case-control study of clinical and microbiological scorings for detection of the prevalence of bacterial vaginosis in diabetic pregnant women

The relationship between diabetes mellitus and bacterial vaginosis in Egyptian pregnant women was studied in 50 pregnant women with gestational and pregestational diabetes and in 50 control subjects. All were selected after applying certain exclusion criteria. Both groups were matched in age, gestational age, gravidity and socioeconomic status. Bacterial vaginosis was diagnosed clinically according to Amsel et al. [1983] criteria and by using Nugent et al. [1991] scoring system of gram stained vaginal smears. The prevalence of bacterial vaginosis among the diabetic [22%] and the control [18%] groups was statistically insignificant [P > 0.05]. Candida was significantly higher among the diabetic group [26%] than the control group [10%] [P < 0.05]. But there was a negative correlation between fungal infection and bacterial vaginosis, which may be explained by the difference in pH of the vagina. There was a good correlation between clinical criteria and gram staining for diagnosis of bacterial vaginosis with 100% sensitivity for diabetic and control groups and 97% and 100% specificity for both groups respectively. Detection of clue cells was the most sensitive and specific [100%] for diagnosis of bacterial vaginosis. Diabetes was not proved to be a risk factor for bacterial vaginosis and further studies with larger number of cases are needed to assess this correlation. Also, the clinical criteria and gram staining of vaginal discharge, plus the history and clinical examination are useful for the diagnosis of cases with bacterial vaginosis

Antibiotic prophylaxis in premature rupture of membranes: maternal and fetal outcome

The purpose of the study was to evaluate the effectiveness of Amoxycilline Clevulinate [Augmentin] as a prophylaxis against maternal and neonatal infections in P.R.O.M. Thirty-Five pregnant patients with gestational ages between 28-34 weeks, with a definitely diagnosed rupture of the fetal membranes were included in the study. They were divided into two groups: First: [20 cases] were given Augmentin 625 mg. tablet /12 hours for 5 days. Second: [15 cases] managed conservatively without antibiotics. Both groups were studied for prolongation of pregnancy, bacteriological examination of post partum endo uterine and neonatal nasopharyngeal swabs. Patients of the study group showed a significant prolongation of pregnancy than the control group. The mean duration of the period from the onset of R.O.M. till delivery was 5 days in the study group and 2.5 days in the controls [P< 0.05]. Bacteriological examination of uterine swabs showed a significant reduction of the incidence of [+ve] cultures in the study group [+ve swabs in 55%] than the control group [+ve swabs in 93%]. Neonatal naso-pharyngeal cultures showed a significant reduction of +ve cultures in the study group [in 40% of patients] than in the control group [80% of patients]. Augmentin therapy in patients with P.R.O.M. can significantly reduce the incidence of both maternal and neonatal infectious morbidity besides allowing for more prolongation of pregnancy giving the chance for better fetal maturation