Association of bacterial vaginosis with preterm delivery

ABSTRACT

Preterm delivery is the leading cause of infant morbidity and mortality. Preterm labor and premature rupture of membranes and low birth weight have been associated with either specific maternal genital tract infections or an altered microflora in pregnancy. Bacterial vaginosis is one of the implicating factors for preterm labor and preterm delivery. Objective of the study is to study the frequency of Bacterial vaginosis in preterm labor. By identifying and observing the frequency of Bacterial vaginosis as a causative factor in preterm labor, we can reduce its frequency by taking certain measures and indirectly we would be able to overcome the problem of infant mortality and morbidity due to prematurity. Observational study. Fifty patients.Obstetric and Gynecology department unit II of Abbasi Shaheed Hospital and Karachi Medical and Dental College Karachi, From Jan 2003 to Jan 2004. Patients included were presented with established labor after 24[th] weeks and before 37[th] weeks of gestations. Patients with singleton pregnancy were with or without rupture of membranes. Patients excluded were multiple pregnancies, current pregnancy with sepsis, cervical incompetence, and antepartum bleeding. Patients presented with chorioamnionitis, diabetes, mellitus, hypertension, cardiac disease, renal disease and urinary tract infection were also excluded. Patients presented with effective uterine contractions after 24[th] weeks and before 37[th] weeks of gestation were admitted. Full history and examination were recorded on a given proforma. Full base line investigations, including complete blood picture, random blood sugar, and urine detailed report, blood group and Rh factor were done. High vaginal swab was taken and sent for culture/sensitivity and microscopy for clue cells. Vaginal pH was determined by using Nitrazine paper and change in color of Nitrazine paper was recorded. Whiff test was performed by taking some secretion by disposable syringe on glass slide and fishy odor was observed after adding a drop of KOH on slide. Amsel's criteria were applied to all cases preterm labor and results was analyzed on SPSS 10. Results were based on Amsel's criteria. Fifty patients were enrolled in this study. Out of fifty patients only 2[4%] patients fulfilled all four criteria, while 29[58%] patients fulfilled three criteria, 4[8%] patients fulfilled 2 criteria and 15[13%] patients fulfilled 1 criterion. Hence Bacterial vaginosis was found in 35[70%] patients. Bacterial vaginosis was associated with majority of patients presented with preterm labor and responsible for perinatal morbidity and morbidity