From the Guidelines
Bacterial Vaginosis (BV) is associated with several complications, including premature rupture of the membranes, preterm labor, preterm birth, and postpartum endometritis.
Complications of BV
- Premature rupture of the membranes
- Preterm labor
- Preterm birth
- Postpartum endometritis 1
- Endometritis
- Pelvic Inflammatory Disease (PID)
- Vaginal cuff cellulitis following invasive procedures such as endometrial biopsy, hysterectomy, hysterosalpingography, placement of IUD, caesarian section, or uterine curettage 1
Treatment and Prevention
Treatment of BV with metronidazole substantially reduced post-abortion PID 1. The optimal treatment regimen for pregnant women with BV is unclear, but oral metronidazole and oral clindamycin, as well as vaginal metronidazole gel or clindamycin cream, are used to treat BV 1. High-risk pregnant women who have asymptomatic BV may be evaluated for treatment to reduce the risk for prematurity 1. It may be reasonable to consider treatment of BV (symptomatic or asymptomatic) before performing surgical abortion procedures 1.
From the Research
Complications of Bacterial Vaginosis (BV)
The complications of Bacterial Vaginosis (BV) are numerous and can have severe consequences on a woman's reproductive health. Some of the complications include:
- Preterm birth (PTB) 2
- Low birth weight (LBW) 2
- Preterm premature rupture of membranes (PROM) 2
- Chorioamnionitis 3
- Amniotic fluid infections 3
- Postpartum and postabortal endomyometritis 3
- Postabortal pelvic inflammatory disease (PID) 3
- Increased risk of contracting sexually transmitted infections such as gonorrhea, genital herpes, Chlamydia, Trichomonas, and human immunodeficiency virus 4, 3
- Vaginal cuff cellulitis, pelvic cellulitis, pelvic abscess, and PID after hysterectomy 3
- Adverse fertility outcomes, including infertility and poor fertility 5
Risk Factors for Complications
Certain risk factors can increase the likelihood of complications from BV, including:
- Multiple sexual partners 2
- Age 2
- Socioeconomic status 2
- Unhygienic practices 2
- Ethnicity 2
- Second trimester 2
- Spontaneous abortion 2
- Vaginal douching 2
- Symptoms of BV 2
- History of sexually transmitted infections (STIs) 2
Treatment and Prevention
While antibiotics such as metronidazole and clindamycin are the current treatment for BV, they may not provide a long-term cure 4. Other approaches to treatment and prevention are being explored, including probiotics, vaginal microbiome transplantation, pH modulation, and biofilm disruption 4. Behavioral modifications such as smoking cessation, condom use, and hormonal contraception may also help prevent BV 4.