Preterm Labor And Delivery Linked To Bacterial Vaginosis – Part II

During the course of the comparative study undertaken to find the link between the presence of Bacterial Vaginosis(BV) and idiopathic preterm labor on 75pregnant women admitted with preterm labor without any noticeable cause, a vaginal examination was additionally done to note the dilatation and cervical effacement and to corroborate the existence of membranes.

An Amine test was carried out by adding KOH of ten percent strength to the vaginal discharge and the emanation of an odious amine similar odour was noted that was an indicator of a positive amine test. A smear was made for gram stain for clue cells. The detection of BV was affirmed on the basis of Nugent’s criteria on gram stain that recognized the varied morphotypes as lactobacillus type, Gardnerella vaginalis and bacteroides type or the mobiluncus types. Each of these morphotypes was then quantified on a rating of zero to four plus on the basis of the number of each morphotype noticed in oil immersion under x magnification.

The patients were administered hydration, sedation and given intravenous infusion of ritodrine in standardised dosage for tocolysis and were changed to oral dose of tocolytics subsequent to stoppage of contractions for a period of twelve hours. The ritodrine infusion was halted if contractions continued after two hours in spite of high dosages of ritodrine or if there was progression of labor. The unfavourable side effects that were cited include maternal tachycardia more than 120 per minute or systolic blood pressure less than 100mm Hg.

All the patients tested affirmative for presence of BV and were treated with appropriate oral dosage of metronidazole twice daily for five days. These women were kept track of to note the outcome of the current episode, any future PTL episodes, outcome of pregnancy and the formation of puerperal and neonatal complications.

In the study group, an undesirable outcome was seen in 92.9% women testing affirmative for BV and merely in 49.3% of the women testing negative for BV. Additionally women with BV were more prone to deliver prior to 34 weeks (57.1% versus 14.8%).

The conclusion from the study shows that BV is linked with both preterm labor and preterm delivery.  It is noted to be more strongly linked with very preterm delivery that is less than 34 weeks. Hence, antenatal screening of women having BV would surely be warranted in the antenatal populace at greater risk for preterm labor.

Read more at : Preterm Labor And Delivery Linked To Bacterial Vaginosis – Part I

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