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Fluconazole Vaginitis Study Group
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Vaginal Infection and Prematurity Study Group
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Krohn MA, Hillier SL, Nugent RP, Cotch MF, Carey JC, Gibbs RS, Eschenbach DA: The genital flora of women with intraamniotic infection. Vaginal Infection and Prematurity Study Group. J Infect Dis 1995, 171:1475-1480. A further publication from the Vaginal Infection and Prematurity Study Group. Among the cohort of 11 989 pregnant women enrolled at 23-26 weeks of duration and followed through delivery, micro-organisms associated with bacterial vaginosis were associated with an increased risk of intra-amniotic infection, as was bacterial vaginosis.
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Hillier SL, Krohn MA, Cassen E, Easterling TR, Rabe LK, Eschenbach DA: The role of bacterial vaginosis and vaginal bacteria in amniotic fluid infection in women in preterm labor with intact fetal membranes. Clin Infect Dis 1995, 20(suppl 2):276-278. This Seattle study of 225 women admitted during preterm labor but with intact fetal membrane confirmed that many of these patients have amniotic fluid infection, and once more documents the association of the latter with bacterial vaginosis. Finally the presence of F. nucleatum and B. ureolyticus in the vagina closely correlates with increased risk of amnionitis, supporting the importance of the ascending route of infection.
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McGregor JA, French JI, Jones W, Milligan K, McKinney PJ, Patterson E, Parker R: Bacterial vaginosis is associated with prematurity and vaginal fluid mucinase and sialidase. Am J Obstet Gynecol 1994, 170:1048-1059. A prospective evaluation of vaginal fluid mucinase and sialidase in 271 pregnant women (16-27 weeks gestation) treated with 2% clindamycin vaginal cream or with placebo. Mucinase and sialidase activities were increased in association with bacterial vaginosis. Topical treatment, although effective treatment of bacterial vaginosis, failed to reduce risks of perinatal morbidity and clinical failure, correlated with persistence of sialidase-producing micro-organisms.
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Hay PE, Morgan DJ, Ison CA, Bhide SA, Romney M, McKenzie P, Pearson J, Lamont RF, Taylor Robinson D: A longitudinal study of bacterial vaginosis during pregnancy. Br J Obstet Gynecol 1994, 101:1048-1053.
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Hay, P.E.1
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26
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0027965899
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Bacterial vaginosis in pregnancy and efficacy of short courses oral metronidazole treatment: A randomized controlled trial
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Morales WJ, Schorr S, Albritton J: Effects of metronidazole in patients with preterm birth in preceding pregnancy and bacterial vaginosis: a placebo-controlled, double-blind study. Am J Obstet Gynecol 1994, 171:345-349. In a prospective study, 80 pregnant women with bacterial vaginosis were randomized to receive metronidazole, 250 mg three times a day for 7 days, or placebo. Compared with placebo, patients in the metronidazole group had significantly less preterm labor, preterm births, and rupture of membranes.
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Prevention of premature birth by screening and treatment of common genital tract infections: Results of a prospective controlled evaluation
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McGregor JA, French JI, Parker R, Draper D, Patterson E, Jones W, Thorsgard K, McFee J: Prevention of premature birth by screening and treatment of common genital tract infections: results of a prospective controlled evaluation. Am J Obstet Gynecol 1995, 173:157-167. A prospective controlled treatment trial conducted on 1260 women confirmed that the presence of bacterial vaginosis is associated with increased risks of pregnancy loss at < 22 weeks, preterm premature rupture of membranes, and preterm birth. Oral clindamycin treatment was associated with a 50% reduction of bacterial vaginosis-linked preterm birth and premature rupture of membranes.
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Am J Obstet Gynecol
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McGregor, J.A.1
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Sweet RL: Role of bacterial vaginosis in pelvic inflammatory disease. Clin Infect Dis 1995, 20(suppl 2):271-275.
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Korn AP, Bolan G, Padian N, Otim-Smith M, Schachter J, Landers DV: Plasma cell endometritis in women with symptomatic bacterial Vaginosis. Obstet Gynecol 1995, 85:387-390. A study of endometrial biopsies obtained from 41 symptomatic women, including 22 with symptomatic bacterial vaginosis, revealed the frequent presence of plasma cell endometritis in women with bacterial vaginosis. This well performed histopathological study strengthens the association between bacterial vaginosis and non-chlamydial, non-gonococcal, upper genital tract infection.
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Bacterial vaginosis and cervical intraepithelial neoplasia
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Platz-Christensen JJ, Sundstrom E, Larsson PG: bacterial vaginosis and cervical intraepithelial neoplasia. Acta Obstet Gynecol Scand 1994, 73:586-588. This is an interesting and potentially extremely important observation linking bacterial vaginosis with the development of cervical intraepithelial neoplasia, possibly a cofactor to human papilloma virus.
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Sobel JD: Desquamative inflammatory vaginitis: a new subgroup of purulent vaginitis responsive to topical 2% clindamycin therapy. Am J Obstet Gynecol 1994, 171:1215-1220. A retrospective review of 51 women with chronic purulent vaginitis, excluding trichomoniasis, with unique features of epithelial surface desquamation and loss of lactobacillus-dominant flora. Patients frequently failed to respond to oral metronidazole but improved dramatically with clindamycin. Not a controlled study, and microbiological data was incomplete.
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Am J Obstet Gynecol
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Sobel, J.D.1
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Horowitz BJ, Mardh PA, Nagy E, Ronk EL: Vaginal lactobacillosis. Am J Obstet Gynecol 1994, 170:857-861.
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