title: The cervical mucus plug inhibits, but does not block, the passage of ascending bacteria from the vagina during pregnancy.
abstract: OBJECTIVE
  To evaluate the microbial load and the inflammatory response in the distal and proximal parts of the cervical mucus plug.
  
  
  METHODS
  Experimental research.
  
  
  METHODS
  Twenty women with a normal, singleton pregnancy.
  
  
  METHODS
  Vaginal swabs and specimens from the distal and proximal parts of the cervical mucus plug.
  
  
  METHODS
  Immunohistochemistry, enzyme-linked immunosorbent assay, quantitative polymerase chain reaction and histology.
  
  
  RESULTS
  The 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 60,240 (interquartile range 96,386) 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).
  
  
  CONCLUSIONS
  The cervical mucus plug inhibits, but does not block, the passage of Ureaplasma parvum during its ascending route from the vagina through the cervical canal.
authors.affiliation: Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Lea K
authors.initials: LK
authors.lastname: Hansen
authors.forename: Naja
authors.initials: N
authors.lastname: Becher
authors.forename: Sara
authors.initials: S
authors.lastname: Bastholm
authors.forename: Julie
authors.initials: J
authors.lastname: Glavind
authors.forename: Mette
authors.initials: M
authors.lastname: Ramsing
authors.forename: Chong J
authors.initials: CJ
authors.lastname: Kim
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.forename: Jørgen S
authors.initials: JS
authors.lastname: Jensen
authors.forename: Niels
authors.initials: N
authors.lastname: Uldbjerg
mesh_terms: D000328:Adult; D002582:Cervix Mucus / Q000378:metabolism / Q000382:microbiology* / Q000502:physiology; D002584:Cervix Uteri / Q000378:metabolism; D005260:Female; D006801:Humans; D020784:Matrix Metalloproteinase 8 / Q000378:metabolism; D011247:Pregnancy; D014621:Vagina / Q000378:metabolism / Q000382:microbiology*
chemical_list: D020784:Matrix Metalloproteinase 8
keywords: 16S rDNA quantitative polymerase chain reaction; Cervical mucus plug; Lactobacillus species; antimicrobial properties; intra-amniotic infection