Obstetrics and GynecOlOGy Bacterial Vaginosis in Pregnancy (<28 Weeks) and its Effect on Pregnancy Outcome: A Study from a Western UP City (original) (raw)
Related papers
Innovative publication, 2016
Introduction: Bacterial vagiriosis (BV) is an extremely prevalent vaginal condition. BV prevalence in pregnancy is 15-30 percent. BV is a polymicrobial, superficial vaginal infection involving a reduction in the amount of hydrogen-peroxide-producing Lactobacillus and an overgrowth of anaerobic and Gram-negative or Gram-variable bacteria. BV can be symptomatic or asymptomatic. BV in pregnancy has been associated with preterm labour and delivery, premature rupture of membranes amniotic fluid infections and post-partum endometritis. Materials and Methods: 500 antenatal women of less than 28 are gestation without known risk for PTL admitted or attending antenatal outpatient clinic in Department of Obstetrics and Gynaecology, LLRM and associated SVBP Hospital in last one year were enrolled after a written and informed consent. We studied the presence of bacterial vaginosis in these women uses NUGENTS criteria and correlated it with adverse pregnancy outcome. Prematurity, PROM and post-partum endometritis were considered as adverse pregnancy outcomes. Result: BV was found in 98 of the 500 women studied. Out of the 98 positive cases, 53 cases were less than 20 weeks gestation and the remaining 45 were between 20-28 weeks gestation. Twenty three of the 98 BV patients had preterm delivery and this association was significant (p<0.0001). Out of the 53 patients of BV diagnosed in 11-20 weeks period of gestation, 12 patients had preterm delivery. The remaining 11 preterm deliveries occurred in BV patients diagnosed after 20 weeks gestation. The association of more number of preterm deliveries in patients with BV diagnosed in 11-20 weeks period of gestation was not significant (p=0.2). Fourteen patients of BV had PROM and this association was also significant (p<0.001). Six patients of BV also had postpartum endometritis. Conclusion: The above results suggest that screening for BV should start in early pregnancy and a high index of suspicion for preterm delivery should be kept in antenatal patients with BV.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2003
Objectives: Assess the predictive values of bacterial vaginosis (BV) for preterm delivery (PD) and neonatal infection and compare them with standard markers of infection among women with preterm labour (PL). Study design: Prospective blinded study in a tertiary referral centre in Paris. Women hospitalised for PL with intact membranes at a term between 24 and 34 weeks were included. Vaginal fluid, collected at inclusion was Gram-stained, scored, and interpreted according to Nugent's criteria. Results: Out of 354 women tested, 254 had normal flora (72.3%), 76 intermediate (21.7%) and 24 BV (6.8%). A history of spontaneous miscarriage after 14 weeks was the only risk factor significantly associated with BV. BV was not significantly associated with PD < 35 weeks or neonatal infection. Very preterm delivery (before 33 weeks) was significantly associated with the flora grade (P ¼ 0:02): women with normal, intermediate and abnormal flora, respectively had 27 (10.6%), 14 (18.4%) and 6 (25.0%) births before 33 weeks. Of the markers tested, the highest risk of very preterm delivery was associated with BV (odds ratio 2.95, 95% CI (1.1-0.8.1)) and CRP > 20 mg/dl (4.23 95% CI (1.8-9.7)). Predictive value of BV for preterm birth before 33 weeks were: sensitivity 12.8%, specificity 95.0%, positive predictive value 35.3%, and negative predictive value 84.3%. Conclusions: The frequency of BV and its association with PD are probably very variable and must be interpreted differently from one population to another. While we found an association between BV results and delivery before 33 weeks, the predictive value of BV was disappointing. Although these findings reinforce the importance of a useful marker of subclinical infection, the usefulness of testing for BV in women with PL has not been demonstrated. #
To Estimate the Prevalence of Bacterial Vaginosis in Labour
Journal of Medical Science And clinical Research, 2018
Background: Bacterial vaginosis (BV) is the most frequent type of vaginitis in women of reproductive age. BV is an imbalance in the ecology of the normal vaginal flora that is characterized by the depletion of lactobacilli, and the proliferation of anaerobic bacteria. In pregnancy, certain complications such as preterm delivery, premature rupture of the membranes, and amniotic fluid infection, postpartum endometritis are increased because of infection with BV. This study investigated the prevalence of BV among pregnant women in labour to avoid BV associated complications. Treating bacterial vaginosis can reduce the preventable cause of preterm birth as preterm labour is not only a medical and social problem but also an economic burden. Objectives: To estimate the prevalence of BV in women presenting with preterm and term labour and to analyze its association as the causative factor of PTL. Methods: A cross sectional study involving 260 patients with preterm and term labour was conducted at AIMSR, Bathinda. BV was determined to be present or absent on the basis of Amsel's criteria and Nugent criteria. Statistical analysis was based on simple percentages among related variables. Results: Bacterial vaginosis was more prevalent in patients with preterm labour group (44.4%) as compared to patients in term labour group (18.4%) and the difference was statistically significant Since the P-value is <0.001.Bacterial vaginosis among preterm labour is about three times higher than among term labour group. Conclusion: BV is most common preventable cause of preterm labour. Therefore, the testing for BV and its prompt treatment may reduce the risk of PTL. This will also go a long way in the prevention of neonatal complications due to prematurity.
