Time course of the regression of asymptomatic bacterial vaginosis in pregnancy with and without treatment.


Journal Article

OBJECTIVE: The purpose of this study was to determine the effectiveness of treatment over time for bacterial vaginosis in pregnancy and the probability of spontaneous resolution with placebo. STUDY DESIGN: Women with asymptomatic bacterial vaginosis on Gram stain were assigned randomly at 16 to 23 weeks of gestation to receive two 2-g doses of metronidazole or placebo 48 hours apart and were re-evaluated for changes in Gram stain score on one occasion > or =2 weeks later. RESULTS: Of 658 women who underwent metronidazole therapy, treatment was successful (score, <7) in 78% of those women who were seen at 2 to 3.9 weeks of gestation, which was similar to women seen > or =10 weeks after treatment. In 683 women who underwent placebo therapy, spontaneous resolution increased significantly from 13% at 2 to 3.9 weeks of gestation to 36% at > or =10 weeks of gestation. Spontaneous resolution was more common with lower vaginal pH or lactobacilli on Gram stain at the time of random assignment. CONCLUSION: The effectiveness of metronidazole therapy of bacterial vaginosis persists for > or =10 weeks. Women who underwent placebo therapy had significant remission of bacterial vaginosis over > or =10 weeks. Remission was more common when the initial vaginal microbiologic disturbances were less severe.

Full Text

Cited Authors

  • Klebanoff, MA; Hauth, JC; MacPherson, CA; Carey, JC; Heine, RP; Wapner, RJ; Iams, JD; Moawad, A; Miodovnik, M; Sibai, BM; vanDorsten, JP; Dombrowski, MP; National Institute for Child Health and Development Maternal Fetal Medicine Units Network,

Published Date

  • February 2004

Published In

Volume / Issue

  • 190 / 2

Start / End Page

  • 363 - 370

PubMed ID

  • 14981375

Pubmed Central ID

  • 14981375

Electronic International Standard Serial Number (EISSN)

  • 1097-6868

International Standard Serial Number (ISSN)

  • 0002-9378

Digital Object Identifier (DOI)

  • 10.1016/j.ajog.2003.08.020


  • eng