Anamnestic and microbiological predictors of miscarriage

Abstract

Hypothesis/aims of study. Miscarriage is a significant medical and social problem. The etiology of pregnancy losses is diverse and depends on many factors. It is believed that dysbiotic disorders of the vagina are one of the main causes of this pathology. While the etiopathogenesis of miscarriage is actively studied, many questions still remain open. The aim of the study was to investigate anamnestic and microbiological predictor factors of miscarriage.
 Study design, materials, and methods. In a prospective cohort study, 159 pregnant women were examined in the first trimester of pregnancy: the anamnesis, course of pregnancy, vaginal microflora, and present pregnancy outcome were studied. The vaginal microflora was analyzed using microscopic, bacteriological and quantitative real-time PCR methods. Depending on the present pregnancy outcome, the patients were divided into two groups: those delivered at term and women with early and late miscarriage. The analysis of predictors of miscarriage of the ongoing pregnancy was performed depending on the period of delivery.
 Results. The rate of miscarriage in women was 13%. The independent predictors of early miscarriage were chronic endometritis (OR 10.54; 95% CI 2.54 to 43.64), the dominance of Lactobacillus iners in the vaginal microflora (OR 8.52; 95% CI 2.07 to 35.05), and the prevalence of non-Lactobacillus species in microscopy of vaginal preparations (OR 4.50; 95% CI 1.02 to 19.69). The dominance of Lactobacillus crispatus was a significant protective factor of late miscarriage (OR 0.20; 95% CI 0.04 to 0.99).
 Conclusion. The undertaken analysis revealed significant associations of a number of anamnestic and microbiological predictor factors with miscarriage, which will enable to substantiate approaches for predicting pregnancy outcomes at different gestational age and to develop methods of pre-conception care and treatment in women with different risk of miscarriage.

Is there an association between the vaginal microbiome and first trimester miscarriage? A prospective observational study

“…in microscopy of vaginal preparations. The dominance of L. crispatus was a significant protective factor of late miscarriage 36 . In the present study the dominance of L. iners in women with recurrent miscarriage may account also for the differences in species diversity and richness (Table 3).…”

The impact of cesarean section and its complications on fertility rates

“…Вопросу оценки репродуктивных исходов у женщин с рубцом на матке после КС всегда уделялось особое внимание во всем мире, о чем свидетельствуют многочисленные систематические обзо-ры и метаанализы, отражающие актуальность проблемы [5,8,9]. При этом эксперты ВОЗ указывают на необходимость проведения дополнительных исследований, уточняющих влияние многократных операций КС на материнскую и перинатальную заболеваемость, а также будущие показатели здоровья матери и ребенка.…”

“…Анализ взаимосвязи неблагоприятных исходов беременности с учетом данных гинекологического анамнеза показал, что значимым предиктором невынашивания беременности после выполненных операций КС является хронический эндометрит [8][9][10]. По данным Американской академии педиатрии и Американского колледжа акушеров и гинекологов (ACOG), хронический эндометрит выявляется примерно у 60 % женщин, перенесших КС по медицинским показаниям [11].…”