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Purpose: To assess the effectiveness of vaginal administration of the probiotic Lactobacillus rhamnosus BMX 54 in preventing the occurrence of abnormal vaginal flora and the alteration of parameters relevant to the progression of pregnancy. Methods: Sixty pregnant women were assigned randomly to the untreated arm of the study ( n = 30) or received ( n = 30) vaginal application of one tablet containing Lactobacillus rhamnosus BMX 54, once a week for 12 weeks. Every 4 weeks (T0-T3), vaginal and cervical swabs were collected and pH, and quantity and quality of vaginal discharge measured as well as consistency, length and dilatation of cervix, and level of the presenting part of the foetus relative to interspinous diameter. Results: In untreated women, there was a significant trend towards increase in the presence of pathogenic microorganisms in the vaginal and/or cervical swabs ( p < 0.05), and in average pH values ( p < 0.05), amount ( p < 0.05) and 'whiff test' positivity ( p < 0.05) of vaginal discharge. Significant trend was also found for decrease in length ( p < 0.0001) and increase in dilatation ( p < 0.05) of cervix, as well as for lower position of the foetus ( p < 0.0001). In the group treated with Lactobacillus rhamnosus BMX 54, none of these values significantly changed throughout the observation period, with the exception of cervical length that was significantly decreased at T3 ( p < 0.01). Conclusions: During pregnancy, vaginal administration of Lactobacillus rhamnosus BMX 54 is effective in preventing the development of abnormal vaginal microflora, lowering of the presenting part of the foetus and modifying cervical parameters that could represent risk factors of vulnerability to preterm delivery. [ABSTRACT FROM AUTHOR]