Probiotics in Obstetrics & Gynaecology Dr Dipti Nabh , Dr Sharda Jain

1. Probiotics in
Obstetrics & Gynaecology
Dr. Dipti Nabh

2. Over 350 ppts are available on
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3. Normal Vaginal Microbial Ecosystem
•Human vagina microbial ecosystem
most often dominated by
• L. crispatus
• L. jensenii,
• L. gasseri,
• L. iners,
• L. acidophilus,
• L. fermentum,
• L. plantarum,
• L. brevis,
• L. salivarius,
• L. casei,
• L. vaginalis
• L. reuteri
• L. rhamnosu
•Other less common bacterial species
found in the vagina includes
•Prevotella
•Megasphaera
• Atopobium vaginae
•Peptostreptococcus
•staphylococcus spp
•Streptococcus spp.
•Gardnerella vaginalis
• Sneathia
• Bacteroides spp
Sarah Cribby, “Vaginal Microbiota and the Use of Probiotics,” Interdisciplinary Perspectives on Infectious Diseases, vol., 2008
Lacto Bacillus are gram positive rods, present in the Vaginal microflora in 100% of women.

4. Normal Vaginal Flora-protective role

5. Normal Vaginal Flora – Protective Role

6. HISTORY OF PROBIOTICS
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7. DEFINITION OF PROBIOTICS

8. PROBIOTICS
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9. PROBIOTICS
Best Probiotic for :
Acne, Vaginal Health, Diarrhea
Best Probiotic for : Immunity
Best Probiotic for : Skin Support

10. PROBIOTICS IN FOOD

11. PROBIOTICS vs. ANTIBIOTICS

12. PROPERTIES OF PROBIOTICS

13. PROPERTIES OF PROBIOTICS

15. PROBIOTICS IN GI TRACT

16. PROBIOTICS AND VAGINAL HEALTH
Mechanism of action
• Proposed direct & indirect anti-pathogenic mechanisms of
lactobacilli include:
– Production of lactic acid & bacteriocins that directly kill or
inhibit bacterial and viral pathogens,
– Formation of microcolonies that adhere to the epithelial
cell receptors and form a physical barrier against pathogen
adhesion,
– Stimulation of host Defense Mechanisms against
pathogens

17. PROBIOTICS AND VAGINAL HEALTH
Mechanism of Action
L. brevis CD2
↓ Polyamines↓ Epithelial exfoliation
↓ CLUE CELLS ( bacterial) ↓ VAGINAL DISCHARGE ↓ UNPLEASANT ODOR
L salivarius subsp. Salicinius &
L. plantarum
↑ Ceramide
Sphingomyelinase
Sphingomyelinase
Arginine Deiminase
↓ VIRAL INFECTIONS

18. Probiotics & Vaginal health
• Obstetrical complications – Chorioamnionitis
– Preterm delivery

19. PROBIOTICS AND FERTILITY
• BV is associated with dramatic increases in IL-1β concentrations
• IL-1β may trigger the generation of reactive oxygen species (ROS)
• ROS exert detrimental effects on spermatozoa
• Probiotic prevent sperm lipid peroxidation (oxidative damage)
• Pretreatment with probiotics prevent the effect on both sperm
motility and viability
• Probiotic protects human spermatozoa from radical oxygen
species in the presence of vaginal disorders
• Improves the fertilization potential of the female host
Barbonetti et al. Fertil Steril, 2011, 95: 2485.

20. PROBIOTICS – ROUTE OF ADMINISTRATION

21. VAGINAL PROBIOTICS
ORAL VAGINAL

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