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Dispersion and alterations of vaginal flora across pregnancy trimesters
Hazel Çağın KUZEY1, Onur GÜRALP2, İrem CAN SEVER3, Erdal Polat4, Kübra CAN KURT4, Tarık ALTINOK51Clinic of Obstetrics and Gynecology, Şişli Memorial Hospital, İstanbul, Türkiye, 2Department of Obstetrics and Gynecology, Carl von Ossietzky University of Oldenburg Faculty of Medicine, Niedersachsen, Germany, 3Clinic of Obstetrics and Gynecology, Special Clinic, İstanbul, Türkiye, 4Department of Microbiology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye, 5Department of Obstetrics and Gynecology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
Objectives: This study aimed to examine the distribution and variations in vaginal pathogens throughout different trimesters of pregnancy, utilizing both vaginal culture and polymerase chain reaction (PCR) techniques, in order to ascertain the presence and prevalence of microorganisms across the various stages of pregnancy. Materials and Methods: A total of forty-six healthy pregnant women with no reported discharge complaints were recruited for this study. They were monitored at 6-13 weeks, 20-26 weeks, and 32-38 weeks of gestation until delivery. Vaginal swab samples were collected and subjected to multiplex PCR, microscopic examination, aerobic culture media, and gram staining. Results: Candida species (spp.) emerged as the most frequently isolated microorganisms in vaginal swab samples from each trimester, followed by Escherichia coli and Ureaplasma urealyticum. The prevalence of Candida spp. increased proportionally with advancing trimesters. Notably, the pregnancies of these women showed no complications such as premature labor or premature membrane rupture. Gardnerella vaginalis was the predominant microorganism isolated in the first trimester, succeeded by Atopobium vaginae, Bacteroides fragilis, Mobiluncus curtisii, and Mobiluncus mulieris in decreasing order. However, the quantity of Gardnerella vaginalis did not exhibit a significant increase in the second and third trimesters. Conclusion: This study suggests Gardnerella vaginalis as the most commonly isolated vaginal microorganism during the first trimester, alongside other bacterial species associated with bacterial vaginosis. Importantly, the quantities of these bacteria remained relatively stable in the second and third trimesters. These findings suggest a dynamic shift in vaginal microbiota during pregnancy, including an escalation in Candida spp. as pregnancy progresses. Further research is warranted to comprehend the implications of these changes and their potential ramifications for vaginal and feto-maternal health.
Cite This Article
KUZEY H, GÜRALP O, CAN SEVER İ, Polat E, CAN KURT K, ALTINOK T. Dispersion and alterations of vaginal flora across pregnancy trimesters. 2023; 42(3): 84-91
Corresponding Author: KUZEY H.
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