Role of Bacterial Vaginosis in threatened preterm and preterm labour, and its screening
Innovative publication, 2016
Background: 8-10% pregnancies end in preterm labour or threatened preterm labour which has maternal and foetal complications just due to infections such as bacterial vaginosis, which can be identified by simple tests like Amsel Criteria and treated at the earliest with appropriate antibiotics. Aim: To establish the role of bacterial vaginosis in preterm labour and threatened preterm labour based on Amsel criteria. Materials and Methods: 100 pregnant women with gestational age between 28 and 36 weeks, of which 50 women with symptoms of threatened preterm labour and preterm labour were kept as study group and another 50 pregnant women in the same gestational age without any symptoms of threatened preterm or preterm labour were kept as control group. Examination of vaginal discharge, vaginal pH, microscopy for clue cells and Whiff test, which are Amsel's criteria, were done. Chi-square test was used to find out the association of variables and p value less than 0.05 was taken as statistically significant. Results: The women in study group had higher incidence of vaginal discharge than control group. All the bacterial vaginosis cases had vaginal pH >4.5. The negative predictive value of vaginal fluid pH > 4.5 in our study is 100%. In our study 27% cases in all groups were found to have whiff test positive. 20% had clue cells on microscope examination. All the Amsel's criterion was statistically highly significant between the study and the control group. Conclusion: The strong correlation between presence of Bacterial Vaginosis and the incidence of threatened preterm and preterm labour is established. Amsel's criteria are simple, inexpensive, easily reproducible method of diagnosing BV and can be used on a mass scale. By diagnosing and treating bacterial vaginosis in threatened preterm labour, preterm deliveries can be prevented to a certain extent, if not atleast in order to buy time for the inclusion of steroids which will decrease the perinatal morbidity and mortality by decreasing Respiratory Distress Syndrome and intraventricular haemorrhage.
Bacterial Vaginosis as a Risk Factor for Preterm Labour-An Analysis of Age and Duration of Marriage
Journal of gynecology and obstetrics, 2016
Preterm labour is the onset of labour between ≥ 24 weeks to < 37 weeks of gestation. Bacterial Vaginosis (BV) is a polymicrobial condition with predominant lactobacilli in the vaginal flora. It is an important risk factor for preterm labour with an incidence of 5-18% of all deliveries causing increased perinatal morbidity and mortality with subsequent neurodevelopmental problems as cerebral palsy. We aimed to determine the association of BV with preterm labour population. A case control study was conducted comparing the prevalence of bacterial vaginosis in women having term labour with those who had preterm delivery. Chi square test was used to compare differences in participants' age, duration of pregnancy and duration of marriage. Odd ratio and CI was calculated for the association between BV and preterm labour. Nearly half of the participants that experienced preterm labour were between 21 and 25 years old (46.7%, n = 35) and nearly half of the participants that experienced term pregnancy were between 21 and 25 years old as well (48.0%, n = 36). Additionally, the majority of participants had been married for three to four years, for those that experienced preterm labour (64.0%, n = 48) and term pregnancy (52.0%, n = 39). Furthermore, nearly half of the participants' duration of pregnancy was between 33 and 34 weeks (49.3%, n = 37) and 52.0% of participants who experienced term pregnancy had been pregnant for 37 to 38 weeks (n = 39). Women with Bacterial Vaginosis, experienced preterm labour in 26.7% cases (n = 20) as compared to those who had term pregnancy 12.0% (n = 9). BV was significantly associated with preterm labour (OR=7.3, 95% CI =1.9-27.5, P=0.003). There was no significant difference in participants' age between preterm labour and term pregnancy groups, (p value=0.880). Additionally, there was no significant difference in participants' duration of marriage between preterm labour and term pregnancy groups, (p value=0.801). Bacterial Vaginosis is a risk factor for preterm labor. The study also concluded that there is no significant association between age, duration of pregnancy and duration of marriage between preterm labour and term pregnancy groups.
