The vaginal flora in pregnancy, or vaginal microbiota in pregnancy, is different from the

vaginal flora Vaginal flora, vaginal microbiota or vaginal microbiome are the microorganisms that colonize the vagina. They were discovered by the German gynecologist Albert Döderlein in 1892 and are part of the overall human flora. The amount and type of ...

(the population of microorganisms that resides in the vagina) before

sexual maturity Sexual maturity is the capability of an organism to reproduce. In humans it might be considered synonymous with adulthood, but here puberty is the name for the process of biological sexual maturation, while adulthood is based on cultural definit ...

, during reproductive years, and after

menopause Menopause, also known as the climacteric, is the time in women's lives when menstrual periods stop permanently, and they are no longer able to bear children. Menopause usually occurs between the age of 47 and 54. Medical professionals often ...

. A description of the vaginal flora of pregnant women who are

immunocompromised Immunodeficiency, also known as immunocompromisation, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that a ...

is not covered in this article. The composition of the vaginal flora significantly differs in

pregnancy Pregnancy is the time during which one or more offspring develops (gestation, gestates) inside a woman, woman's uterus (womb). A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occur ...

. Bacteria or viruses that are infectious most often have no symptoms.

Normal microbiota

Microbiota in pregnancy

In normal pregnancy, the resident vaginal flora is thought to provide protection against infection. The microbiota during pregnancy is predominantly Lactobacillus spp. Microbiota composition can change during the course of the pregnancy. If the microbiota populations become more diverse, indicating that the normal Lactobacillus-dominated population has changed to a bacterial vaginosis population, risks of adverse pregnancy outcomes increase. Vaginal discharge is common during pregnancy but is not an indicator of bacterial vaginosis or abnormal Lactobacillus-dominated microbiota. The treatment of abnormal vaginal microbiota populations with lactobacilli and estriol during pregnancy was found to restore the microbiota to a normal state.

Bacterial vaginosis and pregnancy

Bacterial vaginosis Bacterial vaginosis (BV) is a disease of the vagina caused by excessive growth of bacteria. Common symptoms include increased vaginal discharge that often smells like fish. The discharge is usually white or gray in color. Burning with urination ...

in pregnancy is an alteration of the normal vaginal microbiota of pregnancy. Intrauterine infections in pregnancy are caused by bacteria that cause inflammation. The women may experience few or no symptoms. This sometimes leads to

chorioamnionitis Chorioamnionitis, also known as intra-amniotic infection (IAI), is inflammation of the fetal membranes ( amnion and chorion), usually due to bacterial infection. In 2015, a National Institute of Child Health and Human Development Workshop expert ...

and other negative pregnancy outcomes. Chorioamnionitis is due to the presence of microbes like

ureaplasma ''Ureaplasma'' is a genus of bacteria belonging to the family Mycoplasmataceae. As the name imples, ''Ureaplasma'' is urease positive. Phylogeny The currently accepted taxonomy is based on the List of Prokaryotic names with Standing in Nomenc ...

and mycoplasma species this generates the release of proinflammatory cytokines and chemokines, IL-8 which causes cervical ripening and can result in premature birth. When there are high bacterial counts in of the vagina during pregnancy is typically due to the presence of the following organisms: * '' G. vaginalis'' * '' F. nucleatum'' * ''

Staphylococci ''Staphylococcus'' is a genus of Gram-positive bacteria in the family Staphylococcaceae from the order Bacillales. Under the microscope, they appear spherical ( cocci), and form in grape-like clusters. ''Staphylococcus'' species are facultati ...

spp'' * '' Streptococci'' * ''

Atopobium vaginae ''Fannyhessea vaginae'' is a species of bacteria in the family ''Atopobiaceae''. It is a facultative anaerobic, Gram-positive rod-shaped or elliptical coccobacilli found as single elements or in pairs or short chains. It is typically isolated fr ...

'' * '' Mobiluncus spp'' * '' Mycoplasma'' spp * Bacteroides ureolyticus * ''

Fusobacterium ''Fusobacterium'' is a genus of anaerobic, Gram-negative, non-sporeforming bacteria belonging to Gracilicutes. Individual cells are slender, rod-shaped bacilli with pointed ends. Strains of ''Fusobacterium'' cause several human diseases, includi ...

History

Investigations into reproductive-associated microbiomes began around 1885 by Theodor Escherich. He wrote that meconium from the newborn was free of bacteria. This was interpreted as the uterine environment was sterile. Other investigations used sterile diapers for meconium collection. No bacteria were able to be cultured from the samples. Bacteria were detected and were directly proportional to the time between birth and the passage of meconium.

Normal microbiota

Microbiota in pregnancy

Bacterial vaginosis and pregnancy

History

References

Further reading