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Chapter 2 : Vaginal Ecology in Pregnancy

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Abstract:

The vaginal ecology of pregnant women does not differ substantially from that of women who are not pregnant. However, studies conducted over the last decade have established that most of the organisms that infect amniotic fluid or cause chorioamnionitis are derived from the lower genital tract. In addition, recent studies have established that some organisms that are considered part of the normal vaginal microflora are associated with an increased risk of preterm or low-birth-weight delivery or both when they are present at high density in the vagina. The chapter discusses the frequency of genital microorganisms in women of different ethnic groups. Bacterial vaginosis is a condition in which high concentrations of vaginal lactobacilli are replaced by a mixed population of , anaerobic gram-negative rods and cocci, and genital mycoplasmas. A number of studies have evaluated the association between genital or urinary tract colonization with group B streptococci and adverse outcomes of pregnancy. Urogenital colonization by group B streptococci has been associated with premature rupture of membranes in several studies. To date, there are no longitudinal studies demonstrating that vaginal colonization earlier in pregnancy is a risk factor for preterm birth, nor are there studies demonstrating that treatment of vaginal can prevent preterm birth. There are a number of areas suitable for further research in the area of vaginal ecology and pregnancy.

Citation: Hillier S. 1999. Vaginal Ecology in Pregnancy, p 27-42. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch2
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Figure 1

Prevalence of facultative lactobacilli at three sampling times during pregnancy. Modified from .

Citation: Hillier S. 1999. Vaginal Ecology in Pregnancy, p 27-42. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch2
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References

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Tables

Generic image for table
Table 1

Vaginal microflora of 85 pregnant women having -predominant lora who gave birth at term

Citation: Hillier S. 1999. Vaginal Ecology in Pregnancy, p 27-42. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch2
Generic image for table
Table 2

Frequency of genital microorganisms in women of different ethnic groups

Citation: Hillier S. 1999. Vaginal Ecology in Pregnancy, p 27-42. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch2
Generic image for table
Table 3

Relationship of , species, and with amniotic fluid infection

Citation: Hillier S. 1999. Vaginal Ecology in Pregnancy, p 27-42. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch2

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