2% (18 of 39) of patients with cervical insufficiency and 16.7% (5 of 30) of patients without cervical insufficiency (χ²=5,374, p=0,020). In pregnant women with cervical insufficiency, a violation of the vaginal microbiocenosis in the form of bacterial vaginosis is more often observed, which is accompanied by a higher pH level of vaginal fluid (Z= -2,784; p=0,005). In patients of the main group, according to the results of bacteriological examination of vaginal discharge, positive cultures were found in 41.0% (16 of 39) cases versus 6.7% (2 of 30) cases in the comparison group (χ²=8,676; p=0,003). According to Femoflor-16 data, vaginal microbiocenosis disorders were noted in 23.1% (9 of 39) of patients in the main group and 23.3% (7 of 30) in the comparison group (χ²=0,069; p=0,792). In the vaginal microbiocenosis of patients with cervical insufficiency, microorganisms of the Enterobacteriaceae family (p=0,0005), Staphylococcus spp. (p=0,0001) are significantly more frequently represented; the concentration of Ureaplasma (urealyticum + parvum) is increased to more than 104 GE/ml.
Conclusion. The method of pH-metry of vaginal fluid is necessary as a screening method for diagnosing disorders of the vaginal microbiocenosis in patients with cervical insufficiency before its correction, the use of molecular genetic methods for diagnosing the state of the vaginal microbiocenosis allows for a more accurate determination of the state of the urogenital tract microbiota in order to select a drug treatment regimen before correcting cervical insufficiency.
About the Authors
A. V. Gatalskaya
Gomel State Medical University
Belarus
Belarus
Anna V. Gatalskaya, Assistant at the Department of Obstetrics and Gynecology with the course of Advanced Training and Retraining
Gomel
T. N. Zakharenkova
Gomel State Medical University
Belarus
Belarus
Tatsiana N. Zakharenkova, Candidate of Medical Sciences, Associate Professor, Head of the Department of Obstetrics and Gynecology with the course of Advanced Training and Retraining
Gomel
References
1. Mancabelli L, Tarracchini C, Milani C, Lugli GA, Fontana F, Turronie F, et al. Vaginotypes of the human vaginal microbiome. Environmental Microbiology. 2021;23(3):1780-1792. DOI: https://doi.org/10.1111/1462-2920.15441
2. Kwon MS, Lee HK. Host and Microbiome Interplay Shapes the Vaginal Microenvironment. Front Immunol. 2022 Jun 28;13:919728. DOI: https://doi.org/10.3389/fimmu.2022.919728
3. Budilovskaya OV. Current views on vaginal lactobacilli in women of reproductive age. Journal of Obstetrics and Women’s Diseases. 2016;65(4):34-43. (in Russ.). DOI: https://doi.org/10.17816/JOWD65434-43
4. Lehtoranta L, Ala-Jaakkola R, Laitila A, Maukonen J. Healthy Vaginal Microbiota and Influence of Probiotics Across the Female Life Span. Frontiers in Microbiology. 2022;(13):819958. DOI: https://dx.doi.org/10.3389/fmicb.2022.819958
5. Garcia-Velasco J, Menabrito M, Catalan IB. What fertility specialists should know about the vaginal microbiome: A review. Reproductive Biomedicine Online. 2017;(35):103-112. DOI: http://dx.doi.org/10.1016/j.rbmo.2017.04.005
6. France MT, Ma B, Gajer P, Brown S, Humphrys MS, Holm JB, et al. VALENCIA: a nearest centroid classification method for vaginal microbial communities based on composition. Microbiome. 2020 Nov 23;8(1):166. DOI: https://dx.doi.org/10.1186/s40168-020-00934-6
7. Fedorova KS, Abramovskikh KA, Savochkina AYu, Minasova AA, Zotova MA, Samatova AI, et al. The state of the vaginal biocenosis depending on the species diversity of lactobacilli. Infection and immunity. 2024; 3(14): 544-550. (In Russ.).
