Recent metagenomics and microbiology studies have identified microorganisms that are typical of the fetoplacental unit. Considering this emerging evidence, the placenta, uterus, and the amniotic cavity are not sterile and not immune privileged. However, there is evidence for a beneficial interaction between active maternal immune system and the presence of commensal pathogens, which lead to an immune-tolerant state, thereby preventing fetal rejection. Multiple conditions associated with the loss of the normal flora are described (dysbiosis), which could result in perinatal and puerperal adverse events, including, directly or indirectly, postpartum hemorrhage. Altered flora when associated with a severe proinflammatory state and combined with patient's genetic and environmental factors confers a high-risk adverse outcome. Better understanding of the adverse role of dysbiosis in pregnancy outcome will improve maternal outcome.

中文翻译：

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产妇出血中产妇子宫菌群的免疫学作用。

最近的宏基因组学和微生物学研究已经确定了胎儿胎盘单位的典型微生物。考虑到这一新兴证据，胎盘，子宫和羊膜腔不是无菌的，也不具有免疫特权。但是，有证据表明，活跃的母体免疫系统与共生病原体之间存在有益的相互作用，从而导致免疫耐受状态，从而防止胎儿排斥。描述了与正常菌群丧失相关的多种情况（生物异常），可能导致围产期和产后不良事件，包括直接或间接的产后出血。与严重的促炎状态相关并与患者的遗传和环境因素相结合时，菌群改变会带来高风险的不良后果。