A M Gülmezoglu1. 1. Special Department of Research, Development and Research Training in Human Reproduction, UNDP/UNFPA/WHO/World Bank, World Health Organisation, Geneva 27, Switzerland, CH-1211. gulmezoglum@who.ch
Abstract
BACKGROUND: Vaginitis due to Trichomonas vaginalis is one of the most common of sexually transmitted diseases. Trichomoniasis affects women during pregnancy as well but it is not clearly established whether it causes preterm birth and other pregnancy complications. OBJECTIVES: The objective of this review was to assess the effects of various treatments for trichomoniasis during pregnancy. SEARCH STRATEGY: The Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. Date of last search: 22 December 1999. SELECTION CRITERIA: Randomised trials comparing antitrichomonas agents during pregnancy. DATA COLLECTION AND ANALYSIS: Eligibility and trial quality was assessed by one reviewer. MAIN RESULTS: One study in which benzoylmetronidazole was compared to no treatment in low risk symptomatic and asymptomatic women was included. Of the treated women, 95% (97/102) and 93% (77/83) were free of infection on day seven and week four respectively. This equates to a relative risk of 0.11, and 95% confidence interval 0.05 to 0.24. About 75% of partners were reported to have taken the treatment. REVIEWER'S CONCLUSIONS: Metronidazole, given as a single dose, is likely to provide parasitological cure for trichomonas, but it is not known whether this treatment will have any effect on pregnancy outcomes. The cure rate could probably be higher if more partners used the treatment.
BACKGROUND:Vaginitis due to Trichomonas vaginalis is one of the most common of sexually transmitted diseases. Trichomoniasis affects women during pregnancy as well but it is not clearly established whether it causes preterm birth and other pregnancy complications. OBJECTIVES: The objective of this review was to assess the effects of various treatments for trichomoniasis during pregnancy. SEARCH STRATEGY: The Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. Date of last search: 22 December 1999. SELECTION CRITERIA: Randomised trials comparing antitrichomonas agents during pregnancy. DATA COLLECTION AND ANALYSIS: Eligibility and trial quality was assessed by one reviewer. MAIN RESULTS: One study in which benzoylmetronidazole was compared to no treatment in low risk symptomatic and asymptomatic women was included. Of the treated women, 95% (97/102) and 93% (77/83) were free of infection on day seven and week four respectively. This equates to a relative risk of 0.11, and 95% confidence interval 0.05 to 0.24. About 75% of partners were reported to have taken the treatment. REVIEWER'S CONCLUSIONS:Metronidazole, given as a single dose, is likely to provide parasitological cure for trichomonas, but it is not known whether this treatment will have any effect on pregnancy outcomes. The cure rate could probably be higher if more partners used the treatment.