This is a very serious infection, and on ...

Frederick R. Jelovsek MD

Bacterial infection vaginal pain in the lower part at any time, but during pregnancy, they can actually cause other serious problems related to pregnancy outcomes. Bacterial vaginosis is associated with preterm labor, premature rupture of membranes, leading to premature delivery, infection of the amniotic fluid, placenta and baby during childbirth. In fact, an estimated 15% -20% of all pregnant women bacterial vaginosis, BV. In recent articles

Hemmill H: Bacterial vaginal infections in pregnant patients. Patient, 1999 (August), and those performing 25-28

looked at the diagnosis and treatment of infections of BV during pregnancy. There are different types of bacterial vaginal infections? There are two main types of bacterial vaginal infections, a total mixed bacteria infection called bacterial vaginosis (BV) and streptococcal bacterial vaginosis. Any of them can be associated with complications for pregnant women. BV can cause premature labor and delivery. Strep vaginitis can do the same and, moreover, it can cause infection in the newborn child. This is a very serious infection and about 4% of children who get the infection die, and those who survive other serious infection in the brain, lungs and bones. What is strep vaginosis? Vaginosis caused by streptococcus is a creamy, white discharge. There is usually no burning vulva, as is with a yeast infection and discharge is very fragrant, like bacterial vaginosis. If the doctor looks at the discharge under a microscope, no white blood cells and lactobacilli, the normal bacteria in the vagina. There are several types of strep that can be present in the vagina, Groups A, B and D streptococcus. About 70% of streptococcal vaginosis is caused by group B and 30% related to group D. Group infections are rare. Acute vaginosis can occur spontaneously, but often is associated with antibiotics are for bacterial vaginosis. Metronidazole (Flagyl) is a common treatment for BV, but it does not treat streptococcus, streptococcus growths so common. This is a problem that a vaginal cream, clindamycin vaginal cream, which is often used for bacterial vaginosis during pregnancy is no longer shvalyuvalysya as it leads to vaginosis streptococcus. Oral clindamycin is still approved for bacterial vaginosis and no evidence that it produces streptococcus overgrowth. Should I be tested for the presence of bacterial vaginosis during pregnancy? Any woman who had prior streptococcal vaginal infection during pregnancy or even a history of preterm labor or premature rupture of membranes during previous pregnancy should be tested again, or even just empirically treated as if it was such an infection. This check should be for bacterial vaginosis, microscopic examination of vaginal discharge or special tests place amines, as well as streptococcal bacterial vaginosis is a streptococcal cultures or reliable screening test. Testing or treatment of bacterial vaginosis should occur after 16 weeks of pregnancy and testing or treatment of strep vaginosis should occur at 35-37 weeks and at any time during the presentation of labor, labor or suspected history of Rupture of membranes (membranes) to the childbirth. For most women, lower risk, which is usually two different strategies:

aggressively diagnose and treat any pregnant woman vaginosis, which has signs of vaginal discharge, odor or irritation of the vulva

regularly screen after 16 weeks of pregnancy for BV, and treatment and follow-up order, BV, to make sure recurrences are minimized (note that this approach has not yet been excluded as a cost-effective by many suppliers, but it makes sense, if 15-20% of all pregnant women, BV and 50% completely asymptomatic)

screen or treat only high risk patients with a past history of preterm delivery complications or with a temperature of more than 100. 4 ° F (38. 0 ° C) or membrane over 18 hours

If bacterial vaginosis cause complications during pregnancy, will it also cause problems with conception or cause abortion? No, it does not seem to cause difficulty getting pregnant. Yes, this is due to increase in the number of miscarriages. A recent study

Ralph SG, Rutherford AJ, Wilson JD: Influence of bacterial vaginosis on conception and miscarriage in first trimester: cohort study. BMJ 1999 July 24, 319 (7204) :220-3

showed a miscarriage rate of 31. 6% in women with bacterial vaginosis compared with 18. 5% of normal speed background in women with normal vaginal bacteria. Is there anything I can do during pregnancy or earlier to prevent or detect bacterial vaginosis? Union of diagnosis and treatment only beginning to be introduced in the standard of medical care recommendations. A study conducted in Germany to prevent preterm labor using vaginal pH gloves that women buy strattera used to check their vaginal pH twice a week during pregnancy. High pH over 4. 7 (pH is a measure of acidity of vaginal secretions) was associated with bacterial vaginosis. He was then treated with lactobacillus tablets (normal vaginal bacteria) or antibiotics and the frequency of preterm birth and very low birth weight children was reduced. Vaginal pH gloves are not available in the U.S., but it may soon. Tablets containing lactobacilli placed in the vagina to restore the normal flora bacteria are available in many pharmacies and health food stores. Doctors do not recommend using them regularly, if there is no need for them, because regular use of irrigation has been shown to actually produce more bacterial vaginosis than treatment. Thus, the concept put any medical substances in the vagina on a regular basis, if not required, is believed to be in a position potentially lead to changes that may lead to infection. The best strategy may work with your doctor to make sure to check vaginal discharge or before conception or after about 16 weeks of pregnancy (because there is a very low rate of new vaginosis after 16 weeks). Your doctor may do a microscopic exam or just check the pH of the vagina. If not positive, discuss treatment with antibiotics for this and then consider the following to make sure that the infection is gone. If you have problems with recurrent BV, consult your doctor if you can use vaginal lactobacillus tablets to try to reduce the likelihood of relapse. In addition, it goes without saying that douching is not what you should do during pregnancy and even if you are pregnant, you should consider not douching on a regular basis. .