Objective: To determine and to compare the levels of secretory immunoglobulin A in samples of colostrum and milk of mothers of term and preterm neonates. Material and Methods: The levels of secretory immunoglobulin A of 10 mothers of term neonates and 10 mothers of preterm neonates were determined from 5mL of colostrum or milk collected on the 1 st , 4 th , 10 th and 15 th days of the puerperal period, using the radial immunodifusion technique. We employed anamnesis, as well as physical and gynecological exams in women in the puerperal period. All the patients were attended at the Januário Cicco Maternity College. Results: The secretory immunoglobulin A levels were significantly higher in the colostrum and milk of mothers of preterm neonates when compared with the levels found in colostrum and milk of mothers of term neonates (Mann-Whitney test, p<0.0001). There was a significant decline in the secretory immunoglobulin A levels of the colostrum and milk of the mothers of term and preterm neonates during the four periods (KruskalWallis test, p<00001). Conclusions: The secretory immunoglobulin A levels in colostrum and milk of mothers of preterm neonates were significantly higher than in the mothers of term neonates, demonstrating immunological adaptation in preterm neonate breast-feeding.

The diagnosis and treatment of Chlamydia cervicitis during pregnancy can reduce perinatal morbidity and mortality associated with this infection. However, clinical trials are needed to confirm these findings.

Background Pregnant patients are potentially vulnerable to COVID‐19. Objectives To clarify the clinical features of COVID‐19 and analyze maternal/fetal morbidity and mortality and the obstetric and neonatal outcomes of pregnant patients. Search strategy Embase, PubMed, Web of Science, CINAHAL, LILACS, Google Scholar, and Scopus. Selection criteria Articles published from December 2019 to February 2021. Data collection and analysis The reviewers extracted relevant data from the full‐text. Data synthesis was performed using the R‐4.1.0 Project for Statistical Computing for Windows. The meta‐analysis of the included studies was carried out using the random‐effects model (DerSimonian and Laird). Heterogeneity was measured using I2 analysis. Results A total of 70 studies included 10 047 pregnant women with COVID‐19, of whom 71.6% were in their third trimester. The most common symptoms were fever, cough, chest pain, dyspnea, and fatigue. Most newborns were delivered preterm (24%, 95% confidence interval [CI] 0.17–0.34, I2 = 93%) and via cesarean delivery (42%, 95% CI 0.38–0.47, I2 = 92%). There were 108 maternal mortalities (2%, 95% CI 0.01–0.03, I2 = 54%) and 50 abortions (5%, 95% CI 0.03–0.09, I2 = 73%). The neonatal outcomes included fetal distress (11%, 95% CI 0.06–0.19, I2 = 91%), birth weight (15%, 95% CI 0.10–0.21, I2 = 76%), APGAR <7 (19%, 95% CI 0.12–0.28, I2 = 43%), admission to the neonatal intensive care unit (28%, 95% CI 0.17–0.43, I2 = 90%), and fetal mortality (2%, 95% CI 0.01–0.03, I2 = 46%). Conclusion  There was no evidence of severe acute respiratory syndrome coronavirus‐2 in the placenta, breast milk, umbilical cord, and amniotic fluid of pregnant patients. PROSPERO registration number: CRD42020181519.

RESUMOObjetivo: verificar se alta freqüência de coitos vaginais e o uso de duchas higiênicas interferem com a microbiota vaginal. Métodos: noventa e sete mulheres atendidas em centro de saúde localizado em zona de prostituição na cidade de Campinas foram avaliadas em estudo prospectivo de corte transversal. A anamnese determinou as freqüências de coitos vaginais e do uso de duchas higiênicas nas 44 profissionais do sexo e nas 53 não-profissionais do sexo estudadas. O conteúdo vaginal foi coletado com swab estéril de Dacron, da parede vaginal direita, e disposto em duas lâminas de vidro. A microbiota vaginal foi estudada em microscopia óptica com lente de imersão em esfregaço corado pela técnica de Gram. Os dados foram analisados pelo teste exato de Fisher. As mulheres profissionais e não profissionais do sexo apresentaram, respectivamente, média de idade de 24,9 (± 6,4) e 31,5 (± 9,7) anos, hábito de fumar em 52,2 e 24,5%, prática do uso de lubrificantes vaginais em 56,8 e 0% e prática de uso de condom em 100 e 41,5% dos casos respectivamente. Resultados: apenas 1,8% das mulheres do grupo controle tinham sete ou mais relações sexuais por semana, em evidente contraste com as profissionais do sexo (97,7%). Não houve diferenças significativas quanto à raça, escolaridade e paridade. A vaginose bacteriana e a flora vaginal anormal foram mais observadas nas profissionais do sexo do que no grupo controle (p=0,02 e 0,001) e associou-se à alta freqüência (sete ou mais vezes) de coitos vaginais semanais (p=0,04 e 0,001). O diagnóstico de vaginose citolítica foi mais freqüente nas mulheres não-profissionais do sexo (p=0,04) e com menor freqüência de relações sexuais (p=0,04). O uso de duchas higiênicas foi mais comum nas profissionais do sexo (p=0,002). Entretanto, esta prática não esteve associada aos distúrbios da microbiota vaginal e nem à presença de vulvovagintes. Conclusões: profissionais do sexo com sete ou mais relações sexuais semanais apresentaram maior freqüência de vaginose bacteriana e alterações da flora vaginal. O hábito de duchas vaginais não interferiu com o ecossistema vaginal das mulheres estudadas. PALAVRAS-CHAVE:Prostituição; Coito; Aparelhos sanitários; Vaginose bacteriana; Vagina/microbiologia ABSTRACT Purpose: to verify if the high frequency of vaginal intercourses and the use of doushing interferes with vaginal microbiota. Methods: ninety-seven women were examined at a health center located in the prostitution area of the city of Campinas, and evaluated in a prospective cross-sectional study. Anamnesis determined the frequency of vaginal intercourse and the use of douching in the 44 sex professionals and 53 non-professionals studied. The vaginal content was collected with a sterile Dacron swab, from the right vaginal wall, and placed on to two glass laminas. The vaginal microbiota smear stained by the Gram technique was studied with light microcopy using immersion lens and the data were analyzed. The sex professionals and non-professionals presented mean age of 24.9±6.4 and 31.5±9.7, habit of smoki...

