Microbial Flora Changes in Cesarean Section Uterus and Its Possible Correlation With Inflammation

Area of Science:

• Reproductive Medicine
• Microbiome Research
• Immunology

Background:

• The relationship between uterine flora changes and impaired fecundity remains unclear.
• This study investigates differences in uterine microbial flora between women with post-cesarean section (CS) scar diverticulum and those after vaginal delivery.

Purpose of the Study:

• To analyze differences in uterine microbial flora between CS and vaginal delivery groups.
• To explore correlations between altered microbial flora and local inflammation.
• To assess the impact of CS on uterine microbiota composition and its potential link to infertility.

Main Methods:

• A case-control study involving infertile women undergoing hysteroscopy.
• 16S rDNA analysis of uterine swab samples (cervix and endometrium) from CS and control groups.
• Luminex platform used to quantify 34 inflammatory cytokines in endometrium samples.

Main Results:

• Higher microbial diversity observed in the CS group, particularly in endometrium tissues.
• Significant differences in microbial flora structure (phylum to genus level) between groups.
• Increased abundance of *Proteobacteria* and *Neisseriaceae* in CS groups (cervix); increased *Staphylococcaceae* in CS endometrium.
• *Lactobacillus* was higher in the cervix of the control group.
• Positive correlation between *Staphylococcaceae* and IL-2; negative correlation with IL-8.

Conclusions:

• Disrupted uterine microbiota composition following CS is associated with local inflammation.
• The interplay between the uterine microbiota and the immune system may contribute to clinical disorders.
• Further research is required to elucidate the underlying mechanisms linking CS, microbiota, inflammation, and fecundity.