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Bacterial vaginosis in association with spontaneous abortion and recurrent pregnancy losses

Context: Bacterial vaginosis (BV) is related to the increased risk of miscarriage, preterm labor, and postpartum endometritis. Aims: The aim of this study was to evaluate the association between BV and the history of spontaneous abortion and recurrent pregnancy losses. We also examined periods of gestation, including the first and second trimester miscarriages. Materials and Methods: The study population consisted of 200 fertile women. Sixty one (30.5%) of 200 women had the history of a spontaneous abortion in the last six months (N = 30) and at least three recurrent pregnancy losses (N = 31). BV was diagnosed either by using Papanicolaou staining, Gram staining, or by culturing with BV-associated bacteria, Gardnerella vaginalis. Results: The presence of BV was statistically associated with the history of a spontaneous abortion in the last 6 months (P < 0.05), whereas there was no significant relationship between BV and recurrent pregnancy losses (P > 0.05). These women were also evaluated in view of periods of gestation. Forty-seven (77%) of 61 women had first trimester miscarriage (≤12 weeks) and 14 (23%) of 61 women had second trimester miscarriage (>12 weeks). There was a statistically significant relationship between BV and second trimester miscarriage (P < 0.05). Positive BV findings were not associated with discharge, itching, and pain (P > 0.05). Conclusion: BV may contribute to spontaneous abortion and second trimester miscarriage.

Interactions of Actinomyces-Like Organisms with Host Cells: Light Microscopic Examination

Objective: To determine the interactions of Actinomyces-like organisms (ALOs) with host cells, including vaginal epithelial cells, polymorphonuclear leukocytes (PMNLs) and erythrocytes, using Pap smear microscopy and based on their light microscopic appearances. Study Design: Cervicovaginal samples obtained from 200 patients were examined by both Pap smear microscopy and anaerobic culturing. Since the results obtained by these methods were not concordant for diagnosis of genital Actinomyces, the results of Pap smear microscopy were used as a reference, and the smears with ALOs were carefully screened with regard to interactions of ALOs with host cells. Results: ALOs were detected as attached to vaginal epithelial cells, PMNLs and erythrocytes via their filament-like structures. At some attachment sites, the epithelial cell membrane and filaments of ALOs were almost fused with each other. A group of PMNLs surrounded the ALOs. However, ALOs were observed to form colonies to evade phagocytosis by PMNLs. At the connection points between erythrocytes and ALOs, the findings of interest were the changes in the shapes of the erythrocytes and filament-like structures of the ALOs on the erythrocyte membrane. Conclusions: The adhesiveness of ALOs can be observed in routine Papanicolaou-stained cervicovaginal smears at light microscopic level.