Bacterial vaginosis (BV) is a qualitative and quantitative disorder of the microflora of the urogenital tract. In BV, there is an absence or decrease in the total number of lactobacilli and an increase in the number of anaerobic microorganisms, such as Gardrenella vaginalis, Prevotella, Atopobium vaginae, Mobiluncus, Bifidobacterium, Sneathia, Leptotrichia, and other BV-associated bacteria [1]. BV is common in patients of reproductive age. The prevalence of BV in pregnant women is 8-51% [2]. BV in pregnant women is caused by complications during pregnancy, in particular chorioamnionitis, spontaneous miscarriage, premature rupture of the membranes, premature birth (PR) and a deficiency in the child's body weight at birth. Globally, the rate of neonatal mortality associated with HIV reaches 2.9 million. Over 80% of neonatal mortality is accounted for by newborns with OD, 2/3 of whom are premature, 1/3 are full–term infants with low body weight [3]. In the study by X. Zhang et al. Of the 186 pregnant women with gestational diabetes mellitus (GDM), 106 had an abnormal composition of the vaginal microflora. Patients with abnormal microflora showed a high incidence of premature rupture of the membranes (32.1%), PR (7.5%) and choriamnionitis (2.5%) [4]. 

premature birth, bacterial vaginosis, pregnancy, probiotic, clindamycin

N.Z. Mammayeva I.B. Manukhin and S.D. Osmanova Moscow State Medical and Dental University named after A.I. Evdokimov Address for correspondence: Naina Zainutinovna Mammayeva, letuchka92@mail.ru For citation: Mammayeva N.Z., Manukhin I.B., Osmanova S.D. Modern treatment of bacterial vaginosis in the second trimester of pregnancy. Effective pharmacotherapy. 2023; 19 (37): 6–10. DOI 10.33978/2307-3586-2023-19-37-6-10 Effective pharmacotherapy. 2023. Volume 19. No. 37. Obstetrics and Gynecology

Ilina I.Yu., Dobrokhotova Yu.E. Bacterial vaginosis. Possible solutions to the problem. Russian Medical Journal. 2020; 11: 75–8. [Ilina I.Yu., Dobrokhotova Yu.E. Bacterial vaginosis. Possible solutions to the problem. Russian Medical Journal. 2020; 11: 75–8. (in Russian)]

Ruiz-Perez D., Coudray M.S., Colbert B., Krupp K. et al. Effect of metronidazole on vaginal microbiota associated with asymptomatic bacterial vaginosis. Access Microbiol. 2021; 3(5): 000226. DOI: 10.1099/acmi.0.000226

Kira E.F., Rastorgueva L.I., Khalturina Yu.V., Pushkina V.V. Vaginal infections. A two-stage treatment method. Obstetrics and gynecology. 2020; 4: 201-8. [Kiga E.F., Rastorgueva L.I., Khalturina Yu.V., Pushkina V.V. Vaginal infections. Two-step treatment. Obstetrics and Gynegology. 2020; 4: 201–8. (in Russian)]. DOI: 10.18565/aig.2020.4.201-208

Pustotina O.A. Bacterial vaginosis: pathogenesis, diagnosis, treatment and prevention. Obstetrics and gynecology. 2018; 3: 150–6. [Pustotina O.A. Bacterial vaginosis: pathogenesis, diagnosis, treatment, and prevention. Obstetrics and Gynegology. 2018; 3: 150–6. (in Russian)]. DOI: 10.18565/aig.2018.3.150-156

Radzinsky V.E., Anufrieva V.G., Belinina A.A., Bespalaya A.V. and others. Empirical treatment of vulvovaginitis in women of reproductive age in routine clinical practice. Obstetrics and gynecology. 2020; 2: 160–8. [Radzinsky V.E., Anufrieva V.G., Belinina A.A., Bespalay A.V. et al. Empirical therapy for vulvovaginitis in reproductive-aged women in routine clinical practice. Obstetrics and Gynegology. 2020; 2: 160–8. (in Russian)]. DOI: 10.18565/aig.2020.2.161-168

Crucitti T., Hardy L., van de Wijgert J., Agaba S. et al. Contraceptive rings promote vaginal lactobacilli in a high bacterial vaginosis prevalence population: a randomised, openlabel longitudinal study in Rwandan women. PLoS One. 2018; 13(7): e0201003. DOI: 10.1371/journal.pone.0201003 Bitsadze V.O., Radetskaya L.S. Experience of using a topical combination drug containing metronidazole and miconazole for the treatment of bacterial vaginosis and candidal vulvovaginitis in pregnant women. Gynecology. 2016; 18(6): 56–60.

