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  • 1
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To determine the longitudinal changes in the incidence of bacterial vaginosis in pregnancy.Design A prospective study of women during pregnancy.Setting A District General Hospital in North-West London.Subject Seven hundred and eighteen pregnant women attending antenatal clinics. At their first attendance and subsequently, Gram-stained vaginal smears were examined and Mycoplasma hominis and Gardnerella vaginalis were sought by culture.Results Initially, 87 (12%) women had bacterial vaginosis diagnosed on Gram-stained reading of the vaginal smears. Examination of further smears, obtained from 176 women at 36 weeks of gestation, showed that those whose vaginal flora was normal initially, and who went to term, rarely developed vaginosis (three of 127, 2.4%). Samples were obtained at 36 weeks gestation from 32 women who had bacterial vaginosis initially, and went to term. In almost 50% (15 of 32) of these a normal lactobacillus-dominated flora had regenerated. Thirty-five women (5%) had initial vaginal smears graded as intermediate. From this group, six of the 17 (35%) women from whom samples were obtained at 36 weeks gestation still had flora of an intermediate pattern; 10 (59%) now had normal flora and only one (6%) had developed bacterial vaginosis. Women with bacterial vaginosis were more likely to be culture-positive for M. hominis than those with normal flora (34/78 versus 10/563, odds ratio 42.73 (18.9 to 102.3) P 〈 0.001), or to be culture-positive for G. vaginalis than those with normal flora (35/78 versus 21/563, odds ratio 21.0 (10.75 to 41.2) P 〈 0.001).Conclusion Pregnant women do not commonly develop bacterial vaginosis after 16 weeks gestation, and if present, it remits spontaneously in approximately half of those who reach term. As bacterial vaginosis is associated with increased rates of second trimester miscarriage and preterm delivery, any treatment aimed at its eradication in pregnancy should be given no later than the beginning of the second trimester of pregnancy.
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 96 (1989), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. A double-blind, placebo-controlled, trial of leucocyte interferon showed that, contrary to previous reports, interferon had no significant effect on cervical intraepithelial neoplasia (CIN) when applied topically in a geld. DNA hybridization of cervical scrapes was used to monitor the effect of interferon on the human papillomaviruses (HPV) associated with CIN. There was, however, no significant difference in the expression of HPV 6 or 16 in the cervical epithelium of patients treated with interferon compared with those given a placebo. By using superficial cells scraped from the surface of the cervical epithelium as a source of DNA for viral studies, we were able to investigate the relation between HPV and CIN without interfering withthe natural history of the disease. HPV 16 was detected in lesions which persisted while HPV 6 only was detected in one lesion that regressed. Regression was clearly associated with reduction in the number of copies of viral DNA per cell in this case. Dual infection with HPV types 6 and 16 were recorded in two patients with persistent lesions. In one patient, hybridization studies indicated that infectionwith HPV 16 could have occurred after infection with type 6 was established, and it is postulated that this may have changed the nature of the cervical lesion.
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 89 (1982), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Attempts were made to isolate Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum from women with cervical intraepithelial neoplasia (CIN), from those with microinvasive or invasive cervical cancer, and from a control group of similar women with other gynaecological problems. C. trachomatis was found in a significantly greater proportion of women with CIN (8%) or cervical cancer (18%) than in the control group (1%), whereas M. hominis and U. urealyticum were approximately as common in each group. Histological examination of the cervix in cone biopsies or hysterectomy specimens from 26 women with CIN and from 39 women of similar age with no evidence of CIN showed lymphoid follicles, previously reported to be associated with chlamydial infection, in nine of the specimens with CIN, but in none of the specimens without CIN.
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  • 6
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Follicular cervicitis was recognised in 15 (44 per cent) of 34 women who were examined colposcopically and who were sexual partners of men with non-gonococcal urethritis. Valid results of culture for Chlamydia trachomatis were obtained in 26 cases: the organism was isolated from the cervix of five of 11 women in whom follicular cervicitis had been diagnosed, but from only one of 15 whose cervices did not have this change. A similar correlation was not found for infection with Mycoplasma hominis or Ureaplasma urealyticum.
