Influence of early self-diagnosis and treatment of bacterial vaginosis on preterm birth rate

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• 作者：Ali Sungkar^a ; Yuditiya Purwosunu^a ; ^b ; ^c ; ^{yudi@med.showa-u.ac.jp} ; Muhamad F. Aziz^a ; Hadi Pratomo^d ; Bambang Sutrisna^d ; Akihiko Sekizawa^b
• 关键词：Bacterial vaginosis ; Gram stain ; Preterm birth ; Self-diagnosis ; Vaginal pH
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：2012
• 期刊代码：130_00207292
• 类别：med
• 出版时间：June, 2012
• 卷：117
• 期：3
• 页码：264-267
• 文件大小：215 K

摘要

Objective

To assess whether early self-diagnosis and treatment of bacterial vaginosis (BV) could lower the preterm birth rate among a group of Indonesian women.

Methods

A randomized controlled trial of 331 pregnant women (14-18 weeks) was conducted. Participants were randomly assigned to either the active model group (n = 176) or the control group (n = 155). Women in the active model group were equipped with a kit to self-evaluate vaginal pH; those with a positive test result were treated with a twice daily dose of 500 mg of metronidazole for 7 days. The primary end point was preterm birth rate.

Results

There were 6 (3.8%) and 8 (5.4%) preterm births in the active model and control groups, respectively (P = 0.468). No spontaneous abortions were recorded in either group. When compared with the gold standard (Gram staining), the vaginal acidity test had low ability to detect BV, with 88.7%specificity and 36.9%sensitivity. The positive predictive value of the test was 35.0%PPV, while the negative predictive value was 89.4%.

Conclusion

Early self-diagnosis and treatment of BV did not reduce the preterm birth rate of the study group.

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