A meta-analysis conducted in 2007 found that the intermediate vaginal microbiota was not associated with PTD, perinatal mortality, or maternal or neonatal infection 10. and the vagina may or may not contain anaerobic bacteria 8, 9. This dysbiosis constitutes a widely heterogeneous group that shows a high degree of variability in the presence of Lactobacillus spp. Although antibiotic therapy reduces the risk of PTD in pregnant women with abnormal vaginal microbiota, the use of prophylactic antibiotics in the general obstetric population is still under discussion 5, 6.Ĭurrently, there is insufficient evidence on the natural history of intermediate vaginal microbiota to determine its prognosis 7. Since treatment of abnormal vaginal microbiota has been reported to have a positive effect in pregnant women, BV is widely accepted as a risk factor for PTD 4. enhances anaerobic bacterial growth, which can subsequently progress to vaginal dysbiosis and bacterial vaginosis (BV) 3. Healthy vaginal microbiota, dominated by Lactobacillus species (spp.), is a significant protective factor against vaginal infections that are potentially associated with PTD 2.

This small study found a trend toward a benefit of treatment with vaginal lactobacilli during pregnancy.ĭespite progress in perinatology, prevention of preterm delivery (PTD) is still a leading problem in obstetrics 1. Among women without lactobacilli (the IM0N4 group), the Nugent sore decreased by 4 points only in the women who received treatment, and gestational age at delivery and neonatal birthweight were both significantly higher in the treated subgroup than in the untreated subgroup ( p = 0.047 and p = 0.016, respectively). Half of the women in each group received the treatment.

Pregnant women with intermediate microbiota of the vagina and a Nugent score of 4 were enrolled in two groups: intermediate vaginal microbiota and a Nugent score of 4 with lactobacilli (IMLN4) and intermediate vaginal microbiota and a Nugent score of 4 without lactobacilli (IM0N4), with and without vaginal lactobacilli at baseline, respectively.

We treated women with this vaginal dysbiosis in the first trimester of pregnancy using a vaginally applied lactobacilli preparation to restore the normal microbiota in order to delay the preterm delivery rate. The intermediate bacterial microbiota is a heterogeneous group that varies in the severity of the dysbiosis, from minor deficiency to total absence of vaginal Lactobacillus spp.

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