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Bacterial vaginosis in pregnancy: Evidence-based approaches
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
James A. McGregor, Michael W. McCullough
Associations between bacterial vaginosis and increased risk for adverse pregnancy outcomes have been investigated through case-control, cross-sectional, prospective cohort studies and randomized controlled treatment trials (Table 3) (4–13,38,50,54,56,60,74–76). Despite differences in study design, definitions of preterm birth, and the techniques used to identify bacterial vaginosis, research from around the world supports the association between bacterial vaginosis and increased risk of preterm labor, preterm birth, and preterm premature rupture of the membranes (Table 3) (5–13,38,56,78). Crucially, bacterial vaginosis and associated microorganisms appear to increase the risk of preterm birth at the lowest viable gestational ages (8). Two published studies report an association between previable second-trimester pregnancy loss and bacterial vaginosis, suggesting that pathophysiologic processes associated with bacterial vaginosis cause a continuum of both previable loss and birth of severely premature newborns (11,56).
DRCOG MCQs for Circuit A Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Cervical smear may suggest the diagnosis of: Adenomyosis.Bacterial vaginosis.Trichomonas vaginalis.Cervical intraepithelial neoplasia (CIN).Invasive carcinoma of the cervix.
Sexually transmitted infections
Published in Suzanne Everett, Handbook of Contraception and Sexual Health, 2020
Bacterial vaginosis (BV) is not a sexually transmitted infection and is caused by an overgrowth of anaerobic organisms in the vagina. It causes a fishy-smelling vaginal discharge, with soreness and itching; it is associated in pregnancy with premature rupture of membranes, preterm birth and post-partum endometritis. Treatment first line is metronidazole 400 mg twice daily for five days; contact screening is not required. If a woman suffers from recurrent BV, you may wish to refer her to a specialist clinic as she may have trichomonas and her partner should be treated. Women should be encouraged to avoid washing the vagina with bath and beauty products. The vagina is a self-cleaning organ; these products clean out the natural flora in the vagina, causing an overgrowth of anaerobic organisms and BV. Woman often wash more often after sexual intercourse, so you will need to discuss how BV is caused to reduce recurrences.
Progress towards the clinical use of antimicrobial peptides: challenges and opportunities
Published in Expert Opinion on Biological Therapy, 2023
Paula Espinal, Ester Fusté, Josep M. Sierra, Guadalupe Jiménez-Galisteo, Teresa Vinuesa, Miguel Viñas
This section deals with an example of the use of antimicrobial peptides to restore microbial equilibrium. It is common for health states to depend, to a greater or lesser extent, on the balance between microbial populations and host cells. In some areas and systems this is particularly noticeable. For instance, the maintenance of the bacterial equilibrium plays a key role in the mouth or in the vagina. Bacterial vaginosis is a gynecological condition affecting more than 30% of women at the reproductive age worldwide, in which there is an imbalance between the autochthonous and normal microflora of the vagina and the colonizers, that is to say pathogenic bacteria. Bacterial vaginosis is caused both by anaerobic and aerobic bacteria that are less susceptible to antimicrobials than the resident microbiota and subsequently become dominant in the human vaginal microbiota. In such scenarios the use of conventional antibiotics is precluded, since the vaginal microbiota is formed by species characteristically susceptible to antimicrobial agents. Antimicrobial peptides (AMPs) have been proposed as a suitable alternative to achieve the elimination of invading multidrug-resistant bacteria colonizing the vagina.
Sexual Enrichment Aids: A Mixed Methods Study Evaluating Use, Hygiene, and Risk Perception among Women
Published in The Journal of Sex Research, 2022
Amanda L. Collar, Jesus E. Fuentes, Heidi Rishel Brakey, Kathryn M. Frietze
Together, these and other behaviors while using SEAs need to be more fully understood due to the potential for negative or positive health outcomes for women. SEA use among women is associated with positive sexual function, including in the domains of desire, arousal, lubrication, orgasms, and decreased pain (Herbenick et al., 2009, 2011). Additionally, SEA use is associated with certain health-promoting activities, including gynecological visits and genital self-exams within the past year (Herbenick et al., 2009). However, there are some studies that suggest SEAs may also play a role in negative health outcomes. Women who share their SEAs are more likely to report a past diagnosis of Candida infection and bacterial vaginosis (Wood et al., 2017). Bacterial vaginosis is also associated with a failure to always clean SEAs before use (Marrazzo et al., 2002). Bacterial vaginosis, a condition in which the vaginal flora becomes imbalanced, can infer significant risk to women, including an increased risk of preterm birth, low birth weight, and endometritis (both postpartum and post-abortal), pelvic inflammatory disease, and increased risk of human immunodeficiency virus acquisition (Gravett et al., 1986; Hillier et al., 1995; Peipert et al., 1997; Taha et al., 1998). Finally, SEAs may be able to harbor infectious diseases. Although infectious disease transmission by SEAs has not been well studied, one study did show that Human Papillomavirus (HPV) could be detected on certain SEAs after use, in some cases even 24 hours after cleaning (Anderson et al., 2014).
Lactic acid, citric acid, and potassium bitartrate non-hormonal prescription vaginal pH modulator (VPM) gel for the prevention of pregnancy
Published in Expert Review of Clinical Pharmacology, 2022
There have been several studies comparing the microbicidal effects of VPM to both Buffergel and Aci-jel. Buffergel is an aqueous gel with a pH of 3.9; the active ingredient is the hydrogen ions released by carbopol 1974P, a polyacrylic acid [51]. Designed to protect against HIV infection by maintaining the normal acidity of the vagina in the presence of sperm [51,52], it is not considered to be a direct competitor to VPM as it is not currently available or in active development. The effectiveness of Buffergel as a vaginal contraceptive with the use of a diaphragm was evaluated in a phase III trial, and was determined to have comparable efficacy to N-9 plus diaphragm [53]. Aci-jel, a vagina gel containing 0.94% glacial acetic acid, is used to maintain the acidity in the vagina. In a clinical study, it showed promise in reducing episodes of recurrent bacterial vaginosis (BV) [54].