Vaginosis delays preterm delivery

Treatment of pregnant women who have a bacterial infection of the vagina (also known as bacterial vaginosis) with clindamycin cream can help delay delivery and reduce complications for the newborn infant. Bacterial vaginosis is a non-sexually transmitted infection caused by the overgrowth of certain bacteria in the vagina. Douching can raise a woman's chances of getting the disease, which may cause a foul smelling discharge or may have no symptoms at all. The infection can be successfully treated with local antibiotics, such as clindamycin. Bacterial vaginosis is associated with a doubling of the risk of preterm birth but whether treatment of bacterial vaginosis reduces this risk was controversial. Researchers from Karnsjukhuset, Skovde, Sweden, conducted a study involving 819 women with bacterial vaginosis who were randomly selected to receive either a 7-day course of clindamycin vaginal cream treatment or no treatment. The birth rate before 37 weeks of gestation did not differ significantly between the clindamycin and control groups. However, the 11 cases of late miscarriage or preterm birth in the clindamycin group had an average gestation of 33 days longer than that of the 12 cases in the comparison group. In addition, preterm delivery prior to 33 completed weeks was much less common in the clindamycin group than in the comparison group. Preterm infants born to mothers in the clindamycin group required an average of 18 days in the neonatal intensive care unit, compared with 45 days for preterm infants born to mothers in the comparison group. Clindamycin vaginal cream therapy was found to be associated with significantly prolonged gestation and reduced cost of neonatal care in women with bacterial vaginosis. Many women have more discharge when pregnant and are often told that it is normal to have a little discharge during pregnancy but this could be wrong. In such women, investigations need to be done with standard tests to look for bacterial vaginosis.