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The relationship between bacterial vaginosis and preterm birth. A review

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Abstract

Bacterial vaginosis is currently the most prevalent form of vaginal infection of reproductive age women. The etiology of bacterial vaginosis has not yet been defined. However, clear criteria for diagnosis and treatment have been established in the absence as well as in presence of pregnancy. Recent data show an association between bacterial vaginosis and preterm labor and delivery. This review outlines the role of bacterial vaginosis in preterm birth and other pregnancy complications.

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References

  1. ACOG Technical Bulletin (1996) Vaginitis 221:6–7

    Google Scholar 

  2. Amsel R, Totten PA, Spiegel CA, et al. (1983) Nonspecific vaginitis: diagnostic criteria and microbial and epidemiological associations. Am J Med 74:14–22

    Article  PubMed  CAS  Google Scholar 

  3. Bhalla P, Rewati N, Chadha P (1989) Gardnerella vaginalis in CuT20 users. Indian J Med Res 89:80–86

    PubMed  CAS  Google Scholar 

  4. Biswas MK (1993) Bacterial Vaginosis. Clin Obstet Gynecol 36:166–176

    Article  PubMed  CAS  Google Scholar 

  5. Blackwell A, Barlow D (1982) Clinical diagnosis of anaerobic vaginosis: a practical guide. Br J Vener Dis 58:387–393

    PubMed  CAS  Google Scholar 

  6. Centers for Disease Control and Prevention. 1993 Sexually transmitted diseases guidelines. MMWR 42 (RR-14):1–102

    Google Scholar 

  7. Doderlein A (1894) Die Scheidensekretuntersuchungen. Zentralbl Gynaekol 18:10–14

    Google Scholar 

  8. Drife J (1989) Infection and preterm birth. Br J Obstet Gynecol 96:1128–1130

    CAS  Google Scholar 

  9. Ernest JM, Meis PJ, Moore ML, Swain M (1989) Vaginal pH: a marker of premature rupture of the membranes. Obstet Gynecol 74:734–738

    PubMed  CAS  Google Scholar 

  10. Eschenbach DA, Gravett MG, Chen KCS, et al. (1984) Bacterial vaginosis during pregnancy: An association with prematurity and postpartum complications. In: Mardh PA, Taylor Robinson D, eds. Bacterial vaginosis. Stockholm: Almqvist and Wiksel, pp 214–218

    Google Scholar 

  11. Eschenbach DA, Davick PR, William BL, et al. (1989) Prevalence of hydrogen peroxide-producing lactobacillus species in normal women and women with bacterial vaginosis. J Clin Microbiol 27:251–256

    PubMed  CAS  Google Scholar 

  12. Eschenbach DA (1989) Bacterial vaginosis: Emphasis on upper genital tract complications. Obstet Gynecol Clin NA 16:593–610

    CAS  Google Scholar 

  13. Gardner HL, Dukes CD (1955) Haemophilus vaginalis vaginitis. Am J Obstet Gynecol 69:962

    PubMed  CAS  Google Scholar 

  14. Gibbs RS (1985) Infection after Cesarean section. Clin Obstet Gynecol 28:697–710

    Article  PubMed  CAS  Google Scholar 

  15. Gravett MG, Preston Nelson H, De Rouen T, et al. (1986) Independent associations of bacterial vaginosis and Chlamydia trachomatis infections with adverse pregnancy outcome. JAMA 256:1899–1903

    Article  PubMed  CAS  Google Scholar 

  16. Gravett MG, Hummel D, Eschenbach DA (1986) Preterm labor associated with subclinical amniotic fluid infection and with bacterial vaginosis. Obstet Gynecol 67:229–237

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  18. Hawrylyshyn PA, Bernstein P, Papsin FR (1981) Risk factors associated with infection following cesarean section. Am J Obstet Gynecol 139:294–298

    PubMed  CAS  Google Scholar 

  19. Hay PE, Lamont RF, Taylor-Robinsin D, et al. (1994) Abnormal bacterial colonization of the genital tract and subsequent preterm delivery and late miscarriage. Br Med J 308: 295–298

    CAS  Google Scholar 

  20. Hill GB, Eschenbach DA, Holmes KK (1984) Bacteriology of the vagina. Scan J Urol Nephrol 86:23–39

    CAS  Google Scholar 

  21. Hillier SL, Martius J, Krohn MA, et al. A case controlled study of chorioamniotic infection and histologic chorioamnionitis in prematurity. N Engl J Med 319:972–988

