Prepregnancy preparation of women with mixed vaginal dysbiosis

Abstract

Prepregnancy preparation of women with mixed vaginal dysbiosis I.O. Borovikov, I.I. Kutsenko, E.R. Rubinina, S.K. Batman, A.S. Magay Kuban State Medical University, Krasnodar, Russian Federation The paper discusses prepregnancy preparation of women with mixed vaginal dysbiosis. Clinical features of this disorder, therapeutic options and their clinical and microbiological efficacy are addressed. Aim: To analyze clinical experience and efficacy of different variants of topical treatment in women with mixed vaginal dysbiosis planning to become pregnant. Patients and Methods: Comparative open randomized study was performed in 123 women with mixed vaginal dysbiosis who became pregnant (and went into labor) within 6 months after treatment completion. Group I (n=31) received complex medication containing metronidazole and miconazole/Metromicon-Neo® (1 intravaginal suppository twice a day for 7 days). Group II (n=32) received intravaginal applications of clotrimazole (2% cream) once a day for 6 days. Group III (n=30) received intravaginal applications of clindamycin phosphate 2% cream once a day for 6 days. Group IV (n=30) received complex medication containing neomycin sulfate and nystatin, prednisone (1 vaginal tablet at night for 10 days). After decontamination therapy all women underwent topical intravaginal contamination with medications containing lyophilizate of acidophilic lactobacilli. Urogenital microbiota were assessed (by PCR), vaginal pH was measured, and Hay/Ison criteria were analyzed. Results: Similarly high clinical and microbiological efficacy of prepregnancy topical therapy with Metromicon-Neo® and clindamycin for mixed vaginal dysbiosis was demonstrated. However, intravaginal administration of clindamycin phosphate required further additional antifungal treatment. Metromicon-Neo® (metronidazole and miconazole) was characterized by greater medication adherence. Keywords: vaginal dysbiosis, bacteria, Lactobacillus, metronidazole, miconazole, clotrimazole, clindamycin phosphate, neomycin sulfate, nystatin. For citation: Borovikov I.O., Kutsenko I.I., Rubinina E.R. et al. Prepregnancy preparation of women with mixed vaginal dysbiosis. Russian Journal of Woman and Child Health. 2019;2(2):–119.