The cervical mucus plug inhibits, but does not block, the passage of ascending bacteria from the vagina during pregnancy

ObjectiveTo evaluate the microbial load and the inflammatory response in the distal and proximal parts of the cervical mucus plug. DesignExperimental research. PopulationTwenty women with a normal, singleton pregnancy. SampleVaginal swabs and specimens from the distal and proximal parts of the cervical mucus plug. MethodsImmunohistochemistry, enzyme-linked immunosorbent assay, quantitative polymerase chain reaction and histology. ResultsThe total bacterial load (16S rDNA) was significantly lower in the cervical mucus plug compared with the vagina (p=0.001). Among women harboring Ureaplasma parvum, the median genome equivalents/g were 1574 (interquartile range 2526) in the proximal part, 657 (interquartile range 1620) in the distal part and 60240 (interquartile range 96386) in the vagina. Histological examinations and quantitative polymerase chain reaction revealed considerable amounts of lactobacilli and inflammatory cells in both parts of the cervical mucus plug. The matrix metalloproteinase-8 concentration was decreased in the proximal part of the plug compared with the distal part (p=0.08). ConclusionThe cervical mucus plug inhibits, but does not block, the passage of Ureaplasma parvum during its ascending route from the vagina through the cervical canal.