Vaginal microbiocenosis in various clinical forms of miscarriage

Introduction. Numerous studies have shown that vaginal dysbiosis can complicate the course and outcome of pregnancy. Real-time polymerase chain reaction (RT-PCR) allows for a multivariate quantitative analysis of conditionally pathogenic microflora from the urogenital tract, which represents a novel approach to the diagnosis of inflammatory diseases and dysbiotic conditions of the lower female genitals. Aim: to determine and compare the parameters of vaginal microbiocenosis between various clinical forms of miscarriage. Materials and methods. For the microbiological analysis, we used scrapings from the posterolateral vaginal fornix mucosa. The samples were analyzed using the RT-PCR assay. Three groups of women with clinically identified and sonographically confirmed miscarriages were examined. The clinical forms were: threatened miscarriage (TM), spontaneous abortion (SA), and undeveloped pregnancy (UP). Results. Significant differences in the vaginal microbiocenosis parameters were found between the UP vs SA and TM vs UP groups; these changes negatively affected the course and outcome of pregnancy. The highest occurrence (68 %) of microbiocenosis disorders was found in patients of the TM group. The most common carriers of Candida fungi were patients of the UP (60 %) and TM (56 %) groups. Mycoplasma genitalium was the most common infectious agent in the TM group (14 %), and Mycoplasma hominis - in the SA group (40 %). In most cases (54 %), the carriers of CMV infection were detected in the UP group. Four parameters were found statistically significant for the TM and SA groups: the reduced presence of Lactobacillus spp. (p = 0.001), the increased presence of Gardnerella vaginalis + Prevotella bivia + Porphyromonas spp. (p = 0.01), Mycoplasma hominis (p = 0.001), and CMV infection (p = 0.004). For the UP group, the significant indicator was the presence of CMV (p = 0.001). Conclusion. The results indicate a negative role of the above infectious agents in the development of various clinical forms of miscarriage.

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