Items in AFP with MESH term: Vaginosis, Bacterial
ABSTRACT: Genitourinary tract infections are one cause of preterm delivery. Prematurity is one of the leading causes of perinatal mortality in the United States. Uterine contractions may be induced by cytokines and prostaglandins, which are released by microorganisms. Asymptomatic bacteriuria, gonococcal cervicitis and bacterial vaginosis are strongly associated with preterm delivery. The role of Chlamydia trachomatis, Trichomonas vaginalis and Ureaplasma urealyticum is less clear. By adopting a rational approach to the diagnosis and treatment of genitourinary infections, family physicians can substantially decrease a patient's risk of preterm delivery.
Bacterial Vaginosis: An Update - Article
ABSTRACT: Bacterial vaginosis is the most common cause of vaginal discharge. Recent studies have confirmed its association with pelvic inflammatory disease and adverse pregnancy outcomes. Bacterial vaginosis is treated with oral metronidazole (given either as a single dose or a seven-day course) or clindamycin. Treatment with topical clindamycin or metronidazole is also effective in returning the vaginal flora to normal but may be less effective in preventing the increased incidence of adverse pregnancy outcomes.
Diagnosis of Vaginitis - Article
ABSTRACT: Vaginitis is the most common gynecologic diagnosis in the primary care setting. In approximately 90 percent of affected women, this condition occurs secondary to bacterial vaginosis, vulvovaginal candidiasis or trichomoniasis. Vaginitis develops when the vaginal flora has been altered by introduction of a pathogen or by changes in the vaginal environment that allow pathogens to proliferate. The evaluation of vaginitis requires a directed history and physical examination, with focus on the site of involvement and the characteristics of the vaginal discharge. The laboratory evaluation includes microscopic examination of a saline wet-mount preparation and a potassium hydroxide preparation, a litmus test for the pH of vaginal secretions and a "whiff" test. Metronidazole is the primary treatment for bacterial vaginosis and trichomoniasis. Topical antifungal agents are the first-line treatments for candidal vaginitis.
Screening for Bacterial Vaginosis in Pregnancy to Prevent Preterm Delivery - Putting Prevention into Practice
Screening for Bacterial Vaginosis in Pregnancy: Recommendations and Rationale - U.S. Preventive Services Task Force
Screening for and Treating Asymptomatic Bacterial Vaginosis in Pregnancy - Cochrane for Clinicians
Management of Bacterial Vaginosis During Pregnancy - Editorials