Preterm Labor And Delivery Linked To Bacterial Vaginosis – Part I

Pre-term labor or PTL accompanied by ensuing premature delivery continues to be the significant cause of perinatal deaths and morbidity in many underdeveloped countries. The etiological factor that leads to PTL is still vague in huge percentage of cases leading to augmented incidence of idiopathic PTL. Lately, the infection of the lower genital tract particularly bacterial vaginosis or BV has been highly doubted as being the aberrant agent in idiopathic cases of PTL cited till now.

A recent study undertaken in India to examine the relation of BV with idiopathic PTL and preterm delivery involved 150 women hospitalised with idiopathic PTL that were chosen for the study on the basis of the following criteria stated below:

Inclusion criteria

• Singleton pregnancy.
• Gestation age lying between 28 to 36 weeks.
• Intact membranes.
• Those experiencing more than two uterine contractions within a time span of ten minutes and each contraction lasting more than 45 seconds.
• Cervix that has undergone dilatation between one to four centimetres.
• Cervical effacing more than 25%.

Exclusion criteria

• Gestational age being less than 28 weeks.
• Those women with a past of antepartum hemorrhage, urinary tract infection (UTI), respiratory tract infections, diarrhoea or any other palpable reason for preterm labor.
• Medical complications during pregnancy like moderate to chronic anemia, hypertension induced by pregnancy and diabetes mellitus.
• A past of trickling per vaginum or missing membranes.
• More than one pregnancy determined.
• IUGR or Intrauterine Growth Retardation.
• Intrauterine fetal fatality.
• Antibiotic treatment being undertaken during the past thirty days.

The study carried out incorporated 75 women with PTL without any evident reasoning for it. The control set comprised of 75 women carrying single pregnancy at term gestation. A comprehensive history was undertaken particularly to include any history of past abortion, preterm delivery, stillbirths and neonatal fatality. A meticulous general and methodical exam was carried out to note the fundal height, abdominal measurement, presentation, the strength, regularity and period of the uterine contractions and fetal cardiovascular pattern and rate. A speculum examination was carried out to rule out any leaking and to make a note of the type of discharge that was collected to be used for pH evaluation, amine testing and to make a smear to be used for gram staining procedure. Using the strip method the vaginal discharge was tested for pH.

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