Effect of Bacterial Vaginozis and cervical length on preterm delivery in second trimester

Main Article Content

Hacı Öztürk Şahin
Ahmet Gülkılık

Abstract

Objective: Preterm birth is one of the major cause of perinatal morbidity and mortality. Clinical studies have pointed out the association between preterm birth and bacterial vaginosis (BV) infection. Our aim is to discover the incidence of BV and search for the mean cervical length and parameters for the prediction of preterm delivery.


Materials and Methods: 130 pregnant woman between the 16th and 24th gestational week were included in our study. A detailed medical history was obtained from all of the women, and patients with a history of preterm delivery and the Vaginal Ph values and cervical length measurement were evaluated. Vaginal samples were analyzed, gram staining was performed, and a bacterial vaginosis diagnosis was made with Nugent’s criteria.


Results:  Of 130 woman that we included in our study,  only 19 had bacterial vaginosis (14.6 %), and the mean cervical length was measured as 41.79 mm. Preterm birth occurred in nine of the pregnant women (6.9%), and no statistically significant difference was found between BV and shortened cervical length or preterm labor. When we excluded the known preterm birth risk factors from our study, we could not find a significant difference between preterm labor and BV.


Conclusion:  We concluded that BV by itself is not a preterm risk factor. The frequency of BV in the pregnant women in our study group according to the preterm delivery rate and the mean cervical length were similar to those in international studies in which the relationship between cervical length and preterm delivery has been established. We did not come to a significant conclusion in our research; nevertheless, we can relate this result to the preterm delivery rate that is found to be lower than expected.

Downloads

Download data is not yet available.

Article Details

How to Cite
Şahin, H. Öztürk, & Gülkılık, A. (2019). Effect of Bacterial Vaginozis and cervical length on preterm delivery in second trimester. Medical Science and Discovery, 6(11), 305–309. https://doi.org/10.36472/msd.v6i11.325
Section
Research Article

References

Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008; 371: 75–84.

Saigal S, Doyle LW. An overview of mortality and sequelae ofpreterm birth from infancy to adulthood. Lancet 2008; 371: 261–69.

Esplin MS, O’Brien E, Fraser A, et al. Estimating recurrence ofspontaneous preterm delivery. Obstet Gynecol 2008; 112: 516–23.

Hay PE, Lamont RF, Taylor-Robinson D, Morgan DJ, Ison C,Pearson J. Abnormal bacterial colonisation of the genital tract ansubsequent preterm delivery and late miscarriage. BMJ 1994;308: 295–98.

Kurki T, Sivonen A, Renkonen OV, Savia E, Ylikorkala O.Bacterial vaginosis in early pregnancy and pregnancy outcome.Obstet Gynecol 1992; 80: 173–77.

Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D,Holmes KK. Nonspecific vaginitis. Diagnostic criteria and microbialand epidemiologic associations. Am J Med 1983; 74: 14–22.

Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosingbacterial vaginosis is improved by a standardized method of gramstain interpretation. J Clin Microbiol 1991; 29: 297–301.

Desseauve D, Chantrel J, Fruchart A, et al. Prevalence and risk factorsof bacterial vaginosis during the first trimester of pregnancy in a largeFrench population-based study. Eur J Obstet Gynecol Reprod Biol 2012;163: 30–34

Leitich H, Bodner-Adler B, Brunbauer M, Kaider A, Egarter C,Husslein P. Bacterial vaginosis as a risk factor for preterm delivery:a meta-analysis. Am J Obstet Gynecol 2003; 189: 139–47.

Ozdemir I, Demirci F, Yucel O, Erkorkmaz U.Ultrasonographic cervical length measurement at 10-14 and 20-24 weeks gestation and the risk of preterm delivery.Eur J Obstet Gynecol Reprod Biol. 2007 Feb;130(2):176-9.

Thangaraj JS1, Habeebullah S, Samal SK, Amal SS.Mid-Pregnancy Ultrasonographic Cervical Length Measurement (A Predictor of Mode and Timing of Delivery): An Observational Study.J Family Reprod Health. 2018 Mar;12(1):23-26.

Mishra S, Bagga R, Kalra J, Jain V, Dutta S.Routine second trimester cervical length screening in low risk women identified women at risk of a 'very' preterm birth but did not reduce the preterm birth rate: a randomised study from India.J Obstet Gynaecol. 2018 Aug;38(6):789-795.

Surbek DV, Hoesli IM, Holzgreve W.Morphology assessed by transvaginal ultrasonography differs in patients in preterm labor with vs. without bacterial vaginosis.Ultrasound Obstet Gynecol. 2000 Mar;15(3):242-5.

Jantien J,Boomgaard MD,Karin S.Dekker MD,Elsabet Van Rensburg:Am J Obstet Gynecol 1999;181:964-7.

Joesoef M.Riduan JM, Hillier SL, Utomo B, Wiknjosastro G, Linnan M, Kandun N.Bacterial vaginosis and prematurity in Indonesia: association in early and late pregnancy.Am J Obstet Gynecol. 1993 Jul;169(1):175-8.

Michael G.Gravett MG, Nelson HP, DeRouen T, Critchlow C, Eschenbach DA, Holmes KK.Independent associations of bacterial vaginosis and Chlamydia trachomatis infection with adverse pregnancy outcome.JAMA. 1986 Oct 10;256(14):1899-903.

Subtil D, Brabant G, Tilloy E et al.Early clindamycin for bacterial vaginosis in pregnancy (PREMEVA): a multicentre, double-blind, randomised controlled trial.Lancet. 2018 Nov 17;392(10160):2171-2179.

Lamont RF, Nhan-Chang C-L, Sobel JD, Workowski K,Conde-Agudelo A, Romero R. Treatment of abnormal vaginal florain early pregnancy with clindamycin for the prevention ofspontaneous preterm birth: a systematic review and metaanalysis.Am J Obstet Gynecol 2011; 205: 177–90.

Brocklehurst P, Gordon A, Heatley E, Milan SJ. Antibiotics fortreating bacterial vaginosis in pregnancy. Cochrane Database Syst Rev 2013; 1: CD000262.

Krauss-Silva L, Almada-Horta A, Alves MB, Camacho KG, Moreira ME, Braga A. Basic vaginal pH, bacterial vaginosis and aerobic vaginitis: prevalence in early pregnancy and risk of spontaneous preterm delivery, a prospective study in a low socioeconomic and multiethnic South American population. BMC Pregnancy Childbirth. 2014 Mar 19;14:107. doi: 10.1186/1471-2393-14-107.

Mancuso MS, Figueroa D, Szychowski JM, Paden MM, Owen J. Midtrimester bacterial vaginosis and cervical length in women at risk for preterm birth. Am J Obstet Gynecol. 2011 Apr;204(4):342.e1-5. doi: 10.1016/j.ajog.2010.11.003.

Iams JD1, Goldenberg RL, Meis PJ, Mercer BM, Moawad A, Das A, Thom E, McNellis D, Copper RL, Johnson F, Roberts JM.The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network.N Engl J Med. 1996 Feb 29;334(9):567-72.