Should Abnormal Vaginal Flora in 2 nd Trimester of Pregnancy be Treated to Prevent Preterm Labor

Abstract

Screening and treatment of abnormal vaginal flora during pregnancy to prevent preterm labor is a matter of debate for practicing obstetrician and physician in a country where maternal health and its outcome is a big concern. The recent evidence suggests that infection may be implicated in a substantial proportion of cases of preterm delivery. Neonatal morbidity and mortality are primarily influenced by gestational age and less so by birth weight. Microbial flora normally present in the human vagina play a key role in preventing pathological organisms including those responsible for sexually transmitted diseases, yeast infections, bacterial vaginosis (BV), and urinary tract infection. The outcome gathered from various recent studies have been remarkably consistent and managed to support the hypothesis that antibiotic treatment before 20 weeks of gestation reduces the risk of preterm birth. It is concluded that screening for abnormal vaginal flora cannot be generalized, but it may be safely carried out in pregnant women who have a previous history of preterm labor. Antibiotics with lactobacillus treatment can eradicate abnormal vaginal flora in pregnancy, however, screening and treating all pregnant women with asymptomatic BV to prevent preterm birth and its consequences is not substantiated by evidence.

Keywords

• Aerobic vaginitis
• bacterial vaginosis
• vaginal flora