[Bitsadze V.O., Radetskaya L.S. Experience of using the local combination product containing miconazole and metronidazole for the treatment of bacterial vaginosis and vulvovaginal candidiasis in pregnant women. Gynecology. 2016; 18(6): 56–60. (in Russian)]

Amsel R., Totten P.A., Spigel C.A., Chen K.C. et al. Nonspecific vaginitis: diagnostic criteria and microbial and epidemiologic associations. Am. J. Med. 1983; 74(1): 14–22. DOI: 10.1016/0002-9343(83)91112-9

Donders G.G.G., Bellen G., Grinceviciene S., Ruban K. et al. Aerobic vaginitis: no longer a stranger. Res. Microbiol. 2017; 168(9–10): 845–58. DOI: 10.1016/j.resmic.2017.04.004 Padrul M.M., Galinova I.V., Olina A.A., Sadykova G.K. Features of the risk stratification of premature birth. Health risk analysis. 2020; 1: 165–76.

[Padrul' M.M., Galinova I.V., Olina A.A., Sadykova G.K. Stratification of preterm birth risk: peculiari ties. Health Risk Analysis. 2020; 1: 165–76. (in Russian)]. DOI: 10.21668/health.risk/2020.1.17

Goncharova M.A., Tsipinov R.S., Petrov Yu.A. Miscarriage of pregnancy with isthmic-cervical insufficiency. Modern problems of science and education. 2018; 6: 150. [Goncharova M.A., Tsipinov R.S., Petrov Yu.A. Non-extension of pregnancy during isthmic-cervical insufficiency. Modern Problems of Science and Education. 2018; 6: 150. (in Russian)]

Sinyakova A.A., Shipitsyna E.V., Budilovskaya O.V., Bolotskikh V.M. and others. Evaluation of the effectiveness of treatment of vaginal infections in patients with a history of miscarriage. Journal of Obstetrics and Women's Diseases. 2019; 68(5): 63–74. [Siniakova

A.A., Shipitsyna E.V., Budilovskaya O.V., Bolotskikh V.M. et al. The efficiency of treatment of vaginal infections in women with a history of miscarriage. Journal of Obstetrics and Women's Diseases. 2019; 68(5): 63–74. (in Russian)]. DOI: 10.17816/JOWD68563-74

Dobrokhotova Yu.E., Borovkova E.I., Zalesskaya S.A., Nagaytseva E.A. and others. Diagnosis and management tactics of patients with isthmic-cervical insufficiency. Gynecology. 2018; 20(2): 41–5. [Dobrokhotova Yu.E., Borovkova E.I., Zalesskaya S.A., Nagaitseva E.A. et al. Diagnosis and management patients with cervical insufficiency. Gynecology. 2018; 20(2): 41–5. (in Russian)]. DOI: 10.26442/2079-5696_2018.2.41-45

Care A., Jackson R., O'Brien E., Leigh S. et al. Cervical cerclage, pessary, or vaginal progesterone in high-risk pregnant women with short cervix: a randomized feasibility study. J. Matern. Fetal Neonatal Med. 2021; 34(1): 49–57. DOI: 10.1080/14767058.2019.1588245 Petrov Yu.A., Ozdoeva I.M.-B. Isthmic-cervical insufficiency as an etiological factor of premature birth. Scientific review. Medical sciences. 2019; 2: 26–30.

[Petrov Yu.A., Ozdoeva I.M-B. Istmiko-cervical insufficiency as an etiological factor of premature birth. Scientific Review. Medical Sciences. 2019; 2: 26–30. (in Russian)] Mammadalieva N.M., Kim V.D., Mustafazade A.T., Zhunusova D.E. and others. Isthmic-cervical insufficiency: modern aspects of diagnosis and management tactics (literature review). Bulletin of KazNMU. 2018; 2: 10–13. [Mamedaliyeva N.M., Kim V.D.,

Mustafazade A.T., Zhunusova D.E. et al. Cervical insufficiency: modern aspects of diagnostics and tactics of management. Vestnik KazNMU. 2018; 2: 10–13. (in Russian)] Khryanin A.A., Knorring G.Y. Modern concepts of bacterial vaginosis. Gynecology. 2021; 23(1): 37–42. [Khryanin A.A., Knorring G.Yu. Modern understanding of bacterial vaginosis. Gynecology. 2021; 23(1): 37–42. (in Russian)]. DOI: 10.26442/20795696.2021.1.200680