DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20190883

Study of prevalence of bacterial vaginosis in preterm and term labour patients

Tamanna Shree, Amrit Pal Kaur, S. P. S. Dhillon, Loveena Oberoi

Abstract


Background: Bacterial vaginosis (BV) is a clinical condition caused by replacement of the normal hydrogen peroxide producing Lactobacillus species with high concentrations of aerobic and anaerobic bacteria. Studies have shown that spontaneous abortion, preterm labour (PTL), premature birth, preterm premature rupture of membranes, amniotic fluid infection, and postpartum endometritis are increased because of infection with BV. In India, not many studies have been done to estimate the prevalence and association of BV with preterm labour, hence this study is being taken up to know the prevalence of BV in preterm and term labour patients and its relationship with preterm delivery, low birth weight of baby and puerperal sepsis.The objective of the present study was to observe the prevalence of bacterial vaginosis in women presenting with preterm and term labour, its impact on preterm and term delivery and to analyze the maternal and fetal complications associated with BV.

Methods: An observational study involving 100 patients with preterm and term labour (50 patients in each group) was conducted at a BNMCCC, Government Medical College, Amritsar. Women fulfilling the Amsel’s criteria and/or a score of 7 or more on gram staining of vaginal smears (Nugent’s score) was considered to have bacterial vaginosis.

Results: The proportion of patients, who fulfilled Amsel’s criteria and/or a Nugent’s score of 7 or more for the diagnosis of BV, was more in PTL group versus term labour group, and the difference was statistically significant. Prevalence of BV in preterm labour and term labour patients was 18(36%) versus 4(8%) respectively. In PTL group, 27.8% of low birth weight neonates were born to BV positive mothers versus 3.1% were born to BV negative mothers. Maternal postpartum complications observed were 33.3% with BV versus 6.25% without BV in PTL group.

Conclusions: BV is major risk factor for PTL. Therefore, the testing and prompt treatment of BV may reduce the risk of PTL. This will also go a long way in the prevention of maternal morbidity and neonatal complications due to prematurity.


Keywords


Bacterial vaginosis, Preterm labour, Term labour

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References


Romero R, Mazor M. Infection and preterm labor. Clin Obstet Gynecol. 1988;31(3):553-84.

McGregor, James A, French JI. Bacterial Vaginosis in Pregnancy. Obstet and Gynecol Survey. 2000; 55(5):1-19.

Klebanoff MA, Hillier SL, Nugent RP, MacPherson CA, Hauth JC, Carey JC et al. Is bacterial vaginosis a stronger risk factor for preterm birth when it is diagnosed earlier in gestation. Am J Obstet Gynecol. 2005;192(2):470-7.

Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, Holmes KK. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med. 1983;74(1):14-22.

Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. Journal of clinical Microbiol. 1991;29(2):297-301.

US Preventive Services Task Force. Screening for bacterial vaginosis in pregnancy to prevent preterm delivery: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;148:214-9.

Kiran CK, Kandati J, Ponugoti M. Prevalence of bacterial vaginosis in preterm and term labour: a one-year study. Int J Reprod Contracept Obstet Gynecol. 2017;6(6):2292-96.

Bitew A, Abebaw Y, Bekele D, Mihret A. Prevalence of Bacterial Vaginosis and Associated Risk Factors among Women Complaining of Genital Tract Infection. Int J Microbiol. 2017;2017:4919404.

Rose S, Edwin B, Kannan I. Bacterial vaginosis-a risk factor for preterm labour: a case-control study. Indian J Obstet Gynecol Res. 2017;4(4):381-3.

Gonclaves LF, Chaiworapongsa T, Romero R.Intrauterine infection and prematurity. Ment Retard Dev Disabil Res Rev. 2002;8(1):3-13.

Gross MM, Weckend M, Spineli L. Association between increased antenatal vaginal pH and preterm birth rate: a systematic review. Zeitschrift für Geburtshilfe und Neonatol. 2017;221(1):P03-10.

Haahr T, Ersboll AS, Karlsen MA, Svare J, Sneider K, Hee L. et al. Treatment of bacterial vaginosis in pregnancy in order to reduce the risk of spontaneous preterm delivery–a clinical recommendation. Acta obstetricia et gynecologica Scandinavica. 2016;95(8):850-60.

Jain R. Role of bacterial vaginosis in preterm labor - a prospective study. Int J Med Res Rev. 2016;4(4):543-9.