Clinical Microbiology: Open Access, 2016
Background: This study was conducted to investigate whether screening and treatment of bacterial vaginosis (BV) in early pregnancy reduces the risk of spontaneous preterm delivery or preterm premature rupture of membranes (PPROMs). Material and methods: Women were screened for BV during their first visit to the maternal health care unit. After the vaginal samples were air dried, they were sent to the gynecological department and were analyzed using Hay/ Ison modified classification. Eligible women were those who lived in Skaraborg County and delivered at Skaraborgs Hospital in Skövde, Sweden. The women were divided into two groups, namely, screened women (with BV or with lactobacilli flora) and unscreened women. Women with BV were offered treatment with vaginal clindamycin. Results: During 2007-2015, 22,084 deliveries occurred at Skaraborgs Hospital; a total of 6,899 women were screened for BV, out of which 746 (10.8%) had BV flora. Survival analysis showed that women with BV had spontaneous preterm delivery significantly earlier than those with normal lactobacilli flora, even after treatment with vaginal clindamycin (log rank p=0.01). During the same period, 15,189 deliveries occurred at Skaraborgs Hospital; they were not screened for BV. The survival analysis showed that the unscreened women delivered slightly earlier than the screened women (t-test p<0.05), with mean delivery days of 239.4-241.7. Conclusion: Even though patients with BV had been treated with clindamycin, they still suffered from an increased risk of spontaneous preterm delivery as compared to women with normal lactobacilli flora. The difference between the screened women and the unscreened women could be attributed to the positive effect of the treatment of BV with clindamycin if it can be assumed that there is the same amount of untreated BV in the unscreened group.
Bacterial vaginosis – a risk factor for preterm labour: a case-control study
IP Innovative Publication Pvt. Ltd., 2017
Aim: To estimate the prevalence of bacterial vaginosis in preterm labour patients when compared to term labour patients. Materials and Method: It was a hospital based prospective case-control study conducted over a period of two years. Study population was selected as per our study criteria. Speculum examination was done for both control and cases and evaluated for any abnormal vaginal discharge and vaginal pH. Smear from posterior fornix was taken using sterile cotton swabs for wet mount and KOH test (Whiff test). Diagnosis of bacterial vaginosis was made if three of the four signs of Amsel criteria were found. The data were analysed using SPSS software 20 and results were derived. Results: Among the patients bacterial vaginosis was present in 24 of the preterm labour (26.7%) patients and 5 of the term labour (5.6%) patients (Table 1). It was statistically significant (p < 0.001) by Chi-square test. Considering the relative risk(RR), women with bacterial vaginosis has increased risk of preterm labour when compared to patients without bacterial vaginosis(Odds ratio-6.182;RR-4.800). Conclusion: Our study concluded that bacterial vaginosis is one of the most important causes of preterm labour. Routine screening and treatment of bacterial vaginosis for women at high risk for preterm labour will help in reduction of preterm birth related perinatal morbidity and mortality.
Study of association of bacterial vaginosis and preterm labour in a tertiary care hospital
2016
Introduction: Bacterial vaginosis (BV) is a condition characterized by a change in microbial echo system of vagina. This is a polymicrobial disorder with decrease in the number of Hydrogen peroxide (H2O2) producing lactobacillus and overgrowth of several facultative anaerobic bacteria. Treating bacterial vaginosis may prevent preterm labour and improve the perinatal outcome.The present study was done to know the association of bacterial vaginosis with preterm labour and to evaluate perinatal outcome. Materials and methods: A prospective case control study of 100 pregnant women (with 50 preterm and 50 term pregnancies), were evaluated for bacterial vaginosis and perinatal outcome was observed. Results: Preterm labor (PTL) was seen in 64% of unbooked cases and majority cases (48%) were at 32-34 weeks gestational age. The test for bacterial vaginosis was positive for 24% of cases and 8% of control (P<0.05, Odds ratio=3.63,95%CI,1.0812.18), showing its association with preterm labour...