  22. Hillier SL, Krohn MA, Watts DH, Wolner-Hanssen P, Eschenbach DA (1990) Microbiologic efficacy of intravaginal clindamycin cream for the treatment of bacterial vaginosis. Obstet Gynecol 76:407–413

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  25. Livengood CH III, Thomason JL, Hill GB (1990) Bacterial vaginosis: diagostic and pathogenic findings during topical clindamycin therapy. Am J Obstet Gynecol 163:515–520

    PubMed  Google Scholar 

  26. MacDermott RIJ (1995) Bacterial vaginosis. Br J Obstet Gynecol 102:92–94

    CAS  Google Scholar 

  27. Mardh PA, Taylor-Robinson D (1984) Bacterial vaginosis. Uppsala, Stockholm Sweden: Ed. by Almquist and Wiksell, International. pp 259–260

  28. Mardh PA (1991) The vaginal ecosystem. Am J Obstet Gynecol 165:1163–1168

    PubMed  CAS  Google Scholar 

  29. Martius J, Krohn MA, Hillier SA, et al. (1988) Relationship of vaginal lactobacillus species, cervical Chlamydia trachomatis and bacterial vaginosis to preterm birth. Obstet Gynecol 71:89–94

    PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  31. McGregor JA, French JI, Seo K (1991) Adjunctive clindamycin therapy for preterm labor: results of a double-blind placebo controlled trial. Am J Obstet Gynecol 165:867–875

    PubMed  CAS  Google Scholar 

  32. McGregor JA, French JI, Jones W, et al. (1994) 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 170:1048–1060

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  34. Minkoff H, Grunebaum AN, Schwarz RH, et al. (1984) Risk factors for prematurity and premature rupture of membranes: a prospective study of vaginal flora in pregnancy. Am J Obstet Gynecol 150:965–972

    PubMed  CAS  Google Scholar 

  35. Minkoff H, Grunebaum A, Feldman J et al. (1987) Relationship of vaginal pH and Papanicolau smear results to vaginal flora and pregnancy outcome. Internat J Gynecol Obstet 25:17–23

    Article  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  37. Pheiffer TA, Forsyth PS, Durfee MA, et al. (1978) Non-specific vaginitis: Role of Haemophilus vaginalis and treatment with metronidazole. N Engl J Med 298:1429–1434

    Article  Google Scholar 

  38. Riduan JM, Hillier SL, Utomo B, et al. (1993) Bacterial vaginosis and prematurity in Indonesia: Association in early and late pregnancy. Am J Obstet Gynecol 169:175–178

    PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  40. Sobel JD, Myers PG, Kaye D, Levison ME (1981) Adherence of Candida albicans to human vaginal and buccal epithelial cells. J Infect Dis 143:76–82

    PubMed  CAS  Google Scholar 

  41. Sobel JD (1989) Bacterial vaginosis—an ecologic mistery. Ann Int Med 111:551–553

    PubMed  CAS  Google Scholar 

  42. Sobel JD, Chaim W, Thomason J, et al. Comparative study of intravaginal metronidazole and triple sulpha (Sultrin) therapy of bacterial vaginosis. Infect Dis Obstet Gynecol (in press)

  43. Speigel CA, Amsel R, Eschenbach DA, et al. (1980) Anaerobic bacteria in nonspecific vaginitis. N Engl J Med 303:601–606

    Article  Google Scholar 

  44. Totten P, Amsel R, Hale J, et al. (1982) Selective differential human blood bilayer media for isolation of Gardnerella vaginalis. J Clin Microbiol 15:141–147

    PubMed  CAS  Google Scholar 

  45. Watts DH, Krohn MA, Hillier SL, Eschenbach DA (1990) Bacterial vaginosis as a risk factor for post cesarean endometritis. Obstet Gynecol 75:52–58

    PubMed  CAS  Google Scholar 

  46. Watts DH, Krohn MA, Hillier SL, Eschenbach DA (1992) The association of occult amniotic fluid infection with gestational age and neonatal outcome among women in preterm labor. Obstet Gynecol 79:351–357

    Article  PubMed  CAS  Google Scholar 

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Chaim, W., Mazor, M. & Leiberman, J.R. The relationship between bacterial vaginosis and preterm birth. A review. Arch Gynecol Obstet 259, 51–58 (1997). https://doi.org/10.1007/BF02505309

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  • DOI: https://doi.org/10.1007/BF02505309

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