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 99 (1992), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To estimate the prevalence of bacterial vaginosis in women referred to a gynaecology clinic, and to compare two methods of diagnosing bacterial vaginosis.Setting Gynaecology Clinic at Northwick Park HospitalSubjects 114 women aged 16 to 65 referred consecutively to the gynaecology clinic of one consultant.Main outcome measures Detection of bacterial vaginosis by standard compound criteria and by examination of a Gram stained smear of fluid from the posterior vaginal fornix.Results Bacterial vaginosis was detected by both the Gram stain and the compound criteria in 13 women. There was no correlation between the symptom of vaginal discharge and the diagnosis of bacterial vaginosis in this population, but the presence of discharge noted by the clinician was associated with bacterial vaginosis.Conclusions The prevalence of bacterial vaginosis was 11%. The Gram stain provides a simple and inexpensive method for laboratory confirmation of bacterial vaginosis where facilities for using the compound criteria are not available.
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  • 8
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 91 (1984), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. The role of Chlamydia trachomatis, genital mycoplasmas, Campylobacter spp. and other aerobic and anaerobic bacteria in the aetiology of spontaneous abortion was investigated prospectively in 241 pregnant women at a community hospital. Sixteen women who had threatened abortions were a little younger, of lower social class and had had more previous spontaneous abortions than the 76 women who aborted or the 149 women whose pregnancies were not complicated in the early stages by haemorrhage. The demographic characteristics of the latter two groups of women were similar. C.trachomatis was isolated from the cervix of only one woman and she had no genital-tract bleeding at any stage in her pregnancy. Mycoplasma hominis was isolated most often from the women who had threatened abortions but otherwise the prevalence of the other various micro-organisms was similar in women who had spontaneous abortions, threatened abortions, and in those who had pregnancies uncomplicated by vaginal bleeding. It was clear, therefore, that C.trachomatis played no role in the aetiology of spontaneous abortion in the population studied and there was no suggestion that any of the other micro-organisms were involved either.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 88 (1981), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The relation between maternal genital colonization by mycoplasmas and fetal growth was examined in a study of 195 women. Swabs were taken from the endo-cervix on three occasions during pregnancy and once post partum. Ureaplasma urealyticum organisms (ureaplasmas) were recovered from 42·7 per cent of Caucasian women and from 34·6 per cent of Asian women at their first antenatal visit. These Isolation rates remained similar throughout pregnancy, although there was a decrease in isolation after delivery. Mycoplasma hominis was recovered from 6·5 per cent of Caucasians and from 11·5 per cent of Asians at their first antenatal visit and these rates remained fairly constant during pregnancy and after delivery. Caucasian women colonized by ureaplasmas had a longer mean length of gestation (p 〈 0·025) than non-colonized women. Furthermore, the colonized women gave birth to infants who had a statistically significant greater mean birth weight and a greater mean birth weight-for-dates than those of the non-colonized Caucasians. There was no correlation between gestational length, birth weight, or birth weight-for-dates and genital colonization of Asian mothers by ureaplasmas or M. hominis. It is clear that ureaplasmas are not associated with low birth weight in our popu-lation.
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  • 10
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. The association between infection and preterm labour was studied in 72 women in spontaneous preterm labour between 26 and 34 weeks gestation and in 26 control subjects having an elective caesarean section at the same gestational age. The genital microbial flora of each group was studied comprehensively and included mycoplasmas, chlamydiae, ureaplasmas and anaerobes. Subsequent neonatal infection and chorioamnionitis was also studied. Abnormal bacterial colonization, the presence of ureaplasmas, heavy growth of mycoplasmas and chorioamnionitis were all found significantly more often in the study group. This supports the premise that a significant proportion of idiopathic preterm labour is associated with infection and this may permit better prediction and prevention of preterm birth. The continued use of tocolytics should depend upon the identification of the presence or absence of infection. Infection appeared to be the result rather than the cause of ruptured membranes. A recommendation with respect to the classification of abnormal or normal bacterial colonization between 26 and 34 weeks is suggested on the basis of strict criteria.
    Type of Medium: Electronic Resource
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