THE IMPORTANCE OF VAGINAL MICROFLORA IN THE PATHOGENESIS OF PREMATURE RUPTURE OF MEMBRANES

Аннотация

Premature rupture of membranes (PROM) remains a significant obstetric complication, contributing to neonatal morbidity and maternal infections. Emerging evidence suggests that alterations in the vaginal microflora play a critical role in the pathogenesis of PROM. This prospective, multicenter observational study aimed to evaluate the composition of vaginal microflora in pregnant women and its association with PROM. A total of 500 pregnant women, including 250 cases with PROM and 250 gestational age–matched controls, were enrolled between January 2018 and December 2020. Vaginal swabs were analyzed using culture methods and molecular techniques (16S rRNA sequencing) to characterize the microflora [1]. Results indicated a significant association between bacterial vaginosis–related organisms (e.g., Gardnerella vaginalis, Atopobium vaginae) and the occurrence of PROM, with an observed disruption in Lactobacillus-dominated flora. Multivariate logistic regression demonstrated that an abnormal vaginal microflora was an independent predictor of PROM (OR 2.8, 95% CI 1.9–4.2, p < 0.001). Our findings underscore the need for early screening and targeted interventions to restore normal vaginal flora, which may reduce the incidence of PROM and its associated complications [2].