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dOI 10.11603/IJMMR.2413-6077.2017.2.8077

EcOLOgIcAL fEATUREs Of mIcRObIOcENOsIs Of ThE sKIN  
Of mAmmARY gLANds ANd VAgINA IN PREgNANT WOmEN  
WITh ThREAT Of PRETERm LAbOR

V. Ya. Ivankiv, I. M. Malanchyn, N. I. Tkachuk
I. HORBACHEVSKY TERNOPIL STATE MEDICAL UNIVERSITY, TERNOPIL, UKRAINE

Background. The threat of preterm birth is one of the most topical issues in the world medicine. According 
to the statistics, from 12–13 to 25–35 % of all pregnancies end prematurely. One of the causes of preterm labour 
is chronic inflammatory processes of female genital organs and disorder of microbiocenosis. Timely diagnosis 
and adequate treatment will reduce the risk of premature labour and avoid perinatal loss.

Objective. We examined and analysed the microflora of the skin of mammary glands and mucous membrane 
of vagina in healthy pregnant women and patients with threat of preterm labour. 

Methods. The examination of the pregnant was conducted at the TRMPC “Mother and Child” in several 
stages. First of all, we rinsed the skin of mammary glands and smeared from mucous membrane the posterior 
vault of vagina with sterile swabs pre-moistened in physiological solution. After that, the tampons were placed 
in sterile tubes and delivered to laboratory. Sowing was carried out on Petri dishes with sterile medium: ZHSA, 
bloods MPA, Endo, Saburo, thioglycolic medium.

Results. As a result of the research we found saprophytic Gram-positive and Gram-negative microorganisms 
(in women with a physiological course of pregnancy). In pregnant women with preterm labor, there is an increase 
in the number of St. haemolyticus from 13% to 87%, appearance of representatives of the pathogenic flora – 
St. aureus (in 20%).

Conclusions. Changes in the microbiocenosis of the mammary glands and mucous membranes of the va-
gina of pregnant women with preterm labor may indicate the presence of opportunistic microflora, or personal 
hygiene or the presence of associated bacterial infections. It requires the further investigation of possible links 
among the preterm birth and microbiota.

KEY WORDS: microbiocenosis of the skin of mammary glands; mucous membrane of vagina; 
preterm labour.

Corresponding author: Natalia Tkachuk, Department of 
 Microbiology, Virology and Immunology, I. Horbachevsky 
Ternopil State Medical University, 1 Maidan Voli, Ternopil, 
Ukraine, 46001 
Phone number: +380352250539
E-mail: tkachuk@tdmu.edu.ua

Introduction
Currently, the threat of preterm birth is one 

of the most pressing issues in the world. Accor-
ding to literary statistics, from 12–13 to 25–35% 
of all pregnancies ended prematurely [1, 3]. 
One of the causes of preterm labour is chronic 
inflammatory processes of female genital 
organs and disorder (dysbiosis) of micro-
biocenosis [2]. Timely diagnosis and adequate 
treatment reduce the risk of premature labour 
and avoid perinatal loss. In normal conditions, 
women are dominated by lactic acid bacteria in 
vagina, which prefer to live in an acidified me­
dium of healthy vagina [4, 6]. They protect mu-
cous membrane and may show slight scaling 
of mucous membranes. If this Lactobacillus 
becomes little, conditionally pathogenic micro-
bes begin to multiply instead of them. They are 

also normally in a womb of a healthy woman, 
but in very small quantities. If there are many 
of them the imbalance presents and bacterial 
vaginosis develops [5].

According to the literature, the main causes 
of the imbalance of microorganisms are:

– changes of hormonal state in pregnancy, 
when progestogen hormones shift the vaginal 
medium to the paralysis;

– dysbiosis in intestine, which promotes 
changes in the balance of microbes in vagina;

– the use of drugs during pregnancy that 
affect microflora;

– chronic infectious processes in the body 
of a pregnant woman with chronic inflammation 
in the urinary tract that is most often relevant;

– chronic sex infections are not detected in 
time and aggravated during pregnancy 
(Ford H. B, Schust D. J, 2009).

Methods
The examination of the pregnant was con-

ducted at Ternopil Regional Municipal Perinatal 

International Journal of Medicine and Medical Research 
2017, Volume 3, Issue 2, p. 51–53
copyright © 2017, TSMU, All Rights Reserved

V. ya. Ivankiv et al.



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iSSn 2413-6077. iJmmR 2017 Vol. 3 issue 2

Centre “Mother and Child” in several stages. 
First of all, we rinsed the skin of mammary 
glands and smeared from mucous membrane 
the posterior vault of vagina with sterile swabs 
pre-moistened in physiological solution. We 
took the material by scrolling all sides of cotton 
swab. After that, the tampons were placed in 
sterile tubes and delivered to laboratory. The 
time was 20-30 minutes from the stage of taking 
the research material to the crop. Sowing was 
carried out on Petri dishes in sterile medium: 
ZHSA, bloods MPA (for detection of coccious 
microorganisms), Endo (Enterobacteriaceae), 
Saburo (mushrooms of genus Candida), thio-
gly colic medium (anaerobic microorganisms). 
Each of the cups was marked with the indication 
accordingly. Sowing on the medium was carried 
out with tampons: first touching one edge of 
Petri cup, then – scrolling with all sides. Then 
we continued sowing the sterilized bacte-
riological loop perpendicular to the sowing with 
a swab. The media was placed in a thermostat 
for 18-48 hours at an optimum temperature. 
We evaluated the growth of microorganisms 
on the media after incubation in the thermostat 
(their shape, colour, size of colonies, nature of 
surface and edges). Next, we made smears 
from certain types of colonies, stained with 
Gram method and microscopically.

