Vaginal Probiotic Administration in the Management of Preterm Premature Rupture of Membranes

Abstract

Objective: To examine the influence of vaginal probiotic administration as an adjunct to standard antibiotic treatment on perinatal outcome in women with preterm premature rupture of membranes (PPROM). Materials and Methods: This was a prospective randomized trial of cases with PPROM (24-34 weeks) that were admitted to our department between 2011 and 2015. Forty-nine cases received vaginal probiotics for 10 days in combination with antibiotic prophylaxis and were compared to 57 others that received only antibiotics for the same time period. Results: The mean gestational age at birth (35.49 vs. 32.53 weeks), the mean duration of the latency period (5.60 vs. 2.48 weeks), and the mean birth weight (2,439.08 vs. 2,004.81 g) were significantly higher in the study group in comparison to the controls. Moreover, the neonates of the study group had a lower chance to enter the neonatal intensive care unit or the neonatal special care unit, shorter total hospitalization time, and lower need for oxygen administration and mechanical ventilation, as well as lower length of oxygen administration. Conclusions: Vaginal probiotics as an adjunct to antibiotic prophylaxis in women with PPROM prolonged the latency period and improved the perinatal outcome.

Timing of probiotic milk consumption during pregnancy and effects on the incidence of preeclampsia and preterm delivery: a prospective observational cohort study in Norway

“… 70 In a recent prospective randomised trial in women with PPROM, vaginal probiotics (1×10 8 Lactobacillus rhamnosus and L. gasseri ) as an adjunct to antibiotic prophylaxis were shown to prolong the latency period until delivery and improved the perinatal outcome. 71 The probiotic consumers in our study consumed a mean dose of around 1.5 cups per day. This is equivalent to a consumption of at least 188 mL per day, and a probiotic dose of 1.9×10 10 ( Bb12 , LA-5 and LGG in product A and Bb12 and LA-5 in product B) according to the manufacturer.…”

Probiotics and vaginal microecology: fact or fancy?

“…In contrast with these results, a Greek RCT [28] showed a benefit of probiotic administration in women with PPROM. Patients were allocated to 10-days vaginal probiotic supplementation in combination with antibiotic prophylaxis ( n = 59) or to standard antibiotic treatment alone ( n = 57).…”

Reviewing the Composition of Vaginal Microbiota: Inclusion of Nutrition and Probiotic Factors in the Maintenance of Eubiosis

“…In addition, it was not seen a protecting effect of probiotic administration over gestational diabetes, preterm premature rupture of membrane (PPROM), and small and large for gestational age infants. Conversely with these results, Daskalakis and Karambelas have previously shown some positive effects in women with PPROM after probiotic administration [191]. In their study, patients were distributed to receive vaginal probiotic in with antibiotic prophylaxis or standard antibiotic treatment alone for 10-days.…”