Features of the treatment of bacterial vaginosis during pregnancy

Abstract

Introduction. The prevalence of bacterial vaginosis (BV) in the population ranges from 12 to 80% and depends on the cohort of examined women. Of the total confirmed cases, 37-40% are pregnant women.Aim. To assess the effectiveness of the treatment of bacterial vaginosis (BV) in pregnant women.Materials and methods. The study included 43 women at 22 to 30 weeks' gestation, divided into two groups: the treatment group consisted of 30 pregnant women diagnosed with BV, the control group comprised 13 pregnant women with normal vaginal microbiocenosis. To determine the antimicrobial activity of vaginal epithelium, samples of vaginal discharge were examined. The treatment was carried out using clindamycin according to the following regimen: 100 mg intravaginally per day at bedtime for 3 days.Results. The study results showed that the highest activity of antimicrobial peptides (AMP) was found in the group of healthy pregnant women, which accounted for 79.1%. In pregnant women with BV, the level of antimicrobial activity significantly decreased as compared with the group of healthy pregnant women as the severity of the disease increased, amounting to 44.5% in women with mild BV, 36.4% in women with moderate BV and 33.6% in women with severe BV. The level of antimicrobial activity in the group of pregnant women with BV, who received treatment with clindamycin significantly increased by almost two times from the baseline values and amounted to 86.1% in women with mild BV, 78.5% in women with moderate BV and 76.9% in women with severe BV.Conclusion. The production of endogenous antibiotics, AMP, provides adequate protection against infectious agents. After a  course of therapy with clindamycin 100 mg intravaginally at bedtime for 3 days, the AMP level normalized 2 weeks after treatment.