Potential use of lactic acid in obstetrics and gynecology

Abstract

A.M. Savicheva1,2, P.A. Shadrova3 1D.O. Ott Research Institute of Obstetrics, Gynecology, & Reproduction, St. Petersburg,   Russian Federation 2St. Petersburg State Pediatric Medical University, St. Petersburg, Russian Federation 3Pirogov Russian National Research Medical University, Moscow, Russian Federation Inflammatory diseases and dysbiosis provoked by opportunistic microbes currently rank first among lower reproductive tract infections in women. Lactobacilli are predominant in the vaginal microecosystem that is considered the first line of defense against infectious agents. Changes in hormonal profile, the pattern of intimate hygiene and sex life, and other factors impair the vaginal microecosystem. Diseases resulting from the activation of aerobic and anaerobic opportunistic microbes are particularly harmful during pregnancy, since they cause serious reproductive disorders and significantly increase the risks of perinatal complications. Frequent recurrences due to growing antibiotic resistance and the lack of potential antimicrobial treatment in the first trimester of pregnancy force to search for alternative therapeutic tools with good efficacy and safety. Topical agents containing lactic acid decrease vaginal pH and provide unfavorable conditions for the activity o f opportunistic microbes, thereby maintaining the protective functions of Lactobacilli. Lactic acid is a natural chemical for this locus. As a result, agents containing this compound are virtually lacking side effects. They can be used along with antibiotics or as monotherapy. Keywords: bacterial vaginosis, aerobic vaginitis, lactic acid, opportunistic microbes, vaginal microbiota, Lactobacilli, dysbiosis, pregnancy, normal flora. For citation: Savicheva A.M., Shadrova P.A. Potential use of lactic acid in obstetrics and gynecology. Russian Journal of Woman and Child Health. 2022;5(2):138–145 (in Russ.). DOI: 10.32364/2618-8430-2022-5-2-138-145.