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Bacterial vaginosis complicating pregnancy and gynecologic surgery

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Abstract

Bacterial vaginosis, the most commonly diagnosed vaginitis, has traditionally been regarded as a benign condition. However, recent evidence suggests association with preclinical miscarriage, early pregnancy loss, preterm labor, low birth weight infants, gynecologic surgical infections, and postabortal pelvic inflammatory diseases. Since studies show significant reduction in preterm labor and postabortal endometritis with treatment, it is recommended that bacterial vaginosis in high-risk women for preterm labor and women who undergo surgical abortion be treated regardless of symptoms. No treatment is recommended, however, for asymptomatic low-risk women.

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References and Recommended Reading

  1. Hiller SL, Holmes KK: Bacterial vaginosis. In Sexually Transmitted Diseases. Edited by Holmes KK, Mardh PA, Sparling PF, et al. New York: McGraw-Hill; 1999:563–587.

    Google Scholar 

  2. McGregor JA, French JI, Parker R, et al.: Prevention of premature birth by screening and treatment for common genital tract infections: results of prospective controlled evaluation. Am J Obstet Gynecol 1995, 173:157–167.

    Article  PubMed  CAS  Google Scholar 

  3. Donders GG, Van BulckB, Caudron J, et al.: Relationship of bacterial vaginosis and mycoplasma to the risk of spontaneous abortion. Am J Obstet Gynecol 2000, 183:431–437.

    Article  PubMed  CAS  Google Scholar 

  4. Ralph SG, Rutherford AJ, Wilson JD: Influence of bacterial vaginosis on conception and miscarriage in the first trimester: cohort study. BMJ 1999, 319:220–223. A study that looked at the association between bacterial vaginosis and first trimester miscarriage right from conception.

    PubMed  CAS  Google Scholar 

  5. Hay PE, Lamont RF, Taylor -Robinson D, et al.: Abnormal bacterial colonization of the genital tract and subsequent preterm delivery and late miscarriage. BMJ 1994, 308:295–298.

    PubMed  CAS  Google Scholar 

  6. McDonald HM, O’Loughlin JA, Jolley P, et al.: Prenatal microbiological factors associated with preterm birth. Br J Obstet Gynaecol 1992, 99:190–196.

    PubMed  CAS  Google Scholar 

  7. Meis PJ, Goldenberg RL, Mercer B, et al.: The preterm prediction study: significance of vaginal infections. Am J Obstet Gynecol 1995, 173:1231–1235.

    Article  PubMed  CAS  Google Scholar 

  8. Hillier SL, Nugent RP, Eschenbach DA, et al.: Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. N Engl J Med 1995, 333:1737–1742.

    Article  PubMed  CAS  Google Scholar 

  9. Goldenberg RL, Andrews WW, Yuan AC, et al.: Sexually transmitted diseases and adverse outcomes of pregnancy. Clin Perinatol 1997, 24:23–41.

    PubMed  CAS  Google Scholar 

  10. Watts DH, Eschenbach DA, Kenny GE: Early postpartum endometritis: the role of bacteria, genital mycoplasmas, and Chlamydia trachomatis. Obstet Gynecol 1989, 73:52–60.

    PubMed  CAS  Google Scholar 

  11. Silver HM, Sperling RS, St. Clair PJ, Gibbs RS: Evidence relating bacterial vaginosis to intraamniotic infection. Am J Obstet Gynecol 1989, 161:808–812.

    PubMed  CAS  Google Scholar 

  12. Newton ER, Prihoda TJ, Gibbs RS: A clinical and microbiologic analysis of risk factors for puerperal endometritis. Obstet Gynecol 1990, 75:402–406.

    PubMed  CAS  Google Scholar 

  13. Morales WJ, Schorr S, Albritton J: Effect of metronidazole in patients with preterm birth in preceding pregnancy and bacterial vaginosis: a placebo-controlled, double-blind study. Am J Obstet Gynecol 1994, 171:345–347.

    PubMed  CAS  Google Scholar 

  14. McDonald HM, O’Loughlin JA, Vigneswaran R, et al.: Impact of metronidazole therapy on preterm birth in women with bacterial vaginosis flora (Gardnerella vaginalis): a randomized, placebo controlled trial. Br J Obstet Gynaecol 1997, 104:1391–1397.

