Vaginal Germ Carriage And Vaginal Flora Change In Pregnancy

The female genital tract is a bacterial growth environment. There, the protective bacteria form a biofilm and maintain the pH between 3.8 and 4.5. In the event of modification of the normal flora, some bacteria can cause obstetrical complications. In Cameroon, one woman in three suffers from a genital infection during pregnancy. The objective of our study was to determine the vaginal carriage of germs and the modification of vaginal flora in pregnant women at the Ad-Lucem Banka-Bafang Hospital (West-Cameroon). The study was conducted over a period of six months at the Ad-Lucem Banka-Bafang Hospital (West-Cameroon). Cervico-vaginal sampling (CVS) was performed on 210 consecutively selected pregnant women. Cytological classification was assessed using the Nugent score method. Culture on media was done while maximising optimal growth conditions.
Enterosystems gallery (Liofilchem ) was used for identification and, antibiogram was performed according to the King-Baeur technique. The data were analysed in Excel 2010 and SPSS 20. Chi-square test was used for associations with p 0.05 assumed to be significant. A total of 210 pregnant women were enrolled in this multi-criteria study. The women’s mean age was 29 ± 5 years with a range of 16-48 years. The most represented age group was 20-25 years. 42.38% of our study population were housewives and 46.19% had a secondary education. In our study, the vaginal ecosystem varied according to gestational age. Indeed, from the first to the second pregnancy trimester, there was no
significant change in the flora typology. According to the Nugent score, bacterial vaginosis in our study was 26.19%, 53.33% and 56.66% in the first, second and third trimester of pregnancy respectively. Morphotype Gardnerella represented 0.95%, 7.14% and 7.62% in the first, second and third trimester of pregnancy respectively. Regarding the germs isolated in culture, the predominant germ in the first trimester of pregnancy was Candida with a proportion of 4.28%. The E. coli strains were sensitive to the beta-lactams and the sensitivity proportions for Gentamycin were 44%, 80% for Lincomycin and 42% for erythromycin. Most of the antifungals tested on Candida Spp showed a susceptibility profile above 50%. Our study showed that bacterial vaginosis increases with the age of
pregnancy.