Authors:
Ralph SG. Rutherford AJ. Wilson JD.
Institution
J.D. Wilson, Reproductive Medicine Unit, General Infirmary at Leeds, Leeds
LS1 3EX; United Kingdom. E-Mail: jdwilson@dunham.freeuk.com.
Title:
Influence of bacterial vaginosis on conception and miscarriage in the first trimester: Cohort study. (1999 2802)
Source:
British Medical Journal. Vol 319(7204) (pp20-223), 1999.
Abstract:
Objectives. To assess whether bacterial vaginosis affects the rates of conception and miscarriage in the first trimester. Design. Cohort study. Setting. Assisted conception unit of a teaching hospital in Leeds. Participants. 867 consecutive women undergoing in vitro fertilisation. Interventions. Screening for bacterial vaginosis with a Gram stained vaginal smear before egg collection. Main outcome measures. The presence of bacterial vaginosis or normal vaginal flora, and the rate of conception and miscarriage in the first trimester.
Results:
190 of 771 (24.6%) women had bacterial vaginosis. No difference in conception rate was found between those women with bacterial vaginosis and those with normal vaginal flora: 61 women (32.1%) and 146 of 493 women (29.6%) respectively (relative risk 1.08, 95% confidence interval 0.85 to 1.39; odds ratio 1.12, 0.77 to 1.64). However, 22 women (31.6%) with bacterial vaginosis who conceived had a significantly increased risk of miscarriage in the first trimester compared with 27 women (18.5%) with normal vaginal flora (crude relative risk 1.95, 1.11 to 3.42; crude odds ratio 2.49, 1.21 to 5.12). This increased risk remained significant after adjustment for factors known to increase the rate of miscarriage: increasing maternal age, smoking, history of three or more miscarriages, no previous live birth, and polycystic ovaries (adjusted relative risk 2.03, 1.09 to 3.78; adjusted odds ratio 2.67, 1.26 to 5.63). Conclusions. Bacterial vaginosis does not affect conception but is associated with an increased risk of miscarriage in the first trimester in women undergoing in vitro fertilisation, independent of other risk factors.
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- 1 What is a miscarriage?
- 2 What are the different types of miscarriage?
- 3 How accurate are pregnancy tests?
- 4 What is a blighted ovum?
- 5 I have had a hydatidiform mole. What is this?
- 6 Why did I have a spontaneous miscarriage?
- 7 How frequently do miscarriages occur?
- 8 I am miscarrying. How should this be treated?
- 8a Can miscarriage result in anxiety and depression?
- 9 What is meant by recurrent miscarriage?
- 10 I have a problem with recurrent miscarriage. What is the chance of my next pregnancy being successful?
- Q 12.11 Recurrent Miscarriage I have miscarried again. Why does this keep happening?
- 12 What congenital problems might be associated with recurrent miscarriage and how could they be treated?
- 13 What traumatic conditions can cause recurrent miscarriage and how can they be treated?
- 14 Can infection cause recurrent miscarriage and would treatment help?
- 15 Could a metabolic disorder cause recurrent miscarriage?
- 16 Could a hormonal problem account for recurrent miscarriage and would hormone treatment help me?
- 17 Could an autoimmune problem cause recurrent miscarriage and how could this be treated?
- 18 Could a tumour cause recurrent miscarriage?
- 19 What degenerative processes may be associated with recurrent miscarriage?
- 20 After every miscarriage I become more depressed. Could this account for the problem?
- 21 Is it always possible to explain recurrent miscarriage?
- 22 I have a problem with recurrent miscarriage. What treatment is available to ensure that this does not happen again?
- 23 What is an ectopic pregnancy?
- 24 How frequently do ectopic pregnancies occur?
- 25 Why do ectopic pregnancies occur?
- 26 How can an ectopic pregnancy be diagnosed?
- 27 How can an ectopic pregnancy be treated?
- 28 Where can I obtain more information?
- 29 Support Groups.
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