Analysis Of The Therapeutic Effect Of Vaginal Bacterial Probiotic Preparations And Influencing Factors In The Treatment Of Vaginal Bacterial Flora Inhibition At 6-8 Weeks Postpartum

Objective: Vaginal bacterial flora inhibition is a special vaginal microecological imbalance with a high incidence in women at 6-8 weeks postpartum.However,the treatment of Vaginal bacterial flora inhibition is still controversial.In order to improve the vaginal microecosystem and enhance local immunity,it is necessary to observe the natural outcome of patients with vaginal bacterial flora inhibition at 6-8 weeks postpartum to clarify the effectiveness of natural outcome.It is necessary to evaluate the therapeutic effect of vaginal probiotics on Vaginal bacterial flora inhibition and explore new strategies for the treatment of Vaginal bacterial flora inhibition.In addition,in order to improve the recovery rate of Vaginal bacterial flora inhibition,it is necessary to explore the factors affecting its outcome.Methods:According to the inclusion criteria and exclusion criteria,120 postpartum women 6-8 weeks after delivery who were admitted to Shen Yang Women’s and Children’s Hospital from January 2022 to November 2022 and underwent reproductive tract microecological detection suggesting "Vaginal bacterial flora inhibition" were collected.At the same time,the height,weight,lactation status,duration of lochia and other basic information of the patients were collected.Patients were randomly divided into two groups according to their treatment methods.In the probiotics group,60 cases were treated with vaginal lactobacillus for 10 days and returned to the hospital after 7-14 days of drug withdrawal for reexamination of reproductive tract microecology.The natural outcome group(n=60)did not receive any treatment and was reexamined 17-24 days later.The treatment effects were divided into 4 categories: marked effect,improvement,no change,and progress of vaginitis.In addition,marked effect +improvement was recorded as good recovery,and no change + progress of vaginitis was recorded as no recovery.The recovery of vaginal bacterial flora inhibition was analyzed and compared between the two groups.Then they were grouped according to their recovery,53 cases in the good recovery group,67 cases in the non-recovery group.The patient’s review time,age,body mass index(BMI),laboratory examination(white blood cell count,hemoglobin,urine white blood cell),pregnancy status(gestational age,vaginal delivery history,delivery mode,labor duration,birth canal injuries such as lateral incision and perineal cervical laceration,premature rupture of membranes,prophylactic use of antibiotics before delivery,vaginal cleanliness before delivery,and residual placenta and fetal membranes were collected),lactation and duration of lochia,and the influencing factors of recovery of Vaginal bacterial flora inhibition were analyzed.IBM SPSS Statistic 23.0 software was used for statistical analysis.A P value of less than 0.05 was considered statistically significant.Results:In the natural outcome group,25 people(41.67%)still showed Vaginal bacterial flora inhibition after reexamination,21 people(35%)showed a tendency to progress to vaginitis,13 people(21.66%)improved,and only 1 person showed markedly effective recovery(lactobacillus ratio ≥70%).In the probiotics group,13patients(21.67%)still showed Vaginal bacterial flora inhibition after reexamination,only 8 patients(13.33%)showed a tendency to develop vaginitis,23 patients(38.33%)showed improvement,and 16 patients(26.67)showed markedly effective recovery(lactobacillus accounted for ≥70%).In the probiotic group,21 patients(35%)did not recover,and more than half of the patients recovered well(65.00%),while in the natural outcome group,46 patients(76.67%)did not recover,and only 14 patients(23.33%)recovered well.The good recovery group in probiotic group was significantly higher than that in natural outcome group(X~2=21.12,P<0.001).The recovery of postpartum Vaginal bacterial flora inhibition may be related to probiotic treatment,vaginal cleanliness before delivery and postpartum lactation,and the use of probiotics in the vagina was a protective factor for the recovery of vaginal bacterial flora inhibition(OR=6.705,P<0.01).Vaginal cleanliness III-IV before delivery was an independent risk factor for recovery of vaginal bacterial flora inhibition(OR=3.483,P=0.007).Conclusion:Patients with postpartum vaginal bacterial flora inhibition have a low self-healing rate and a risk of developing vaginitis.Vaginal probiotics can effectively treat bacterial flora inhibition and prevent the occurrence of vaginitis,and can be used for patients with postpartum vaginal bacterial flora inhibition as soon as possible.Adverse vaginal environment before delivery can affect the recovery of postpartum vaginal bacterial flora inhibition,and the recovery of vaginal bacterial flora inhibition is poor regardless of treatment.More attention should be paid to the recovery of vaginal bacterial flora inhibition,and further treatment should be given if necessary.