Volume: 4 Issue: 2
Year: 2016, Page: 39-43,
Introduction:Bacterial vaginosis (BV) affects 6–32% of pregnant women. BV is a risk factor for Preterm delivery and is also associated with peripartum complications such as Preterm premature rupture of membranes (PPROM), chorioamnionitis, and Postpartum endometritis. As Bacterial vaginosis in pregnancy is receiving extensive attention as a cause of preterm labour, a comprehensive prospective study was proposed to be undertaken to find out incidence of Bacterial vaginosis in preterm labour in hospital setting with simultaneous medical intervention to prevent premature birth as far as possible.
Aims & Objectives: To study incidence of bacterial vaginosis in preterm and term labour, to study association of bacterial vaginosis with preterm labour (PTL) and to study perinatal outcome in bacterial vaginosis positive cases.
Material and Methods: Fifty women who presented with preterm labour (study group) and fifty women in labour at term (control group) admitted in the Department of Obstetrics and Gynecology, Prathima Institute of Medical sciences, Karimnagar from December 2013 to June 2015 were examined for Bacterial Vaginosis using Amsel criteria and Nugent score. Maternal age, socioeconomic status (SES), previous pregnancy outcome, onset of Preterm birth to delivery, birth weight and Apgar score were all noted. All babies of both groups followed up to first week of neonatal life.
Results: The incidence of bacterial vaginosis in patients with idiopathic preterm labour was 24 percent and among term group was 8 percent. Bacterial vaginosis was significantly (P >0.05) associated with idiopathic preterm labour. Out of 16 patients who had bacterial vaginosis, 12 had preterm delivery (>37 weeks). In 84 patients without bacterial vaginosis 38 had preterm delivery. Bacterial vaginosis was significantly associated with low birth weight babies (P >0.05). Bacterial vaginosis was significantly associated with neonatal jaundice and neonatal sepsis and neonatal death.
Conclusion: This study shows that BV is significantly associated with preterm birth and is one of the most important causes of PTL leading to various neonatal mortality, morbidity and even permanent disability. Also prevention of PTL in pregnant women decreases the incidence of postpartum endometritis and hence reduces maternal morbidity. Methods and materials to detect bacterial vaginosis is very simple, can be carried out as outdoor procedure. If diagnosed in the early part of pregnancy and treated with antimicrobial therapy, then perhaps we can decrease the burden of prematurity which will be great benefit for society and Nation.
Keywords: Bacterial vaginosis, Preterm labour, Perinatal outcome
1. Thomson JL. Gelbartsm, Broekhuizen FF. Advances in the understanding of bacterial vaginosis. J Reprod Med. 1989;34:581-7.
2. Romero R, chaiworapongsa H, kuivanemi H, Tromp G, bacterial vaginosis, the inflammatory response & the risk of preterm birth; A role of genetic epidemiology in prevention of preterm birth; American journal of Obstetrics and Gynaecology:2004:190:1509-19.
3. Marrazzo JM. Evolving issues in understanding and treating bacterial vaginosis. Expert Review of Antiinfective Therapy 2004; 2:913–22.
4. Fredricks DN, Marrazzo JM. Molecular methodology in determining vaginal flora in health and disease: its time has come.Curr Infect Dis Rep 2005; 7:463–70.
5. Carey J C &Klebanoff et al, change in vaginal flora associated with an increased risk of preterm birth; American journal of Obstetrics and Gynaecology 2005:192:1341-6.
6. Cunningham J H, Leveno K J, Bloom S L, Hauth J C: preterm birth in Williams Obstetrics 23rd edition, McGraw Hill 2009:804-27.
7. ACOG- practice bulletin: Clinical management guidance for Obstetrics and Gynaecology, year 1995.
8. DesaiVA, Verma R, Mann PP. Bacterial vaginosisin patients with idiopathicpretermlabour. J ObstetGynacol India 2009; 59(1):53-7.
9. Sirohiwal D, BanoA,Sachan A: tocolysis with retodrine and duvadilon, A comparative study on preterm labour, 2001; 76:66-67.
10. Goldenberg et al, mercer B M et al: preterm prediction study, multiple marker test for preterm labour: American journal of Obstetrics and Gynaecology 2002: 184:643-51.
11. Crohn MA, Hiller SL, Eschanbach DA: comparison of methods of diagnosis of bacterial vaginosis in pregnant women : clinical microbiology 1989, 27: 1266-71.
12. Hiller SL,Mcdharsen et al: vaginal microflora associated bacterial vaginosis in Japanese &thai pregnant women, clinical infectious disease:1996:23:748-52.
13. Goldman MB, Hatch MC, Vaginal infections In Women and health: Academic Press, 2000.
14. Gardner and Duke et al: premature delivery, a risk factor for neonatal complication, journal report, med 41:903:1996.
15. Purwar M, Ughade S, Bhagat B, et al. Bacterial vaginosis in early pregnancy and adverse pregnancy outcome. J ObstetGynecol Res 2001; 27:175–81.
Usharani, Vivekanand,Suvarna. A study of Bacterial Vaginosis and its association with preterm labor and fetal outcome. Perspectives in medical research 2016;4:2:39-43.