Genitourinary syndrome of menopause (GSM) is a term used to define a compilation of signs and symptoms arising from decreased estrogenic stimulation of the vulvovaginal and lower urinary tract. Among 27–84% of women in postmenopausal are affected for symptoms of GSM, and these can unquestionably impair health, sexual function, consequently the quality of life of these women. The main signs and symptoms of GSM include, among others, burning, irritation, vulvovaginal dryness, dyspareunia, urinary symptoms of urgency, dysuria, or recurrent urinary tract infection. The diagnosis can be made through anamnesis, questionnaires, physical exams, and, sometimes, complementary exams. Objective vaginal assessment is essential and can be complemented by using the Vaginal Health Index (VHI), Vaginal Maturation Index (VMI), or vaginal pH measurement. The acknowledgment of this condition by health professionals is crucial for its identification and proper management and exclusion of other conditions that make a differential diagnosis with it.

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The ovulatory cycle has a significant influence on the microbial composition, according to the action of estrogen and progesterone on the stratified squamous epithelium, due to an increase in epithelial thickness, glycogen deposition, and influence on local immunology. The 16S rRNA gene amplification and pyrosequencing study demonstrated that healthy women have community state types (CST), classified as; type “L,” with a predominance of Lactobacillus crispatus, type II, with a predominance of Lactobacillus gasseri, type III, where Lactobacillus iners predominates, and type V with a predominance of Lactobacillus jensenii. Type IV does not identify lactobacilli but a heterogeneous population of bacteria. There seems to be a relationship between increased vaginal bacterial diversity and poverty of lactobacilli with the complaining of vaginal dryness. With menopause, there appears to be a reduction in lactobacilli associated with higher serum levels of follicle-stimulating hormone (FSH) and lower estrogen levels. The evaluation of Gram-stained vaginal smears in postmenopause women must take into account the clinical-laboratory correlation. We should observe two meanly possibilities, atrophy with few bacterial morphotypes, without inflammatory, infiltrate (atrophy without inflammation), and atrophy with evident inflammatory infiltrate (atrophy with inflammation or atrophic vaginitis). The relationship between the microbiome and postmenopausal vulvovaginal symptoms seems to be related to the bacterial vaginal population. However, more robust studies are needed to confirm this impression.

Introduction: treating sexual partners of women with vaginal candidiasis and bacterial vaginosis is an issue in debate. Despite the present recommendations of the international guidelines to not to treat the asymptomatic sexual partners, this is a frequent practice between gynecologists. Objective: evaluate the influence of treating asymptomatic sexual partner of women with recurrent vulvovaginitis. Methods: databases searched: PubMed, Embase, Scielo and CINAHAL. Selection criteria: randomized clinical trials published from 1982 to 2012 were included. Studies involving pregnant women were excluded. Methodological quality was assessed using the Jadad scale. Data collection and analysis: Review Manager 5.1 was used for statistical analysis. Results: eight randomized clinical trials were included based on the chosen criteria: 1,088 women were enrolled. For bacterial vaginosis, the RR for cure was 1.00 (95%CI: 0.95-1.05) (p = 0.13), and for recurrence 0.84 (95%CI: 0.62-1.14) (p = 0.34). Vaginal candidiasis had a RR of 1.03 (95%CI: 0.94-1.14) (p = 0.48) for cure, and 1.02 (95%CI: 0.77-1.33 p = 0.91) for recurrence. Conclusion: treatment of asymptomatic sexual partners of women with vaginal candidiasis or bacterial vaginosis does not affect the cure or recurrence rates and may increase the risk of side effects and unnecessary financial costs.