Results
As a result of microscopic examination, in 

15 women from the control group (pregnant 
women with physiological pregnancy) were 
found:

– on the skin of mammary gland E. soli, 
Fuso bacterium, Gram-positive non-spore ba-
illus, M. roseus, Streptococcus spp., lactose-
negative Enterobacteria in 7%; Lactobacillus, 

St. haemolyticus – in 13%; St. saprophyticus – in 
20%; Corynebacterium – in 27%; Clostridium, 
Tetracoccus, Bacillus spp. – in 33%; M. luteus – 
in 40%, Peptostreptococcus, St. epidermidis, 
M. lylae – in 47%; Bacteroideus – in 60% of the 
examined patients were present;

– in the vaginal smears St. hominis, Strep-
tococcus, Gram-positive non-spore bacillus, 
St. haemolyticus in 7%; Streptobacillus, Strep-
tococcus spp., M. lylae – in 13%; Tetracoccus, 
Candida, E. soli, St. saprophyticus, Lactose-
negative Enterobacteria – in 20%; M. luteus – in 
33%; Doderlein sticks, Corynebacterium, 
St. epidermis, Bacillus spp. – in 40%; Clostridium, 
Bacteroideus, Enterococcus – in 47%; Lacto-
bacillus – in 73% of the examined women were 
evidenced.

In the patients with a threat of preterm 
labour, it was found:

– on the skin of mammary glands: 
M. sedentarius, St. hominis, M. roseus, Lac-
tobacillus, Gamma-hemolyticus strepto coccus – 
in 7%; M. varians, Bacillus spp. – in 13%; Co-

Fig. 1. Cultures of microorganisms on Petri dishes (Endo 
medium)

Fig. 2. Cultures of microorganisms on Petri dishes (bloods 
MPA medium)

Fig. 3. Cultures of microorganisms on Petri dishes (ZHSA 
medium)

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rynebakterium spp., St. aureus, M. lylae – in 
20%; M. luteus, St. epidermidis – in 33%; 
St. haemolyticus – in 87% of the exemined;

– in the vagina smears: St. epidermidis, 
M. luteus, Streptobacillus in – 7%; St. aureus, 
Lactose-negative Enterococcus – in 13%; Alpha-
hemolyticus streptococcus, Beta-hemolyticus 
streptococcus in – 20%; Bacillus spp., Candida, 
E. coli – in 27%; Enterococcus – in 53%; St. hae-
molyticus in 67% of the examined pregnant 
women.

Discussion
According to foreign statistics, approximately 

25% of all cases of preterm labour were caused 
by mother or foetus indications, 30% – due to 
premature rupture of membranes of foetus [8]. 
Many scholars argue that most of the premature 
labour occurs on the background of uncompli-
cated pregnancy [7, 9].

But, despite this, and summing up the re-
sults of our research, we can assume that a 
violation of microflora of vagina and skin of 
ma mmary glands is one of the causes of pre-
term labour. That is why women with violations 
of microflora of vagina and skin of mammary 
glands should be under the obstetrician super-
vision of obstetrician-gynaecologist. Each pre-
gnant woman should be thoroughly examined 
to prevent complications during labour and 
avoid perinatal loss. In the detection of any 
pathology of female genital organs, it is ne-
cessary to conduct timely treatment.

Conclusions
Representatives of normal microflora: sap­

rophytic Gram-positive and Gram-negative 
microorganisms, found on the skin of mammary 
glands of the control group of women, coincide 
with the data of the literature. In the pregnant 
women with preterm labour, there is the in-
crease in the number of St. haemolyticus from 
13% to 87%, the presence of representatives of 
pathogenic flora – St. aureus (in 20% of the 
examined).

In the study of microbiocenoses of mucous 
membrane of vagina in the examined women 
with threat of preterm labour compared with 
the control group, a sharp decrease in the 
number of lactic acid bacteria (Doderlein sticks, 
Lactobacillus) and the increase in the incidence 
of coccal flora (St. haemolyticus, St. aureus, 
Alpha-hemolytic streptococci, Beta-hemolytic 
streptococci).

Changes in the microbiocenosis of mam-
mary glands and mucous membranes of vagina 
of pregnant women with preterm labour may 
indicate the presence of opportunistic micro flora 
or personal hygiene or the presence of associated 
bacterial infections. Perhaps this is one of the 
causes of preterm birth in pregnant women.

The carriage of opportunistic and patho-
genic coccalmicroflora can contribute to inflam­
matory purulent-septic processes in infants and 
new-borns.

References
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№ 624: Premature childbirth. Accessed 03 Nov 2008.
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4. Shchurevskaya OD. Stress of mother during 
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5. Golyanovsky V. Screening and treatment of 
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6. Reznichenko HI. Prevention of miscarriage and 
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Received: 2017-09-20