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Bacterial Vaginosis During Pregnancy

Certain pregnancy problems are more common in women who have bacterial vaginosis than in women who do not. Bacterial vaginosis has been linked to miscarriage , preterm delivery (before 37 completed weeks of pregnancy), and pelvic infection after childbirth. Experts continue to research whether it is a direct or indirect cause.

Screening and treatment

If you are pregnant and have symptoms of a vaginal infection, it is important to be tested for bacterial vaginosis.

If you are pregnant and do not have symptoms of a vaginal infection, talk to your doctor about what is best for you. If you are at low risk for preterm delivery, experts recommend no routine testing. But if you are at high risk for preterm delivery, experts don't know for sure if routine testing is helpful or harmful. 1, 2

Over the past few years, experts have found conflicting evidence that antibiotics for bacterial vaginosis may prevent preterm labor. Some recent reviews of studies suggest that antibiotics for bacterial vaginosis do not prevent preterm birth. But antibiotics do lower the risk of preterm premature rupture of membranes (pPROM) , a condition that leads to preterm birth and sometimes infection. In women who have had a preterm birth before, treating bacterial vaginosis with antibiotics may also lower the risk of having a baby with a low birth weight. 3

Some doctors recommend that all pregnant women who have bacterial vaginosis be treated with oral—not vaginal—antibiotics.

  • Studies show that oral antibiotics such as metronidazole and clindamycin are effective treatments that avoid increased risk to the fetus. 2
  • Use of clindamycin vaginal cream has been shown to have a slightly increased risk for preterm birth, so it is not recommended for use during pregnancy. 4
  • Tinidazole is not recommended for use during pregnancy.

Citations

  1. U.S. Preventive Services Task Force (2008). Screening for bacterial vaginosis in pregnancy to prevent preterm delivery: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 148(3): 214–220.
  2. Centers for Disease Control and Prevention (2010). Diseases characterized by vaginal discharge section of Sexually transmitted diseases treatment guidelines. MMWR, 59(RR-12): 1–110.
  3. McDonald HM, et al. (2007). Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database of Systematic Reviews (1).
  4. Hillier S, et al. (2008). Bacterial vaginosis. In KK Holmes et al., eds., Sexually Transmitted Diseases, 4th ed., pp. 737–768. New York: McGraw-Hill.
By Healthwise Staff
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Specialist Medical Reviewer Jeanne Marrazzo, MD, MPH - Infectious Disease
Last Revised August 9, 2011

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