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Category: Volume 06 Issue 10 October 2018
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Title: The Role of Bacterial Vaginosis in Preterm Labour

Authors: Shuchi Jain, Shivi Jain, Madhu Jain, Kumari Nisha, Shampa Anupurba

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i10.139

Abstract

Introduction: Preterm delivery is one of the major causes of perinatal mortality in India (26/1000 live birth). Bacterial vaginosisis said to be implicated as one of the causes of preterm labour.

Objective: To find out the association of bacterial vaginosis (BV) and preterm labour detected at 16-20 weeks and at 28-32 weeks of gestation.

Material and Method:  Out of 810 pregnant women enrolled in the study in first trimester, 92 were excluded due to high risk factor for preterm labour. In the remaining 718 pregnant women, cotton wool swab was taken from posterior fornix and BV was detected. Diagnosis of BV was made by Neugent’s scoring system at 16-20 weeks and again at 28-32 weeks of gestation by Bellard score.

Result: The prevalence rate ofBV was 4.87% (35/718) at 16-28 weeks and 3.88% (27/670) at 28-32 weeks of gestation. The rate of preterm delivery among pregnant women with BV at 16-28 weeks was highest (19.75%, OR 1.9, CI 0.5-4.7) in comparison to BV detected at28-32 weeks (15.38%.OR 1.4, CI 0.4-39).

Conclusion: Bacterial Vaginosis at 16-28 weeks is an independent risk factor for preterm labour (OR 1.9, 95%, CI 0.5-4.7).

Keywords: Pre-term labour, Bacterial vaginosis, Trans-vaginal Ultrasound.

References

  1. Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet 2015; 385(9966): 430–440. [PubMed]
  2. Registrar General of India. Sample registration system (SRS) statistical report 2013. New Delhi: 2013.
  3. World Health Organization. WHO Data. Available at http://data.un.org/Explorer.aspx?d=WHO (accessed on 20 August 2014).
  1. Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 2012; 379: 2151–2161. [PubMed]
  2. Hay PE, Lamont RF, Taylor-Robinson D, Morgan DJ, Ison C, Pearson J. Abnormal bacterial colonization of the genital tract and subsequent preterm delivery and late BMJ 1994; 308: 295-8.
  3. Andrew WW, Goldenberg RL, Hauth JC. Preterm labour: Emerging role of genital tract infections. Infect Agents Dis 1995; 4: 196-211.
  4. Hillier SL, Krohn MA, Cassen E, Rabe LK, Eschenbach DA. The role of bacterial vaginosis and vaginal bacteria amniotic fluid infection among women in preterm labour with intact membrane. Clin Infect Dis 1995; 20: 276-278.
  5. Neugent RP, Krohn MA and Hillier SL. Reliability of diagnosing bacterial vaginosisis improved by a standardized method of Gram Stain Interpretation. J ClinMicrobiol 1991; 29: 297-301.
  6. Ballard JL, Khoury JC, Wedig K, Eilers-Walsman BL et al. New Ballard score: expanded to include extremely premature infant. J Pediatrics 1991;119:417-423.
  7. Amsel R, Totten PA, Spiegel CA, Chen KCS, Eschenbach D & Holmes KK. Non specificvaginosis: diagnostic criteria and microbial and epidemiology association. Am J Med 1983; 74: 14-22.
  8. Hillier SL, Krohn MA, Nugent RP, Gibbs RS. Characteristics of three vagina flora patterns assessed by Gram Stain among pregnant women. Am J ObstetGynecol 1992; 166: 938-944.
  9. Carey JC, Klebanoff MA, Hauth JC , Hiller SL, Thom EA, Ernest JM, Heine RP, Nugent RP, Fischer L Melly, Wapner R, Varner M. Metronidazole to prevent preterm delivery in pregnant women with asymptomatic bacterial vaginosis. N Eng J Med 2000; 342:534-40.
  10. Riduan JM, Hiller SL, Utomo B et al. Bacterial vaginosis and prematurity in Indonesia association in early and late pregnancy. Am J ObstetGynecol 1993; 169: 175-8.
  11. Goffinet F, Maillard F, Mihoubi N, Kayem G, Ppierni KE, Cabrol D, Paul G. Bacterial vaginosis: Prevalence and Predictive value for premature delivery and neonatal infection in women with preterm labour and intact membranes. Eur J Obstet Gynecol Reprod Biol. 2003; 108: 146-51.
  12. Llahi-camp JM, Rai R Ison C, Regan L, Taylor Robinson D. Association of bacterial vaginosis with a history of second trimester miscarriage. HumReprod 1996; 11: 1515-78.
  13. DH, Krohn MA, Hillier SL, Escenbach DA. The association of occult amniotic fluid infection with gestational age and neonatal outcome among women in preterm labour. Obstet Gynecol 1992; 79: 351-7.
  14. Russel P. Inflammatory lesion of the human placenta: Clinical significance of acute Am J ObstetGynecol 1979;1:127-37.

Corresponding Author

Shivi Jain

Asst. Professor, Dept. of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu

University Varanasi-221005, India