CHANGES IN THE VAGINA ECOSYSTEM AND STATE OF LOCAL IMMUNITY IN WOMEN WITH A HISTORY OF MISCARRIAGE ON THE PRECONCEPTIONAL PERIOD
DOI:
https://doi.org/10.11603/24116-4944.2022.1.13249Keywords:
vaginal microbiocenosis, dysbiosis, local immune response, secretory immunoglobulin A, preconceptional periodAbstract
The aim of the study – to investigate changes in the ecosystem of the vagina and assess the state of local immunity in women with a history of miscarriage on the preconception period.
Materials and Methods. 105 women with a history of miscarriage were involved to the study. They were divided into two groups: group 1 – 40 patients with miscarriage of infectious genesis, group 2 – 45 women with miscarriage on the background of endocrine dysfunction of the reproductive organs. The control group consisted of 20 practically healthy women. All patients underwent anamnestic data collection, gynecological examination, bacteriological and bacterioscopic examination, identification of pathogens in the vagina by the polymerase chain reaction method. The study of the local immune status was based on the assessment of the level of secretory immunoglobulin A (sIg A) by the enzyme immunoassay method. Statistical analysis was carried out using a package based on Microsoft Excel and the "Statistica 12.0" program.
Results and Discussion. In the study, it was established that in women of group 1 on the preconceptional period, the ecosystem of the vagina was characterized by the presence of a significant amount of opportunistic and pathogenic microflora. More than half of patients had dysbiotic disorders with the development of a clinical picture of vaginitis or bacterial vaginosis with a decrease of lactobacilli concentration. In women of group 1, the average sIg A level was 16.26 % lower compared to the control group (p˂0.01). In women of group 2, the sIg A concentration, this indicator was 3.59-fold lower compared to the control group (p˂0.001) and 3.00-fold lower than in the patients of group 1 (p˂0.001), which indicates a significant degree of reduction local immunity.
Conclusions. The characteristic of microbiocenosis features in women with a history of miscarriage have revealed polyinfection with opportunistic and pathogenic flora on the preconceptional period. A statistically significant decrease in the level of secretory Ig A was noted in women with miscarriages of both infectious and endocrine genesis groups with a worse picture in the local immune response system on the background of dyshormonal disorders.
References
Kravchenko, V.G., & Stepanenko, V.I. (2018). Analitychnyi ohliad rivnia zakhvoriuvanosti na infektsii, shcho peredaiutsia statevym shliakhom, u period 1945-2017 rr. ta mozhlyvi perspektyvni zakhody shchodo znyzhennia yikhnoi poshyrenosti v Ukraini [Analytical review of the incidence rate of sexually transmitted infections in the period 1945–2017 and possible prospective measures to reduce their prevalence in Ukraine]. Ukrayinskyi zhurnal dermatolohii, venerolohii, kosmetolohii – Ukrainian Journal of Dermatology, Venerology, Cosmetology, 3 (70), 47-52 [in Ukrainian].
Hruzevskyi, O.A. (2020). Stan systemy tsytokiniv pry bakterialnomu dysbiozi ta bakterialnomu vahinozi [The state of the cytokine system in bacterial dysbiosis and bacterial vaginosis]. Science Rise: Medical Science, 36 (3), 50-56. DOI:10.15587/2519–4798.2020.204094.
Redelinghuys, M.J., Ehlers, M.M, Dreyer, A.V., & Kock, M.M. (2015). Normal flora and bacterial vaginosis in pregnancy: an overview. M. Crit. Rev. Microbiol., 2 (1), 5-12.
Griffin, C., Harding, J., Sutton C. (2015). The vaginal microbiome, vaginal anti – microbial defence mechanisms and the clinical challenge of reducing infection – related preterm birth. BJOG, 122 (7), 1033-1035.
Minukhin,V.V. (2020). The vaginal bacterial dysbiosis severity predicting model according to the normobiota index. Visnyk morfolohii, 26 (3), 24-30. DOI: 10.31393/morphology– journal–2020–26(3)–03.
Fichorova, R.N., Morrison, C.S., Chen, P.L., & Yamamoto H.S. (2020). Aberrant cervical innate immunity predicts onset of dysbiosis and sexually transmitted infections in women of reproductive age. PLoS One, 15 (1), 1232-1236.
DOI:10.1371/journal.pone,0224359.
Nagorna, V.F. (2020). Suchasni uiavlennia pro pikhvovu mikrobiotu [Modern ideas about the vaginal microbiota]. Akusherstvo. Hinekolohiia. Henetyka – Obstetrics. Gynecology. Genetics, 4 (1), 54-58 [in Ukrainian].
Masson, L., Barnabas, S., Deese, J., & Lennard, K. (2019). Inflammatory cytokine biomarkers of asymptomatic sexually transmitted infections and vaginal dysbiosis: a multicentre validation study. Sex Transm. Infect., 95 (1), 5-12.
Gopchuk, O.M., & Morozova, O.V. (2015). Stratehiia vplyvu na vahinalnyi biotsenoz u zhinok hrup ryzyku [Strategy of influence on vaginal biocenosis in women of risk groups]. Zdorovye zhenshchyny – Woman’s Health, 6, 81-83 [in Ukrainian].
Shhuruk, N.V. (2015). Stan mikrobioty pikhvy u zhinok z obtiazhenym reproduktyvnym anamnezom [The state of the vaginal microbiota in women with a burdened reproductive history]. Zdorovia zhinky – Woman’s Health, 6 (101), 134-136.
Suxanova, A.A. (2019). Zdorovia henitalnoho traktu: vid dyferentsiinoi diahnostyky do pravylnoho likuvannia [Health of the genital tract: from differential diagnosis to proper treatment]. Akusherstvo. Hinekolohiia. Reproduktolohiia – Obstetrics. Gynecology. Reproductology, 3 (35), 28-32 [in Ukrainian].
Fedyshyn,T.V., Malyar, V.A. (2017). Reproductive Health of women with early miscarriages in anamnesis associated with vaginal dysbiosis. Likarska sprava – Doctor’s Business,, 5-6, 117-120.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Actual Problems of Pediatrics, Obstetrics and Gynecology
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in this journal agree to the following terms:
1. The authors reserve the right to authorship of the work and pass the journal right of first publication of this work is licensed under a Creative Commons Attribution License, which allows others to freely distribute the work published with reference to the authors of the original work and the first publication of this magazine.
2. Authors are entitled to enter into a separate agreement on additional non-exclusive distribution of work in the form in which it was published in the magazine (eg work place in the electronic repository institution or publish monographs in part), provided that the reference to the first publication of this magazine.
3. Policy magazine allows and encourages authors placement on the Internet (eg, in storage facilities or on personal websites) manuscript of how to submit the manuscript to the editor and during his editorial processing, since it contributes to productive scientific discussion and positive impact on the efficiency and dynamics of citing published work (see. The Effect of Open Access).
