Untreated cervical infections, chorioamnionitis and prematurity.

OBJECTIVE: To examine the relationship of endocervical pathogens and cervicitis with the development of chorioamnionitis, premature rupture of membranes (PROM) and prematurity. METHODS: Three groups of pregnant women were included in the study: group A, controls with no evidence of cervicitis; group B, women with cervicitis due to pathogenic bacteria, who had been treated; and group C, women with untreated cervicitis who had not followed the prescribed therapy. Endocervical samples were cultured and aerobic and anaerobic bacteria isolated to examine the correlation of cervicitis with chorioamnionitis, PROM and prematurity. RESULTS: There was a significantly higher incidence of prematurity in women with untreated cervicitis (group C). Mixed endocervical pathogens were most often involved (36.3%). A significantly higher number of endocervical pathogens were isolated in cases of chorioamnionitis (P < 0.001). Prematurity was seen in 39.6% of cases of chorioamnionitis. Prematurity was also more common in women with PROM (42.1%) than in those with intact membranes (11.8%). CONCLUSION: It is concluded that untreated endocervical infections are an etiological factor of chorioamnionitis, PROM and prematurity.

Chronic or recurrent vaginal candidosis: short-term treatment and prophylaxis with itraconazole.

Twenty-one women (mean age, 35.3 years) with 2 to 4 episodes of vaginal candidosis in the last 6 months were included in the study to evaluate the efficacy and safety of itraconazole as short-term, as well as prophylactic, treatment of chronic candidosis. After clinical evaluation and laboratory confirmation of candidosis, 200 mg of itraconazole were given orally for 3 days. Twelve of the 21 patients were cured. The remaining nine repeated treatment, after which all were cured. All patients were entered in the maintenance phase, and received 200 mg of itraconazole the first day of the menstrual cycle for 6 months. One patient relapsed in the second month, but after taking 200 mg of itraconazole BID for 1 day she remained cured for the rest of the study period. All other patients remained cured for the 6 months of the maintenance period. Three months after the end of prophylactic therapy, 17 of 20 patients (85%) were clinically and mycologically cured. No adverse experiences were reported. It is concluded that itraconazole is an efficient and safe short-term treatment for chronic or recurrent vaginal candidosis. Moreover, the dose of 200 mg once monthly for 6 months proved to be a successful suppressive treatment.