Vaginal probiotics on the outcomes of premature rupture of membranes: a pilot randomised clinical trial.

2022-11-17
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology 42(8)
- Denise Vasconcelos de Moraes
- Dinalva Brito de Queiroz
- José Eleutério

PubMed: 36632810
DOI: 10.1080/01443615.2022.2151349

Study Design

Type: Randomized Controlled Trial (RCT)
Sample size: n = 27
Population: 27 pregnant women with premature rupture of membranes (PROM) between 24 and 36 weeks of gestation
Methods: Randomised, triple-blind, placebo-controlled study; vaginal probiotics (Lactobacillus rhamnosus and L. gasseri) vs placebo
Blinding: Triple-blind
Funding: Unclear

The published literature shows that a balanced vaginal microbiota can have a favourable impact on decreasing the prevalence of premature rupture of membranes (PROM). We studied the effects of vaginal probiotics (Lactobacillus rhamnosus and L. gasseri) on the outcomes of PROM in pregnant women between 24 and 36 weeks of gestation. We performed a randomised, triple-blind, placebo-controlled study. A total of 27 participants were divided into two groups-group 1 (probiotics; n = 16) and group 2 (placebo; n = 11). Although most outcomes did not show much variation, the latency period and gestational age at delivery were higher in group 1 than in group 2. Thus, vaginal use of L. rhamnosus and L. gasseri along with standard treatment appears to increase the latency period and gestational age at delivery in women with PROM.IMPACT STATEMENTWhat is already known on this subject? Delaying delivery increases the risk of infections, but the prolongation of pregnancy allows further foetal maturation, thus reducing the risk of complications associated with premature birth. Moreover, a more extended latency period in pregnancies of <37 weeks of gestation is associated with a better neonatal prognosis.What do the results of this study add? The use of probiotics (L. rhamnosus and L. gasseri) prolongs the latency period in pregnant women with premature rupture of membranes.What are the implications of these findings for clinical practice and/or further research? Probiotics are an exciting option for extending the time to delivery in cases of premature rupture of the membrane, allowing the maturation of the foetal lung.

Research Insights

Lactobacillus gasseri→Improved Patient-Reported Outcome
Although most outcomes did not show much variation
Effect
Neutral
Effect size
Small
Lactobacillus gasseri→Increased Gestational Age at Delivery
the latency period and gestational age at delivery were higher in group 1 than in group 2. Thus, vaginal use of L. rhamnosus and L. gasseri along with standard treatment appears to increase the latency period and gestational age at delivery in women with PROM.
Effect
Beneficial
Effect size
Small
Lactobacillus gasseri→Increased Latency Period
the latency period and gestational age at delivery were higher in group 1 than in group 2. Thus, vaginal use of L. rhamnosus and L. gasseri along with standard treatment appears to increase the latency period and gestational age at delivery in women with PROM.
Effect
Beneficial
Effect size
Small
Lactobacillus rhamnosus→Improved Patient-Reported Outcome
Although most outcomes did not show much variation
Effect
Neutral
Effect size
Small
Lactobacillus rhamnosus→Increased Gestational Age at Delivery
the latency period and gestational age at delivery were higher in group 1 than in group 2. Thus, vaginal use of L. rhamnosus and L. gasseri along with standard treatment appears to increase the latency period and gestational age at delivery in women with PROM.
Effect
Beneficial
Effect size
Small
Lactobacillus rhamnosus→Increased Latency Period
the latency period and gestational age at delivery were higher in group 1 than in group 2. Thus, vaginal use of L. rhamnosus and L. gasseri along with standard treatment appears to increase the latency period and gestational age at delivery in women with PROM.
Effect
Beneficial
Effect size
Small