From the Guidelines
Bartholinitis in an 8-month pregnant woman should be treated promptly with antibiotics to prevent complications such as preterm labor and post-partum endometritis. The treatment of Bartholinitis during pregnancy is crucial to reduce the risk of infectious complications associated with the infection. Although the provided evidence 1 discusses the treatment of bacterial vaginosis (BV) in pregnant women, the principle of treating infections during pregnancy to prevent adverse outcomes can be applied to Bartholinitis as well.
Key Considerations
- The goal of treatment is to relieve symptoms, reduce the risk of complications, and prevent the spread of infection.
- The treatment should be safe for the pregnant woman and the fetus.
- The patient should be monitored for signs of complications such as fever, increasing pain, or preterm labor.
Treatment Options
- Oral antibiotics such as amoxicillin-clavulanate or metronidazole may be considered, however, the choice of antibiotic should be based on the most recent and highest quality evidence.
- Warm sitz baths 3-4 times daily for 10-15 minutes can help relieve symptoms.
- If an abscess is present, surgical drainage may be necessary, with word catheter placement being a preferred method.
Important Considerations in Pregnancy
- Procedures should be performed with the patient in modified lithotomy position with left lateral tilt to prevent compression of the inferior vena cava.
- Pain management can include acetaminophen.
- The patient should be followed up after completion of treatment to verify that therapy was effective, as suggested by the guidelines for treating BV in pregnant women 1.
From the Research
Implications of Bartholinitis in an 8-month Pregnant Woman
- Bartholinitis, or Bartholin gland abscess, is a condition that can occur during pregnancy, with an incidence of 0.13% 2.
- The condition can occur at any trimester, with 20% of cases occurring in the first trimester, 45% in the second trimester, and 27.5% in the third trimester 2.
- Pregnant women with Bartholinitis are more likely to have a history of the condition and be multiparous compared to non-pregnant women 2.
- The bacterial characteristics of Bartholinitis in pregnant women are similar to those in non-pregnant women, with E. coli being the most common pathogen 2.
- Appropriate management of Bartholinitis during pregnancy is crucial to prevent severe infections and ensure favorable maternal and neonatal outcomes 2.
- Antibiotic therapy may be necessary to treat Bartholinitis, and certain antibiotics such as beta-lactams, vancomycin, and metronidazole are considered safe to use during pregnancy 3, 4, 5, 6.
- However, it is essential to carefully select and monitor antibiotic use during pregnancy due to the potential risks and pharmacokinetic alterations 6.