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Objective: evaluation of the efficacy and safety of the use of probiotic Vagilac® in the prevention and treatment of vaginal dysbiosis in pregnancy.Material and methods: 140 pregnant women admitted to the Obstetric Probationary Ward of Moscow Regional Research Institute of Obstetrics and Gynecology of the Ministry of Health of Moscow at 36–39 weeks of gestation were examined and treated. All patients underwent complex clinical and laboratory examination. The patients were divided into 2 groups: I – 60 pregnant women with the established diagnosis of «bacterial vaginosis» (BV) and II – 80 pregnant women, who received antibacterial therapy due to exacerbation of infectious extragenital diseases. Of 140 pregnant women, 100 (60 from Group I and 40 from Group II) received oral probiotic Vagilac® for 10–14 days before delivery: 60 women to treat bacterial vaginosis, and 40 to prevent vaginal dysbiosis against the background of systemic antibiotic therapy. The remaining 40 pregnant women from Group II did not receive the probiotic, for which reason the second group was divided into two subgroups (IIa and IIb).Results: the drug has proved itself as a probiotic that is capable to restore vaginal microflora after various disorders, maintain and keep a healthy balance of bacteria that normally live in the vagina, prevent any disorders associated with antibiotic therapy. During vaginal delivery, traumatic injuries of the birth canal tissues were more common in patients who did not receive Vagilac®. The newborns who were born by the mothers who received Vagilac®, had no manifestations of severe forms of infectious and inflammatory diseases.The conclusion. The conducted studies showed that the treatment of bacterial vaginosis in pregnant women with probiotic Vagilak® was effective, did not adversely affect the fetus/child; in the group with and without BV no candidiasis vulvaginitis was detected.

The article is a review of a study based on extensive clinical data (19 311 pregnant women) on pregnancy and indications for cesarean delivery. The frequency of operative delivery at extragenital diseases and complications of pregnancy is compared with perinatal mortality rate. Obstetric situations are demonstrated in which the caesarean section rate may be reduced without increasing perinatal mortality.