Exclusion criteria were vaginal examination within the last 3 days, isolation of group B streptococcus from the vagina/urine, any use of antibiotics during the current pregnancy, diabetes, treatment with prostaglandins and cervical dilatation beyond 2 cm. The first-trimester participants were between 27 and 39 years old and had a parity range from 0 to 2. The women recruited in late pregnancy were between 24 and 40 years of age, their parity ranged from 0 to 3, the length of the vaginal part of the cervix at specimen collection was from 1 to 3 cm (measured by the midwife during vaginal examination) and cervical external os dilatation was from closed to 2 cm. Seventeen women were recruited in late pregnancy before induction of labor (gestational age 38 +0 to 42 +0 weeks +days), and three women were recruited in the first trimester before termination of pregnancy (gestational age 7 +6 to 9 +0 weeks +days). Participants for the study were recruited at the Department of Obstetrics and Gynecology at Aarhus University Hospital in Aarhus, Denmark. and Lactobacillus spp., and the inflammatory response in the distal and proximal parts of the CMP. The objective of this study was to assess the load of bacteria, in general, as well as those of Ureaplasma spp. A possible difference in the MMP-8 concentrations between the proximal and distal parts of the CMP has not been studied. High concentrations of MMP-8 in the cervical mucus have been considered as a sign of an intense, localized inflammation 16– 18. Matrix metalloproteinase-8 (MMP-8), also known as neutrophil collagenase, is produced by neutrophils, and its presence in high concentrations may indicate an acute inflammatory process. are present in the CMP and are possibly contributing to an antimicrobial environment through a similar mechanism. For this reason, it is interesting to explore whether Lactobacillus spp. are the predominant bacteria in the healthy vaginal microbiome 14, and protect the vagina against pathogenic microorganisms 15. Furthermore, the gradient has not been studied with regard to Ureaplasma spp. This hypothesis is supported by previous studies of spontaneously shed, intact CMPs in which such a gradient has been described, but uncertainty about the true orientation of CMPs collected under these circumstances represents a challenge to the interpretation of these findings 2. the bacterial load in the distal part (toward the vagina) of the CMP should exceed that of the proximal part (near the uterus and chorioamniotic membranes). If the CMP has intense antimicrobial activity, one would expect a bacterial gradient to be present through the plug, i.e. However, the antimicrobial activity of the CMP against this microorganism remains to be studied. parvum as a single microorganism can induce preterm labor as well as a fetal inflammatory response syndrome 12, 13. Furthermore, studies in monkeys (rhesus macaques) and sheep have shown that intrauterine inoculation of U. This is the case in patients with spontaneous preterm labor with intact membranes 9, with preterm premature rupture of membranes 10, and with a short cervix 11. are the bacteria most commonly identified in the amniotic fluid using culture or molecular microbiological techniques 3– 8. Such ascending infections have been causally linked to spontaneous preterm birth and long-term complications in the newborn 3. agalactiae, and is widely accepted as a key component of the innate immune response protecting against infections ascending from the vagina to the uterus 2. aureus, Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecium, Streptococcus pyogenes and S. It exhibits intense antimicrobial activity against Staphylococcus saprophyticus, S. The cervical mucus plug (CMP) is a viscoelastic, gel-like structure that fills the cervical canal during pregnancy 1.
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