Galiñanes Sebastián, Coppolillo Enrique, Cifarelli Maximiliano, Cora Eliseht Martha, Pellisa Ercilia, Losada Mirta, Gruccio Sebastián, Ruda Vega Hilda, Vay Carlos, Famiglietti Angela, Perazzi Beatriz
Clinical Bacteriology Laboratory, Department of Clinical Biochemistry, Hospital de Clínicas, Faculty of Pharmacy and Biochemistry, University of Buenos Aires, Córdoba 2351, 1120, City of Buenos Aires, Argentina.
ISRN Obstet Gynecol. 2011;2011:835926. doi: 10.5402/2011/835926. Epub 2011 Apr 26.
Objective. To assess the vaginal inflammatory status (VIS) in pregnant women, whether symptomatic or asymptomatic, by leukocyte quantification in relation to the microbiota during each pregnancy trimester (T). Materials and Methods. A thousand two hundred and forty eight vaginal exudates from pregnant women were prospectively examined. All the patients underwent a clinical and colposcopic examination and a microbiological study of vaginal exudates. Leukocyte quantification was determined by May-Grunwald Giemsa staining as LNR per field (400X). Results. Statistically significant differences (SSD) in LNR were observed in the VIS of asymptomatic patients (AP) compared with that of symptomatic ones (SP) with normal microbiota: 10-15 for the 1st T, <10, 20 to 25 and >25 for the 2nd T and >25 for the 3rd; with candidiasis: <10 for the 1st T, <10, 15 to 20 and >25 for the 2nd T and <10 and >25 for the 3rd T. In women with trichomoniasis, SSD in the LNR were observed between SP with LNR ≥ 10 and AP with NLR < 10 in the three trimesters altogether. In women with BV, no SSD were observed in the LNR of any AP with respect to SP for the three T. Conclusion. The VIS is influenced by vaginal microbiota and depends on the state of pregnancy and also, on gestational age. The pronounced leukocyte increase in asymptomatic patients in the absence of lower genital tract infection during the third trimester of pregnancy should be highlighted.
目的。通过在每个孕期(T)对与微生物群相关的白细胞进行定量分析,评估孕妇的阴道炎症状态(VIS),无论其有无症状。材料与方法。前瞻性检查了1248例孕妇的阴道分泌物。所有患者均接受了临床和阴道镜检查以及阴道分泌物的微生物学研究。通过May-Grunwald Giemsa染色确定白细胞定量,以每视野(400倍)的白细胞与上皮细胞比率(LNR)表示。结果。与微生物群正常的有症状患者(SP)相比,无症状患者(AP)的VIS中LNR存在统计学显著差异(SSD):孕早期(第1孕期)为10 - 15,第2孕期<10、20至25以及>25,第3孕期>25;念珠菌感染时:第1孕期<10,第2孕期<10、15至20以及>25,第3孕期<10和>25。在滴虫病患者中,三个孕期中LNR≥10的SP与NLR<10的AP之间均观察到LNR的SSD。在细菌性阴道病(BV)患者中,三个孕期中任何AP的LNR与SP相比均未观察到SSD。结论。VIS受阴道微生物群影响,取决于妊娠状态以及孕周。应强调妊娠晚期无症状患者在无下生殖道感染时白细胞显著增加的情况。