State of antimicrobial protection of vaginal secrete in pregnant women during treatment of bacterial vaginosis

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Abstract

Objective: A comprehensive analysis of the relationship between the antimicrobial activity of vaginal secretions and the clinical features of bacterial vaginosis in pregnant women during therapy, with consideration of vaginal pH dynamics and microbiological parameters.

Materials and methods: A total of 97 women participated in the study: 69 with bacterial vaginosis and 28 with normocenosis (normal vaginal flora). Patients with bacterial vaginosis were divided into a main group (n=37), who received combination therapy with an antibiotic and the immunomodulator "Superlymph", and a comparison group (n=32) on antibiotic monotherapy. After treatment, normocenosis was restored in all patients using the dosed cream "Acilact Duo". The antimicrobial activity of antimicrobial peptides was determined in the groups of pregnant women depending on the nature of the clinical symptoms of bacterial vaginosis against the background of its treatment.

Results: The results showed that the highest activity of antimicrobial peptides was observed in women with normocenosis. In bacterial vaginosis this activity decreased in proportion to the severity of the disease. In the main group, after combination therapy, this indicator increased almost twofold from the baseline. This regimen provided a significant improvement in clinical and laboratory parameters, a reduction in recurrences, prolonged remission, and restoration of the microbiota.

Conclusion: Including an assessment of immune status in the diagnosis of bacterial vaginosis in pregnant women, alongside a comprehensive evaluation of the vaginal microbiome, allows for personalized therapy. The results substantiate the advisability of implementing combination therapy into clinical practice.

About the authors

Victor L. Tyutyunnik

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Author for correspondence.
Email: tioutiounnik@mail.ru
ORCID iD: 0000-0002-5830-5099
SPIN-code: 1963-1359
Scopus Author ID: 56190621500
ResearcherId: B-2364-2015

Professor, Dr. Med. Sci., Leading Researcher at the Research and Development Service

Russian Federation, Moscow

Dzhamilia D. Mirzabekova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: Jamilya1705@yandex.ru
ORCID iD: 0000-0002-2391-3334

PhD, obstetrician-gynecologist at the 1st Obstetric Physiological Department

Russian Federation, Moscow

Natalia E. Kan

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: kan-med@mail.ru
ORCID iD: 0000-0001-5087-5946
SPIN-code: 5378-8437
Scopus Author ID: 57008835600
ResearcherId: B-2370-2015

Professor, Dr. Med. Sci., Honored Scientist of the Russian Federation, Deputy Director General for Research – Director of the Institute of Obstetrics

Russian Federation, Moscow

Zarine V. Khachatryan

Perinatal Center of the European Medical Center

Email: z.v.khachatryan@gmail.com
ORCID iD: 0009-0000-2652-6156

PhD, obstetrician-gynecologist of the Maternity Department

Russian Federation, Moscow

Andrey E. Donnikov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: donnikov@dna-technology.ru
ORCID iD: 0000-0003-3504-2406

PhD, Head of the Laboratory of Molecular Genetic Methods

Russian Federation, Moscow

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