obstetric adverse effects reduction through bacterial vaginosis control during pregnancy

Abstract

Background: Obstetric complications of bacterial vaginosis include preterm labor threat; (PTT) ; preterm birth (PB) and premature ruptureof membranes (PROM). Aim: The aim was investigate the efficacy of amina test and pH determination of vaginal fluid as guide method fordiagnosis and oral treatment of BV with amoxicillin-clavulanic acid (AMC) to reduce those adverse effects. Methods: We included 137 women(group A1) with pregnancies of 10-14 weeks’ gestation, among 812 pregnant women, during april-july 2001, in the Hospital Lucio Melendez,Provincia Buenos Aires. Among them we recruited 119 ones we know the end of pregnancy . Clinical study, amina test with HOK 10% and pHdetermination of vaginal fluid were performed. The bacterioscopy examination was carry out after and had not influenced upper initial treatment ofBV. The patients with higher pH than 4.5 and positive amina test were treated with AMC twice a day, 5 days. Pregnant women (814) that wereattended to the same period of previous year at the same hospital, without BV control, were studied as control group (group B). The patients withclinical of BV, pH higher than 4.5 and positive amino test, were treated with AMC 875/125 mg, twice a day, 5 days. Results: the adverse effectsin group B and group A were 15.72%, 8.5% and 6.5% , total 30.71% and 8.4, 3.4 y 5.04%, total 16.8% for PTT, PB and PROM respectively.The total adverse effects reduction among patients of 119 women of group A1 was 14%. Conclusion: The treatment of 8 pregnancy women withBV for reducing at less 1 adverse effect it ́s necessary. Screening and treating BV in pregnant women with aminopenicillin plus betalactamaseinhibitors (amoxicillinplus clavulanic acid or amoxicillin plus sulbactam) could significantly reduce the risks of suffering PTT, PB and PROM,mainly preterm birth as cause the morbility and mortality in almost 35% of subsequent pediatric problems.