Probiotics in obstetrics and gynecology. Literature review

A modern probiotic preparation should include an effective combination of microorganisms with proven probiotic properties, i.e. produce lactic acid, hydrogen peroxide and bactericins, have the ability to grow and colonize, allowing them to become temporary for the period of treatment, or permanent inhabitants of vagina or other micro-ecologies. The World Health Organization (WHO) has outlined certain guidelines for a bacterial strain to be used as a probiotic: it must be capable of survival during passage through the stomach and intestines (for oral forms), resistant to the effects of antibiotics, tested for side effects and adverse effects in humans. Currently, there are only a few recognized lactobacilli or bifidobacterial strains which meet WHO criteria. The main indication for the probiotics use in gynecology is the treatment of bacterial vaginosis, candidiasis and recurrent infections of the urinary tract. Numerous studies have shown the clinical efficacy of introducing probiotics into treatment regimens for these diseases. Probiotics are able to adhere to vaginal epithelial cells and form a protective layer (biofilm) that provides a barrier against infectious pathogens. Vaginal biocenosis disorders often lead to complicated pregnancy, miscarriage, development of placental insufficiency, premature birth and intrauterine infection of the fetus, various pathologies in the newborn (impaired immunity, allergic diseases, etc.). Therefore, the condition of the vaginal microflora of woman is important for health of her child. Its correction is needed at the stage of preconceptional preparation, as well as during pregnancy. At the same time, probiotics are not only beneficial, but also safe for pregnant and lactating women. Vaginal suppositories Florica showed effectiveness and tolerability in maintaining the normal vaginal microbiota balance and prevent recurrence of bacterial vaginosis and vaginal dysbiosis whereas in the absence of its use, the frequency of diseases recurrence was 35% within 6 month