Background The vaginal microbiota of healthy women consists of a wide variety of anaerobic and aerobic bacterial genera and species dominated by the genus Lactobacillus. The activity of lactobacilli helps to maintain the natural healthy balance of the vaginal microbiota. This role is particularly important during pregnancy because vaginal dismicrobism is one of the most important mechanisms for preterm birth and perinatal complications. In the present study, we characterized the impact of a dietary supplementation with the probiotic VSL#3, a mixture of Lactobacillus, Bifidobacterium and Streptococcus strains, on the vaginal microbiota and immunological profiles of healthy women during late pregnancy. Results An association between the oral intake of the probiotic VSL#3 and changes in the composition of the vaginal microbiota of pregnant women was revealed by PCR-DGGE population profiling. Despite no significant changes were found in the amounts of the principal vaginal bacterial populations in women administered with VSL#3, qPCR results suggested a potential role of the probiotic product in counteracting the decrease of Bifidobacterium and the increase of Atopobium, that occurred in control women during late pregnancy. The modulation of the vaginal microbiota was associated with significant changes in some vaginal cytokines. In particular, the decrease of the anti-inflammatory cytokines IL-4 and IL-10 was observed only in control women but not in women supplemented with VSL#3. In addition, the probiotic consumption induced the decrease of the pro-inflammatory chemokine Eotaxin, suggesting a potential anti-inflammatory effect on the vaginal immunity. Conclusion Dietary supplementation with the probiotic VSL#3 during the last trimester of pregnancy was associated to a modulation of the vaginal microbiota and cytokine secretion, with potential implications in preventing preterm birth

Background: Excisional treatments of precancerous lesions of the cervix are associated with a significantly increased risk of preterm birth and obstetric morbidity. Considering the natural history of CIN, it is advisable, particularly for women under 40-45, to abstain from treatment in case of Low-grade lesion (HPV <plusminus> CIN1). However, strict follow-up is needed for these patients. <P>Methods: We analysed the results of periodical follow-up of LSIL patients, to confirm the effectiveness (prompt detection and treatment of progressed lesions and regression or persistence of the remainder) and safety (no risk of invasive cancer during follow-up intervals). Moreover, the progression potential of "vaccine" HPV types (16-18) and "other" hrHPV types has been compared. Patients eligible for the study were 191: age <less>45 yy, with no recurrent LSIL, hrHPV-DNA positive, satisfactory colposcopy (type 1 or 2 TZ), immunocompetent, without suspicion of endocervical or glandular pathology. The period of follow-up continued up to 48 months and was conducted 6-monthly with cytology and colposcopy (and biopsy when indicated).During follow-up, in case of progression to HSIL or other indications, excisional treatment was performed: loop excision by radiosurgery or cold knife conization. <P>Results: progression, regression, and persistence rates are reported in Table 1<IMAGE01><BR>After 48 months follow-up only 10 patients (5.2%) remained with persistent hrHPV-DNA positive, without significant cervical lesions. No cases of invasive disease were found during follow-up intervals. The prevalence of low-grade (HPV<plusminus>CIN1) were not significantly different in "16-18" and "others" cohorts. Evaluating the Kaplan-Meyer curves of progression/regression/persistence probability during follow-up with Mantel--Haenzsel log rank test, no significant differences in progression potential were found in the two cohorts.<IMAGE02> <P>Conclusions: The long-term expectant follow-up of cervical LSIL (up to 48 months) has showed to be safe and effective. Moreover, vaccine is probably going to revolutionize the policy of cervical cancer prevention, but the importance of rarer (non vaccine) high-risk HPV types must not be underestimated.

Celiac disease (CD), an autoimmune disease triggered by dietary gluten, is a multi-systemic disorder that primarily results in mucosal damage of the small intestine. Reproductive disorders and pregnancy complications have been associated with CD. Conflicting results have been published concerning CD and the risk of impaired fetal growth with reduced birthweight. The aim of our multicentric, perspective, case–control study was to determine the prevalence of undiagnosed CD in mothers of small for gestational age (SGA) newborns in two regions of Italy. The study included 480 mothers: group A consisted of 284 SGA newborns’ mothers and group B consisted of 196 appropriate for gestational age (AGA) newborns’ mothers. Tissue transglutaminase type 2 antibodies (TG2) IgA and IgG were measured in blood samples. We diagnosed two new cases of CD in asymptomatic mothers. It may be appropriate to include the TG2 to the panel of prenatal blood test.