Prevention of premature birth by screening and treatment for common genital tract infections: Results of a prospective controlled evaluation

McGregor, James A.; French, Janice I.; Parker, R; Draper, Deborah; Patterson, Elisa; Jones, Ward; Thorsgard, Kyja; McFee, John

doi:10.1016/0002-9378(95)90184-1

Cited by 343 publications

(177 citation statements)

References 21 publications

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“…The disturbed flora, increased leukocytosis, yellow discharge and red inflamed vagina, and also alleged relation with preterm birth 27 , all support involvement of Trichomonas in the category of aerobic vaginitis-like flora. Could the diagnosis of aerobic vaginitis be confused with Trichomonas infection?…”

Section: Vaginal Fluid Constituents No Infection Candida Vaginitis Bamentioning

confidence: 89%

Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis

Donders

2002

BJOG: An International Journal of Obstetrics and Gynaecology

121

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Objective To define an entity of abnormal vaginal flora: aerobic vaginitis.Design Observational study.Setting University Hospital Gasthuisberg, Leuven, Belgium.Sample 631 women attending for routine prenatal care or attending vaginitis clinic.Methods Samples were taken for fresh wet mount microscopy of vaginal fluid, vaginal cultures and measurement of lactate, succinate and cytokine levels in vaginal fluid. Smears deficient in lactobacilli and positive for clue cells were considered to indicate a diagnosis of bacterial vaginosis. Aerobic vaginitis was diagnosed if smears were deficient in lactobacilli, positive for cocci or coarse bacilli, positive for parabasal epithelial cells, and/or positive for vaginal leucocytes (plus their granular aspect). Results Genital complaints include red inflammation, yellow discharge, vaginal dyspareunia. Group B streptococci, escherichia coli, staphylococcus aureus and trichomonas vaginalis are frequently cultured.Vaginal lactate concentration is severely depressed in women with aerobic vaginitis, as in bacterial vaginosis, but vaginal succinate is not produced. Also in contrast to bacterial vaginosis, aerobic vaginitis produces a host immune response that leads to high production of interleukin-6, interleukin-1-b and leukaemia inhibitory factor in the vaginal fluid. Conclusion Aerobic vaginitis is associated with aerobic micro-organisms, mainly group B streptococci and E. coli. Its characteristics are different from those of bacterial vaginosis and elicit an important host response. The most severe form of aerobic vaginitis equals desquamative inflammatory vaginitis. In theory, aerobic vaginitis may be a better candidate than bacterial vaginosis as the cause of pregnancy complications, such as ascending chorioamnionitis, preterm rupture of the membranes and preterm delivery.

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Section: Vaginal Fluid Constituents No Infection Candida Vaginitis Bamentioning

confidence: 89%

Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis

Donders

2002

BJOG: An International Journal of Obstetrics and Gynaecology

121

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“…In addition, other published data have also suggested that treatment of bacterial vaginosis during pregnancy can reduce the risk of neonatal complications, especially prematurity. 3,16,22 The incidence of low-birth-weight infants was four times higher in the group of women with untreated bacterial vaginosis than among those with treated bacterial vaginosis. Low birth weight has been assumed to be a result of the preterm-premature rupture of amniotic membranes and the preterm birth, rather than a direct complication of bacterial vaginosis.…”

Section: Discussionmentioning

confidence: 96%

“…2 The multiple risk factors associated with prematurity include premature rupture of the membranes, previous premature birth, heavy physical work, black ethnicity and age greater than 30 years old. 3,4 To prevent prematurity, the ideal course of action would be to predict which patients are at risk of premature delivery and then implement effective intervention. [5][6][7] In several studies, bacterial vaginosis has been associated with prematurity and other adverse outcomes, independent of other known risk factors.…”

Section: Introductionmentioning

confidence: 99%

Impact of treatment for bacterial vaginosis on prematurity among Brazilian pregnant women: a retrospective cohort study

et al. 2005

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CONTEXT AND OBJECTIVE: Bacterial vaginosis has been associated with prematurity and other perinatal complications. However, the efficacy of the treatment for preventing such complications has not yet been well established. The objective of this study was to evaluate the impact of treatment for bacterial vaginosis on a low-risk population of Brazilian pregnant women, in order to prevent prematurity and other perinatal complications. DESIGN AND SETTING: Observational retrospective cohort study, at the Obstetric and Gynecology Department, Universidade Estadual de Campinas (Unicamp). METHODS: Vaginal bacterioscopy results from 785 low-risk pregnant women were studied. Three different groups of women were identified: 580 without bacterial vaginosis during pregnancy, 134 with bacterial vaginosis treated using imidazoles (metronidazole, tinidazole, or secnidazole) during pregnancy, and 71 with bacterial vaginosis not treated during pregnancy. The diagnosis of bacterial vaginosis was based on Nugent's criteria, from the vaginal bacterioscopy performed during the first prenatal care visit. RESULTS: The frequency of prematurity was 5.5% among the women without bacterial vaginosis, 22.5% among those with untreated bacterial vaginosis and 3.7% among those with treated bacterial vaginosis. The risk ratios for perinatal complications were significantly higher in the group with untreated bacterial vaginosis: premature rupture of membranes, 7.5 (95% CI: 1.9-34.9); preterm labor, 3.4 (95% CI: 1.4-8.1); preterm birth, 6.0 (95% CI: 1.9-19.7); and low birth weight, 4.2 (95% CI: 1.2-14.3). CONCLUSION: The treatment of bacterial vaginosis significantly reduced the rates of prematurity and other perinatal complications among these low-risk Brazilian pregnant women, regardless of the history of previous preterm delivery.

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“…It is reported that women with BV diagnosed in the first trimester of pregnancy (up to 10 weeks gestation) are at an increased risk for adverse pregnancy outcome, such as second trimester pregnancy loss (<26 weeks gestation) and PTD (<37 weeks' gestation) (McGregor et al, 1995;Guerra et al, 2006;Nelson et al, 2007). Nelson and colleagues (2007) found that only severe BV conditions, i.e.…”

Section: Complications Associated With Bacterial Vaginosismentioning

confidence: 99%

Normal flora and bacterial vaginosis in pregnancy: an overview

Redelinghuys

Ehlers

Dreyer

et al. 2015

Critical Reviews in Microbiology

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The female genital tract is an intricate, yet balanced ecosystem that hosts a variety of different residential microflora. The physiological changes that occur during pregnancy may disrupt this balanced ecosystem and predispose women to a potentially pathogenic microbiota. Bacteria that are associated with bacterial vaginosis (BV) are opportunistic pathogens that frequently form part of this microbiota. The overgrowth of and infections with these bacteria are linked to poor obstetric outcomes and increased transmission of other reproductive tract infections (RTIs). These infections increase women's susceptibility of acquiring HIV, the rates of HIV shedding and the development of Acquired Immune

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Prevention of premature birth by screening and treatment for common genital tract infections: Results of a prospective controlled evaluation

Cited by 343 publications

References 21 publications

Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis

Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis

Impact of treatment for bacterial vaginosis on prematurity among Brazilian pregnant women: a retrospective cohort study

Normal flora and bacterial vaginosis in pregnancy: an overview

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