It needs to be recognized that most inferences drawn in our study rely on a limited number of studies, potentially, endangering the generalizability of our findings. Moreover, all studies on cause of infertility in relation to BV included had a cross-sectional design and, therefore, do not allow for causal inferences. Still, there is strong circumstantial evidence that supports a causal link between BV and tubal infertility. Studies with a longitudinal design, on the other hand, strongly support a relation between BV and early pregnancy loss. Unfortunately, no study looked beyond first trimester fetal loss, although it is plausible that the high preterm birth rates with IVF are, at least, in part attributable to BV.
within six months after the second treatment course, patients were treated again with a 28 day course followed by weekly applications for two months. Treatment effect was evaluated by assessment of the presence of the biofilm on voided vaginal epithelial cells through fluorescence-in-situ-hybridisation (FISH). Results The initial cure rate following a 7-day course of octenidine was as high as 87.5%. The six-month relapse rate was however as high as 66.6%. Repeated treatment for 28 days led to an overall cure rate of 75.0%, however was also associated with emergence of complete resistance to octenidine in a subset of women. The overall cure rate after three treatment courses with one year follow-up was 62.5%, with 37.5% of the patients showing complete resistance to octenidine. Conclusion Although octenidine dihydrochloride was initially highly effective, it was also found that the efficacy of repeated and prolonged treatment dropped quickly as challenge with the antiseptic rapidly led to bacterial resistance in a considerable subset of women. Background Little is known about the presence of bacterial vaginosis (BV) associated bacteria in men, but male partners of women with BV have been reported to have a high risk of urethritis. We aimed to examine the role of BV associated bacteria in urine specimens from men with and without non-gonococcal urethritis (NGU). Methods First-pass urines were collected from 44 men with symptomatic NGU (≥ 5 PMNL/hpf) and 97 asymptomatic men without NGU (< 5 PMNL/hpf). Samples were tested for Chlamydia trachomatis (Ct), Mycoplasma genitalium (Mg), Ureaplasma urealyticum (Uu), U. parvum (Up), HSV 1 and 2, and adenovirus by PCR. BacterialQuantitative PCRs were performed to detect Gardnerella vaginalis, BVAB 2, Eggerthella-like uncultured bacterium, Megasphaera type 1, Leptotrichia amnionii, Atopobium vaginae, Sneathia sanguinegens, and Prevotella sp. Results Ct was detected in 9 (21%) cases with NGU and 1 (1%) control without NGU. Mg was detected in 10 cases (23%) and none of the controls. Corresponding figures were for Uu 4 (9%) and 26 (27%), and Up in 6 (14%) and 25 (26%), respectively. HSV type 1 was found in 2 case samples (5%). Controls were all negative for HSV. Adenovirus was found in 2 NGU samples and none of the controls. In 20 (46%) NGU cases no aetiology was found. Background Several studies have shown that bacterial vaginosis (BV) is particularly prevalent in patients with infertility, though it has not been firmly established which risks infertility patients with BV incur for pregnancy outcome. We aimed to assess the prevalence of BV in infertility patients, as well as to quantify the magnitude of the association between BV and cause of infertility on the one hand, and conception rates and early pregnancy loss following in-vitrofertilisation (IVF) on the other hand. Methods Systematic literature review and meta-analysis.Results The estimated prevalence of BV in infertile women is 19% (95% CI: 14 -25%). Abnormal microbiota (Nugent scores 4 to 10) occurs in 39% of the infer...
A woman with five previous normal vaginal deliveries and a history of right salpingectomy for ectopic pregnancy has sudden pain in term labour, with epidural analgesia. A concurrent worsening of fetal heart rate pattern with bradycardia urges quick vacuum delivery. Maternal post-partum pain and hemoglobin (Hb) drop suggest intra-abdominal haemorrhage. The combination of sudden, strong intra-partum pain and fetal distress should raise the suspicion of intra-abdominal haemorrhage. After vaginal delivery an accurate follow-up is mandatory.
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