OBJECTIVE: Multiple studies suggest that bacterial vaginosis (BV) causes preterm labor; yet its routine treatment remains controversial. In order to help to elucidate this controversy, we performed a thorough review of studies with levels of evidence ranging from I to II-II. METHODS: We searched for all of the studies from the years 1994 to 2001 via Medline's database, including MD Consult and Ovid Mednet. RESULTS: Several trials discovered a decrease in the incidence of preterm labor when BV was treated, but most of those trials were performed on women with a history of preterm labor. However, the majority of trials reviewed advise against treatment of a general low-risk obstetric population, as there was no significant decrease in preterm labor. CONCLUSIONS: Therefore, based on the above studies and the current guidelines of the Centers for Disease Control and Prevention (CDC), treating pregnant women in high-risk populations who are diagnosed with BV provides the clinician with an opportunity to possibly prevent preterm labor in this population. In nulliparous women without a history of preterm birth, treatment is recommended if other risk factors are present (e.g. gonorrhea or chlamydia). However, in the general low-risk populations, routine screening is not indicated.
OBJECTIVE: Multiple studies suggest that bacterial vaginosis (BV) causes preterm labor; yet its routine treatment remains controversial. In order to help to elucidate this controversy, we performed a thorough review of studies with levels of evidence ranging from I to II-II. METHODS: We searched for all of the studies from the years 1994 to 2001 via Medline's database, including MD Consult and Ovid Mednet. RESULTS: Several trials discovered a decrease in the incidence of preterm labor when BV was treated, but most of those trials were performed on women with a history of preterm labor. However, the majority of trials reviewed advise against treatment of a general low-risk obstetric population, as there was no significant decrease in preterm labor. CONCLUSIONS: Therefore, based on the above studies and the current guidelines of the Centers for Disease Control and Prevention (CDC), treating pregnant women in high-risk populations who are diagnosed with BV provides the clinician with an opportunity to possibly prevent preterm labor in this population. In nulliparous women without a history of preterm birth, treatment is recommended if other risk factors are present (e.g. gonorrhea or chlamydia). However, in the general low-risk populations, routine screening is not indicated.
Authors: M R Joesoef; S L Hillier; G Wiknjosastro; H Sumampouw; M Linnan; W Norojono; A Idajadi; B Utomo Journal: Am J Obstet Gynecol Date: 1995-11 Impact factor: 8.661
Authors: J A McGregor; J I French; R Parker; D Draper; E Patterson; W Jones; K Thorsgard; J McFee Journal: Am J Obstet Gynecol Date: 1995-07 Impact factor: 8.661
Authors: S L Hillier; R P Nugent; D A Eschenbach; M A Krohn; R S Gibbs; D H Martin; M F Cotch; R Edelman; J G Pastorek; A V Rao Journal: N Engl J Med Date: 1995-12-28 Impact factor: 91.245
Authors: P J Meis; R L Goldenberg; B Mercer; A Moawad; A Das; D McNellis; F Johnson; J D Iams; E Thom; W W Andrews Journal: Am J Obstet Gynecol Date: 1995-10 Impact factor: 8.661
Authors: Joan M Mastrobattista; Mark A Klebanoff; J Christopher Carey; John C Hauth; Cora A Macpherson; J Ernest; Margaret Cotroneo; Kenneth J Leveno; Ronald Wapner; Michael Varner; Jay D Iams; Atef Moawad; Baha M Sibai; Menachem Miodovnik; Mitchell Dombrowski; Mary J O'Sullivan; J Peter Vandorsten; Oded Langer Journal: Am J Perinatol Date: 2008-04 Impact factor: 1.862