Volume: 3 Issue: 3
Year: 2015, Page: 6-10,
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 & 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,1.08-12.18), showing its association with preterm labour. Neonatal complication was more in preterm with bacterial vaginosis.
Conclusion: From this study it is clearly evident that BV is one of the most important causes of PTL leading to various neonatal mortality, morbidity and even permanent disability. Its detection and early treatment may improve the perinatal outcome.
Keywords: Bacterial vaginosis, Preterm labour, Nugent’s test, Amsel test.
1. 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.
2. 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.
3. Goldenberg L, RomeroR ,et al . Epidemiology and causes of preterm birth. The lancet 2008:371;75-84.
4. Ferris MJ, Masztal A, Aldridge KE. Association ofAtopobium vaginae, a recently described metronidazole resistant anaerobe, with bacterial vaginosis.BMC Infect Dis. 2004;4:5. 1471-2334-4-5.
5. Hillier SL, Krohn MA, Eschenbach DA et al. The normal vaginal flora, H2O2-producing lactobacilli, and bacterial vaginosis in pregnant women. Clin Infect Dis 1993; 16: Suppl 4:S273-S281.
6. Guaschino S , De Seta F, Aetiology of preterm labour: bacterial vaginosis. bjog.2006,113,46-51.
7. Nejad VM, Shafaie S, et al. The association of bacterial vaginosis and preterm labor.J Pak Med Assoc. 2008 Mar;58(3):104-6.
8. Robinson JS et al, The contribution of maternal smoking to preterm birth, small for gestational age and low birth weight among Aboriginal and non-Aboriginal births in South Australia. Med J Aust. 2001 Apr 16; 174(8):389-93. PubMed PMID: 11346081.
9. Marrazzo JM. Evolving issues in understanding and treating bacterial vaginosis. Expert Review of Antiinfective Therapy 2004; 2:913–22.
10. Ronalt F, Jack D ,et al. Treatment of abnormal vaginal flora in early pregnancy with clindamycin for the prevention of spontaneous preterm birth: a systematic review and metaanalysis. Am Journal of Obst and Gyn 2011:205:177- 190.
11. 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.
12. Amsel R, Totten PA,et al: Non specific vaginitis, diagnostic criteria, microbial and epidemiological association. Am j med1983;74:14-22.
13. Nugent RP, Krohn MA, and Hillier SL: Reliability of Diagnosing Bacterial Vaginosis is improved by a Standardized Method of Gram Stain Interpretation. J Clin Microbiol 1991; 29:297-301.
14. Nugent RP, Hiller SL et al ,Eschenbach DA et al , association between bacterial vaginosis preterm deliveries of low birth infants , North England Journal of Med, :1995:333;1737.
15. Cunningham J H, Leveno K J,: preterm birth in Williams Obstetrics 23rd edition, Mc Graw Hill 2009:804-27.
16. Hay PE, Lamont RF et al: Abnormal bacterial colonization of the genital tract and subsequent preterm delivery and late miscarriage. BMJ 1994; 308:295-8.
17. Kumar Aruna, Khare Jyoti. Role of bacterial vaginosis in preterm labor. J Obstet Gynecol India, 2007; 57(5): 413- 416.
18. Subtil, D., Denoit, V. The role of bacterial vaginosis in preterm labour and preterm birth: a case study. European J Obst, Gyn 2002; 101: 41-46.
19. Steiner J, Deiss F, et al. Comparison of single-dose vs oneweek course of metronidazole for symptomatic Bacterial Vaginosis. JAMA 1994; 254: 1046-1049.
20. 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.
21. Newton I R, Piper J. bacterial vaginosis and intra-amniotic infection. Am J of obst and gynaecology; 1997;176,672-7.
22. Eschenbach DA , Gravett MG, Chen KC, Hayme UB. Bacterial vaginosis during pregnancy : an association with prematurity and postpartum complications . In mardh PA, Taylor Robinson D,eds. Bacterial vaginosis. Stockholm : Almqvist and Wiksel. 1984;pp 214-18.
Subha Ranjan, Ipsita Mohapatra, G Sahoo. Study of association of bacterial vaginosis and preterm labour in a tertiary care hospital.Perspectives in medical research 2015;3:3:6-10.