Hydrogen Peroxide-producing Lactobacillus in Vaginal Flora of Pregnant Women with Preterm Labor and Intact Membranes / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: To investigate the possible role of vaginal infection in preterm delivery, we studied characteristics of vaginal discharge related to hydrogen peroxide producing Lactobacillus. METHODS: Vaginal specimens were obtained from 66 women with normal pregnancy and 30 women with preterm labor and intact membranes. Vaginal pH, leukocyte counts on wet smear, and scores by Nugent criteria on Gram stain were measured. Lactobacillus were tested for production of hydrogen peroxide using a qualitative assay on a tetramethylbenzidine agar plate after incubated for 30 minutes and 1 hour. One hundred eighty-seven hydrogen peroxide-producing Lactobacillus colonies isolated from vaginal fluid of normal pregnant women, and 77 hydrogen peroxide-producing Lactobacillus colonies isolated from it of women with preterm labor and intact membrane. RESULTS: 1. There were no significant differences in vaginal pH between normal pregnant women and women with preterm labor and intact membranes (4.06 +/- 0.31 vs. 4.04 +/- 0.57, pLeukocyte levels in vaginal wet smear of women with preterm labor and intact membranes were significantly higher than that of normal pregnant women (4.46 +/- 0.47 vs. 2.39 +/- 0.37, p<0.01). 3. Nugent score of Gram stained vaginal smear of women with preterm labor and intact membranes were significantly higher than that of normal pregnant women (2.34 +/- 0.51 vs. 1.21 +/- 0.30, p<0.05). 4. Hydrogen peroxide-producing Lactobacillus levels in vaginal flora of women with preterm labor and intact membranes were significantly lower than that of normal pregnant women incuvated after 30 minutes (strongly positive 2.6%, weakly positive 2.6%, negative 83.1% vs 17.1%, 31.6%, 41.7%, p<0.01) and 1 hour (strongly positive 6.5%, weakly positive 7.8%, negative 59.7% vs 36.9%, 31.6%, 19.8%, p<0.01).

CONCLUSION:

Distribution of vaginal hydrogen peroxide-producing Lactobacillus in vaginal flora as defense factors for vaginal infection may have a important role in the pathophysiology of preterm labor.