Aerobic vaginitis (AV) is a distinct clinical entity characterized by inflammation and abnormal vaginal microflora. Often mistaken for bacterial vaginosis, AV remains relatively unknown and underdiagnosed. AV's understanding is evolving, with some experts suggesting it may primarily be an immunological disorder, the prevalence of which ranges from 7-13% in non-pregnant women and 4.1-8.3% during pregnancy. Pregnancy can affect susceptibility to vaginal infections, leading to adverse outcomes for the woman and the newborn. This review summarizes the correlation between AV and adverse pregnancy outcomes, particularly preterm birth, the leading cause of morbidity and mortality among neonates. Improved understanding of AV's impact on pregnancy outcomes can lead to early recognition, proper management, and effective interventions. While some studies support an association between AV and preterm labor, the existing knowledge of this relationship remains limited. The evidence suggests that AV may contribute to adverse pregnancy outcomes, mainly preterm birth, but further research is needed to establish a definitive link. Further studies are needed to investigate the underlying mechanisms and clarify AV's role in premature labor. A comprehensive understanding of AV's impact on pregnancy outcomes is crucial for early recognition, appropriate management, and effective interventions.

Vaginitis is a widespread issue for women worldwide, yet current diagnostic tools are lacking. Bacterial vaginosis (BV) is the most prevalent type of vaginitis, found in 10-50% of reproductive aged women. Current diagnostic methods for BV rely on clinical criteria, microscopy, or detection of a few microbes by qPCR. However, many vaginal infections lack a single etiological agent and are characterized by changes in the vaginal microbiome community structure (e.g. BV is defined as a loss of protective lactobacilli resulting in an overgrowth of anaerobic bacteria). Shotgun metagenomic sequencing provides a comprehensive view of all the organisms present in the vaginal microbiome (VMB) allowing for a better understanding of all potential etiologies. Here, we describe a robust VMB metagenomics sequencing test with a sensitivity of 88.5%, specificity of 96.2%, and a positive predictive value of 95.8% certified by Clinical Laboratory Improvement Amendments (CLIA), the College of American Pathologist (CAP) and the Clinical Laboratory Evaluation Program (CLEP). We sequenced over 7,000 human vaginal samples with this pipeline and described general findings and comparison to US census data.

Recurrent bacterial vaginosis (RBV) after antibiotic treatments has a relapse rate of 35% within 3 months and 60% within 12 months. Products containing polycarbophil (PLGG), that inhibits bacterial growth and mucoadhesive property, can impair biofilm formation. Here are shown the results of the POLARIS (Polybactum® to assess Recurrent Bacterial Vaginosis) study. The first phase was an interventional, open-label, non-controlled, and multicentre trial enrolling 56 women in Italy and Romania. The second phase was an observational 10-month follow-up without treatment conducted only in Romania. After 3 cycles with PLGG, only 8 BV recurrences out of 54 evaluable patients were identified (rate 14.81%) and for 26 out of 39 patients (66.67%) was evidenced positive effect on Lactobacilli in the vaginal secretions. In the follow-up 35 patients were observed after PLGG stopping treatment; 1 RBV (2.86%) at the 4th month and an additional 6 cases (17.14%) were evidenced at the end of the follow-up period. Therefore, no recurrence was evidenced in 12 subjects (34.28%) at 10th ± 2 months after the end of the PLGGtreatment. The use of PLGG vaginal ovules in the treatment of BV reduces the rate of relapses and improves the microbiological parameters (positive effect on Lactobacilli in 66.7 % of cases).