    PubMed  CAS  Google Scholar 

  15. Hauth JC, Goldenberg RL, Andrews WW, et al.: Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis. N Engl J Med 1995, 333:1732–1736.

    Article  PubMed  CAS  Google Scholar 

  16. McDonald HM, O’Loughlin JA, Vigneswaran R, et al.: Bacterial vaginosis in pregnancy and efficacy of short -course oral metronidazole treatment: a randomized controlled trial. Obstet Gynecol 1994, 84:343–348.

    PubMed  CAS  Google Scholar 

  17. Joesoef MR, Hillier SL, Wiknjosastro G, et al.: Intravaginal clindamycin treatment for bacterial vaginosis: effects on preterm delivery and low birth weight. Am J Obstet Gynecol 1995, 173:1527–1531.

    Article  PubMed  CAS  Google Scholar 

  18. McGregor JA, French JI, Jones W, et al.: Bacterial vaginosis is associated with prematurity and vaginal fluid mucinase and sialidase: results of a controlled trial of topical clindamycin cream. Am J Obstet Gynecol 1994, 170:1048–1060.

    PubMed  CAS  Google Scholar 

  19. Carey JC, Klebanoff MA, Hauth JC, et al.: Metronidazole to prevent preterm delivery in pregnant women with asymptomatic bacterial vaginosis. N Engl J Med 2000, 342:534–540. A large study that showed no reduction in preterm delivery rate when treating asymptomatic patients with short-course oral metronidazole. Study subjects were mostly black and Hispanic and with a high prevalnce of bacterial vaginosis.

    Article  PubMed  CAS  Google Scholar 

  20. Kekki M, Kurki T, Pelkonen J, et al.: Vaginal clindamycin in preventing preterm birth and peripartal infections in asymptomatic women with bacterial vaginosis: a randomized controlled trial. Obstet Gynecol 2001, 97:643–648. Similar type of study to Carey et al. [19••] to assess benefit of treatment on pretem delivery rate of asymptomatic bacterial vaginosis, but with intravaginal clindamycin. Study showed the same result, which is no benefit. Subjects were all white with low risk for preterm delivery.

    Article  PubMed  CAS  Google Scholar 

  21. Soper DE, Bump RC, Hurt WG: Bacterial vaginosis and trichomoniasis vaginitis are risk factors for cuff cellulitis after abdominal hysterectomy. Am J Obstet Gynecol 1990, 163:1016–1023.

    PubMed  CAS  Google Scholar 

  22. Larsson PG, Platz-Christensen JJ, Forssum U, Pahlson C: Clue cells in predicting infections after abdominal hysterectomy. Obstet Gynecol 1991, 77:450–452.

    PubMed  CAS  Google Scholar 

  23. Persson E, Bergstrom M, Larsson P, et al.: Infections after hysterectomy. A prospective nation-wide Swedish study. Acta Obstet Gynecol Scand 1996, 75:757–761.

    PubMed  CAS  Google Scholar 

  24. Larsson PG, Platz-Christensen JJ, Thejls H, et al.: Incidence of pelvic inflammatory disease after first-trimester legal abortion in women with bacterial vaginosis after treatment with metronidazole: a double-blind, randomized study. Am J Obstet Gynecol 1992, 166:100–103.

    PubMed  CAS  Google Scholar 

  25. Larsson PG, Platz-Christensen JJ, Dalaker K, et al.: Treatment with 2% clindamycin vaginal cream prior to first trimester surgical abortion to reduce signs of postoperative infection: a prospective, double-blinded, placebo-controlled, multicenter study. Acta Obstet Gynecol Scand 2000, 79:390–396. A large prospective, double-blinded, placebo-controlled study clearly showing a benefit of treatment in reducing postabortion infection in those with preoperative abnormal vaginal flora.

    Article  PubMed  CAS  Google Scholar 

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  1. 450 Clarkson Avenue, Box 56, 11203, Brooklyn, NY, USA

    Wadchara Pumpradit MD & Michael Augenbraun MD

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  1. Wadchara Pumpradit MD
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  2. Michael Augenbraun MD
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Pumpradit, W., Augenbraun, M. Bacterial vaginosis complicating pregnancy and gynecologic surgery. Curr Infect Dis Rep 4, 141–143 (2002). https://doi.org/10.1007/s11908-002-0055-6

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