Bacterial vaginosis during pregnancy: possible risks

Bacterial vaginosis: symptoms, causes, ways of transmission, treatment

Bacterial vaginosis (BV) is a disease caused by excessive growth of opportunistic and pathogenic (in particular, facultatively anaerobic) microorganisms in the vagina against the background of a decrease in the number of lactic acid bacteria. Bacterial vaginosis is quite common in women of reproductive age. It accounts for 30 to 50% of all vulvovaginal infections.

Bacterial vaginosis: causes

Bacterial vaginosis develops when the normal microflora of the vagina is replaced by opportunistic microorganisms (mycoplasmas, fusobacteria, gardnerella, vaillonella, peptococci, and others).

The causes of bacterial vaginosis are as follows:

• frequent douching;
• use of intrauterine spirals;
• excessive sexual activity;
• uncontrolled use of antibiotics;
• psychosocial stress.

How is bacterial vaginosis transmitted? BV is not a sexually transmitted disease for the following reasons:

• the condition occurs in women who do not have sex;
• there is no equivalent disease in men;
• prescribing antibiotics to a male partner does not affect the frequency of disease exacerbations in women;
• prevalence of BV differs markedly in ethnic groups, which cannot be explained only by different degrees of sexual activity.

Main symptoms of bacterial vaginosis

The disease can be asymptomatic or with clinical manifestations. The diagnosis is confirmed after receiving the results of the analysis of vaginal secretions: pH above 4.5 and a large number of opportunistic bacteria indicate the presence of BV.

Symptoms of bacterial vaginosis are as follows:

1. Discharge from the vagina with an unpleasant "fishy" smell. At the beginning of the disease, they are white or gray in color, as the process progresses, they become yellowish-greenish.
2. Heartburn when urinating.
3. Dysuria (disordered urination).
4. Vaginal itching.
5. Hyperemia of the mucous membrane of the vagina and cervix.

It should be noted that in half of the patients BV is asymptomatic.

How to treat bacterial vaginosis

The drugs of choice are metronidazole and clindamycin. They are prescribed orally and/or in the form of vaginal suppositories. It should be noted that after a course of antibacterial therapy, symptoms remain unchanged in 10-15% of patients. The frequency of relapses reaches 80% and increases as sexual activity increases. The use of estrogen-containing contraceptives reduces the number of repeated exacerbations.

What else can be used to treat bacterial vaginosis? Macrolides, lincosamides, penicillins, nitroimidazoles belong to reserve drugs. Due to the possibility of activation of the candidal flora, antimycotics are prescribed in parallel with antibacterial drugs. You can use combined forms, for example, Terzhinan, Klion-D. Gynecologists also recommend taking probiotics, which help to restore the microflora of the vagina - this reduces the likelihood of recurrence of the disease.

Bacterial vaginosis is not considered a sexually transmitted infection, so the sexual partner is not treated.

Complications of bacterial vaginosis, disease prevention

BV can lead to pregnancy complications and the development of pelvic inflammatory diseases. There is a connection between the decrease in the number of lactobacilli in the vagina and the frequency of infection with gonococci and chlamydia. BV increases the likelihood of infection or reactivation of the human papillomavirus.

Bacterial vaginosis during pregnancy can complicate the course of the underlying disease, which increases the risk of miscarriage or premature birth. Pregnant women with a diagnosis of "Bacterial vaginosis" are more likely to develop chorioamnionitis (inflammation of the amniotic membranes and infection of the amniotic fluid), postpartum endometritis. BV can also cause subclinical iron deficiency. Read more about iron deficiency in early pregnancy on our website https://dobrobut.com. The conducted studies confirmed the connection between bacterial vaginosis and tubal infertility.

The prevention of bacterial vaginosis consists in the refusal of douching, limiting the number of sexual partners, and a healthy lifestyle.