Abstract
Objective
To review the evidence and provide recommendations on screening for and management
of bacterial vaginosis in pregnancy.
Options
The clinical practice options considered in formulating the guideline.
Outcomes
Outcomes evaluated include antibiotic treatment efficacy and cure rates, and the influence
of the treatment of bacterial vaginosis on the rates of adverse pregnancy outcomes
such as preterm labour and delivery and preterm premature rupture of membranes.
Evidence
Medline, EMBASE, CINAHL, and Cochrane databases were searched for articles, published
in English before the end of June 2007 on the topic of bacterial vaginosis in pregnancy.
Values
The evidence obtained was rated using the criteria developed by the Canadian Task
Force on Preventive Health Care.
Benefits, Harms, and Costs
Guideline implementation will assist the practitioner in developing an approach to
the diagnosis and treatment of bacterial vaginosis in pregnant women. Patients will
benefit from appropriate management of this condition.
Validation
These guidelines have been prepared by the Infectious Diseases Committee of the SOGC,
and approved by the Executive and Council of the SOGC.
Sponsors
The Society of Obstetricians and Gynaecologists of Canada.
Recommendations
There is currently no consensus as to whether to screen for or treat bacterial vaginosis
in the general pregnant population in order to prevent adverse outcomes, such as preterm
birth.
- 1.In symptomatic pregnant women, testing for and treatment of bacterial vaginosis is recommended for symptom resolution. Diagnostic criteria are the same for pregnant and non-pregnant women (I-A).
- 2.Treatment with either oral or vaginal antibiotics is acceptable for achieving a cure in pregnant women with symptomatic bacterial vaginosis who are at low risk of adverse obstetric outcomes (I-A).
- 3.Asymptomatic women and women without identified risk factors for preterm birth should not undergo routine screening for or treatment of bacterial vaginosis (I-B).
- 4.Women at increased risk for preterm birth may benefit from routine screening for and treatment of bacterial vaginosis (I-B).
- 5.If treatment for the prevention of adverse pregnancy outcomes is undertaken, it should be with metronidazole 500 mg orally twice daily for seven days or clindamycin 300 mg orally twice daily for seven days. Topical (vaginal) therapy is not recommended for this indication (I-B).
- 6.Testing should be repeated one month after treatment to ensure that cure was achieved (III-L).
Key Words
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Article info
Publication history
No. 211, August 2017
Footnotes
This guideline has been prepared by the Infectious Diseases Committee
∗
and approved by the Executive and Council of the Society of Obstetricians and Gynaecologists of Canada.Infectious Diseases Committee: Marc Boucher, MD, Montréal, QC; Beatrice Cormier, MD, Montréal, QC; Andrée Gruslin, MD, Ottawa, ON; Deborah M. Money, MD, Vancouver, BC; Gina Ogilvie, MD, Vancouver, BC; Caroline Paquet, RM, Trois-Rivières, QC; Audrey Steenbeek, RN, Halifax, NS; Nancy Van Eyk, MD, Halifax, NS; Julie van Schalkwyk, MD, Vancouver, BC; Thomas Wong, MD, Ottawa, ON; Mark H. Yudin (Chair), MD, Toronto, ON. Disclosure statements have been received from all members of the committee.
Identification
Copyright
© 2017 Published by Elsevier Inc. on behalf of The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada
