@article {1897, title = {Effects of hormonal contraception on vaginal flora.}, journal = {Contraception}, volume = {86}, year = {2012}, month = {2012 Nov}, pages = {526-9}, abstract = {

BACKGROUND: The sector of the market that deals with contraception offers a long list of different contraceptive methods. Within the estroprogestinic choice, the routes of administration are oral, transdermic and vaginal one. Even though efficacy is comparable with these methods, secondary and adverse effects are directly involved in the acceptability of the method.

STUDY DESIGN: This was a prospective comparative study. During 1 year, we enrolled 60 asymptomatic women who voluntarily requested combined oral contraception (COC) or combined contraceptive vaginal ring (CCVR group). After a baseline study of vaginal milieu prior to starting hormonal contraception, we performed a follow-up. For each woman, we examined vaginal pH; quantification of leukocytes, lactobacilli, Candida and cocci on saline microscopy fluid; Gram stain with Nugent score and the presence of vaginal infection [culture for Trichomonas vaginalis, albicans and nonalbicans Candida, Group B Streptococcus (GBS)].

RESULTS: At the end of follow-up, there was a little change of vaginal milieu in both groups. We noted an increase of lactobacilli in the CCVR users and an increase of GBS in COC users.

CONCLUSION: CCVR compared to COC users showed an increase of the number of lactobacilli in vaginal flora. It means that an increase of leukorrhea in that group could be protective in terms of prevention of vaginal imbalance/infection.

}, keywords = {Administration, Intravaginal, Adolescent, Adult, Bacterial Load, Candida, Candida albicans, Contraceptive Devices, Female, Contraceptives, Oral, Combined, Female, Humans, Hydrogen-Ion Concentration, Lactobacillus, Leukocyte Count, Middle Aged, Prospective Studies, Streptococcus agalactiae, Trichomonas vaginalis, Vagina}, issn = {1879-0518}, doi = {10.1016/j.contraception.2012.02.012}, author = {De Seta, Francesco and Restaino, Stefano and De Santo, Davide and Stabile, Guglielmo and Banco, Rubina and Busetti, Marina and Barbati, Giulia and Guaschino, Secondo} } @article {1945, title = {The effects of uterine fundal pressure (Kristeller maneuver) on pelvic floor function after vaginal delivery.}, journal = {Arch Gynecol Obstet}, volume = {286}, year = {2012}, month = {2012 Nov}, pages = {1135-9}, abstract = {

PURPOSE: To evaluate the role of uterine fundal pressure during the second stage of labor (Kristeller maneuver) on pelvic floor dysfunction (urinary and anal incontinence, genital prolapse, pelvic floor strength).

METHODS: 522 primiparous women, enrolled 3 months after vaginal delivery, were divided in two groups: group A (297 women) identifies the women who received Kristeller maneuvers with different indications (e.g. fetal distress, failure to progress, mother exhaustion), group B (225 women) the women without maneuver. Participants were questioned about urogynecological symptoms and examined by Q-tip test, digital test, vaginal perineometry and uroflowmetric stop test score.

RESULTS: Mediolateral episiotomies, dyspareunia and perineal pain were significantly higher in Kristeller group, whereas urinary and anal incontinence, genital prolapse and pelvic floor strength were not significantly different between the groups.

CONCLUSIONS: Kristeller maneuver does not modify puerperal pelvic floor function but increases the rate of episiotomies.

}, keywords = {Delivery, Obstetric, Dyspareunia, Dystocia, Episiotomy, Fatigue, Fecal Incontinence, Female, Fetal Distress, Humans, Labor Stage, Second, Pain, Postoperative, Pelvic Floor, Pelvic Organ Prolapse, Perineum, Pregnancy, Pressure, Puerperal Disorders, Urinary Incontinence, Uterus}, issn = {1432-0711}, doi = {10.1007/s00404-012-2444-x}, author = {Sartore, Andrea and De Seta, Francesco and Maso, Gianpaolo and Ricci, Giuseppe and Alberico, Salvatore and Borelli, Massimo and Guaschino, Secondo} } @article {1924, title = {Efficacy of rifaximin vaginal tablets in treatment of bacterial vaginosis: a molecular characterization of the vaginal microbiota.}, journal = {Antimicrob Agents Chemother}, volume = {56}, year = {2012}, month = {2012 Aug}, pages = {4062-70}, abstract = {

Bacterial vaginosis (BV) is a common vaginal disorder characterized by an alteration of the vaginal bacterial morphotypes, associated with sexually transmitted infections and adverse pregnancy outcomes. The purpose of the present study was to evaluate the impact of different doses of rifaximin vaginal tablets (100 mg/day for 5 days, 25 mg/day for 5 days, and 100 mg/day for 2 days) on the vaginal microbiota of 102 European patients with BV enrolled in a multicenter, double-blind, randomized, placebo-controlled study. An integrated molecular approach based on quantitative PCR (qPCR) and PCR-denaturing gradient gel electrophoresis (PCR-DGGE) was used to investigate the effects of vaginal tablets containing the antibiotic. An increase in members of the genus Lactobacillus and a decrease in the BV-related bacterial groups after the antibiotic treatment were demonstrated by qPCR. PCR-DGGE profiles confirmed the capability of rifaximin to modulate the composition of the vaginal microbial communities and to reduce their complexity. This molecular analysis supported the clinical observation that rifaximin at 25 mg/day for 5 days represents an effective treatment to be used in future pivotal studies for the treatment of BV.

}, keywords = {Adolescent, Adult, Anti-Bacterial Agents, Double-Blind Method, Female, Humans, Lactobacillus, Metagenome, Middle Aged, Rifamycins, RNA, Ribosomal, 16S, Vagina, Vaginal Creams, Foams, and Jellies, Vaginosis, Bacterial, Young Adult}, issn = {1098-6596}, doi = {10.1128/AAC.00061-12}, author = {Cruciani, Federica and Brigidi, Patrizia and Calanni, Fiorella and Lauro, Vittoria and Tacchi, Raffaella and Donders, Gilbert and Peters, Klaus and Guaschino, Secondo and Vitali, Beatrice} }