Özge KÖMÜRCÜ KARUSERCİ, Yasemin ZER, Seyhun SUCU, Elif İŞBİLEN, Hanifi BADEMKIRAN, Hilmi TAŞDEMİR

İkinci trimesterde asemptomatik gebeliklerde amniyotik sıvı mikrobiyomu

Amaç: Bu prospektif kohort çalışmasının amacı, ikinci trimesterde asemptomatik gebelerde amniyotik kavitenin olası mikrobiyomunu kültür temelli teknikle değerlendirmektir. Gereç ve Yöntem: Bu prospektif kohort çalışma, Gaziantep Üniversitesi Kadın Hastalıkları ve Doğum Kliniği'nde Ekim 2017- Kasım 2019 tarihleri arasında gerçekleştirildi. Fetüste genetik tarama için amniyosentez yapılan, vajinal enfeksiyon veya koryoamniyonite dair klinik semptomu olmayan 100 gebe kadın çalışmaya dahil edildi. Bu gebelerin amniyotik sıvıları kullanılarak kültür testleri yapılırken, amniyotik sıvılarının glikoz ve lökosit düzeyleri de ölçüldü. Aynı zamanda hastalardan vajinal sürüntü örnekleri alınarak kültür ve gram boyama analizleri yapıldı. Bulgular: 12 hastada (%12, %95 güven aralığı, %0 ile %41) amniyotik sıvı kültürü pozitif çıktı. En sık görülen bakteri E. coli idi (%5). Amniyotik sıvı kültürü sonucu pozitif olan hastalarda klinik enfeksiyon bulgusu izlenmedi. Bu hastalar hiçbir komplikasyon olmaksızın sağlıklı bebekler doğurdu. Sonuç: Amniyotik sıvının kendi mikrobiyomu vardır ve vajinal flora bu mikrobiyomun oluşumunda rol oynar. Bu bir ön çalışmadır; bu nedenle, amniyotik sıvının olası florasının çeşitliliğini bulmak için daha büyük çalışmalara ve geniş kapsamlı moleküler yöntemlere ihtiyaç vardır.

Amniotic fluid microbiome in asymptomatic pregnants at second trimester

Aim: The purpose of this prospective cohort study is to evaluate the possible microbiome of the amniotic cavity in the second trimester in asymptomatic pregnant women by the culture-based technique. Materials and Methods: This prospective cohort study was conducted in Gaziantep University Gynecology and Obstetrics Clinic between October 2017 and November 2019. 100 pregnant women who had amniocentesis for genetic screening in the fetus, and who had no complaints or clinical symptoms of vaginal or chorioamnionitis infection, were included in the study. While culture tests were performed by using the amniotic fluids of these pregnant women, glucose and leukocyte levels of their amniotic fluids were also measured. At the same time, culture and gram staining analyses were performed by collecting vaginal swab specimens from the patients. Results: 12 patients (12%, 95% confidence interval, 0 to 41%) had positive amniotic fluid culture results. The most observed bacteria were E. coli (5%). No findings of clinical infection were observed in the patients with positive amniotic fluid culture results. These patients delivered healthy babies with no complications. Conclusion: The amniotic fluid has its own microbiome, and the vaginal flora plays a role in the formation of this microbiome. This is a preliminary study; therefore, larger studies and targeted broad range molecular methods are needed to find the variety of the possible flora of the amniotic fluid.

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