8. Budilovskaya OV, Shipitsyna EV, Gerasimova EN, et al. Species diversity of vaginal lactobacilli in norm and in dysbiotic states. Journal of Obstetrics and Women’s Diseases. 2017;66(2):24-32. (In Russ.). DOI: https://doi.org/10.17816/JOWD66224-32
9. Demkin VV. Species diversity of lactobacillus of vaginal microbiom: how to see. Molecular Genetics, Microbiology and Virology. 2018;36(3):3-12. (In Russ.). DOI: https://doi.org/10.17116/molgen2018360313
10. Bayar E, Bennett PhR, Chan D, Sykes L, MacIntyre DA. The pregnancy microbiome and preterm birth. Seminars in Immunopathology. 2020;42(4):487-499. DOI: https://dx.doi.org/10.1007/s00281-020-00817-w
11. Odogwu NM, Onebunne CA, Chen J, et al. Lactobacillus crispatus thrives in pregnancy hormonal milieu in a Nigerian patient cohort. Sci Rep. 2021 Sep 13;11(1):18152. DOI: https://dx.doi.org/10.1038/s41598-021-96339-y
12. Bakhtiyarov KR, Abdulaeva ASh, Bimurzayeva MB, Koroleva DV, Kuz’mina PI. Changes in the microbiome as a factor in the development of isthmic cervical insufficiency. V.F. Snegirev Archives of Obstetrics and Gynecology. 2024;11(1):49-56. (in Russ.). DOI: https://dx.doi.org/10.17816/2313-8726-2024-11-1-49-56
13. Dominguez-Bello M.G. Gestational shaping of the maternal vaginal microbiome. Nat Med. 2019;25(6):882-883. DOI: https://doi.org/10.1038/s41591-019-0483-6
14. Khodzhaeva ZS, Guseinova GE, Muravyeva VV, et al. Characteristics of the vaginal microbiota in pregnant women with preterm premature rupture of the membranes. Obstetrics and Gynegology. 2019;(12):64-73. (in Russ.). DOI: https://dx.doi.org/10.18565/aig.2019.12.66-74
15. Mönckeberg M, Valdés R, Kusanovic JP, et al. Patients with acute cervical insufficiency without intra-amniotic infection/ inflammation treated with cerclage have a good prognosis. J. Perinat. Med. 2019;47(5):500-509. DOI: https://dx.doi.org/10.1515/jpm-2018-0388
16. Mešić Ðogić L, Lučić N, Mićić D, et al. Correlation between cervical infection and preterm labor. Med. Glas (Zenica). 2017;14(1): 91-97. DOI: https://dx.doi.org/10.17392/886-16
17. Dolgushina VF, Kurnosenko IV, Alikhanova ES, Semenov YuA. Cervical and Vaginal Infections in Insuficiencia Istmicocervical. Doctor.Ru. 2021;20(1):61-67. (in Russ.).
18. Pustotina OA, Ostromensky VV. Infectious factor in the miscarriage genesis. Effective Pharmacotherapy. 2019;15(13):26- 33. (in Russ.). DOI: https://doi.org/10.33978/2307-3586-2019-15-13-26-33
19. Zakharenkova TN, Kaplan YuD. The influence of urogenital tract microbiota on pregnancy outcome. Obstetrics. Gynecology. Genetics. 2019;16(2):5-15. (in Russ.).
20. Zakharenkova TN, Prikhodko AN, Gatalskaya AV, Balashova VG. Diagnostic Role of pH-Metry of Vaginal Discharge in Various Conditions in Obstetrics and Gynecology. Reproductive Health Eastern Europe. 2025;15 (5):665-678. (in Russ.). DOI: https://dx.doi.org/10.34883/PI.2025.15.5.009
Review
For citations:
Gatalskaya A.V., Zakharenkova T.N. Vaginal microbiocenosis in patients with cervical insufficiency. Health and Ecology Issues. 2026;23(1):70-76. (In Russ.) https://doi.org/10.51523/2708-6011.2026-23-1-08
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