Relationship between Maternal and Perinatal Outcome with High Vaginal Swab Culture: A Cross-sectional Study

Abstract

Introduction: Most of the pregnancies progress normally but unfortunately, few are prone to developing complications. Some antenatal and intra-partum conditions place the mother and the developing foetus or both at risk for complications and infections which undoubtedly play a major role in the same. Vaginal microbiome composition changes during pregnancy. This change is believed to inhibit pathogen growth through secretion of bacteriocins such as lactic acid that maintain acidic pH. Disturbed vaginal environment is associated with complications of pregnancy. Aim: To find the relationship between the microbiological study of High Vaginal Swab (HVS) in pregnancy at term with the maternal and foetal outcome. Materials and Methods: This cross-sectional study was conducted on 200 women who underwent vaginal swab culture during routine prenatal check-up from July 2019 to January 2020, in a hospital in Lucknow, Uttar Pradesh, India. The maternal and perinatal outcome and their relation with microbiological study of HVS were studied. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 11.5. Chi-square test was used for comparison of data for statistical significance. For descriptive statistics percentage, mean and Standard Deviation (SD) was calculated. Results: E.coli (18%) was the most common organism isolated from HVS cultures in this study. Maternal complications, rate of Lower Segment Caesarean Section (LSCS), low APGAR scores (Appearance, Pulse, Grimace, Activity and Respiration), need for neonatal resuscitation and Neonatal Intensive Care Unit (NICU) admission were more in the culture positive group. Conclusion: The study suggests that the abnormal vaginal microbiota is associated with adverse pregnancy outcomes. HVS cultures are simple and non-invasive screening tool which should be used as a routine procedure in all antenatal patients for preventing complications and improving the foeto-maternal outcome.

Keywords

• maternal morbidity
• neonatal intensive care unit admission
• perinatal morbidity
• puerperial pyrexia
• respiratory distress syndrome
• sepsis