Bacterial vaginosis in pregnancy: current findings and future directions.

Bacterial vaginosis (BV) is an extremely prevalent vaginal condition and the number one cause of vaginitis among both pregnant and nonpregnant women (1). Although it is not a reportable disease, current studies have found the prevalence of BV among nonpregnant women to range from 15 percent to 30 percent; up to 50 percent of pregnant women have been found to have BV (2–5). However, the majority of cases of BV are asymptomatic and remain unreported and untreated (3, 6). Previously considered a benign condition, BV has been related to many gynecologic conditions and complications of pregnancy including pelvic inflammatory disease, posthysterectomy vaginal cuff cellulitis, endometritis, amniotic fluid infection, preterm delivery, preterm labor, premature rupture of the membranes, and, possibly, spontaneous abortion (7–12). The role of asymptomatic, compared with symptomatic, BV in both gynecologic and pregnancyrelated conditions has been less studied, although research emphasis is shifting toward determining these independent relations. In laboratory and clinical studies, BV has been shown to ascend to the endometrium and invade the placenta, but the complete impact of this migration in terms of initial and sustained placental development and early fetal development is unclear (13). The purposes of this article is to review the background, diagnosis, and treatment of BV in pregnancy; discuss the epidemiology and consequences of BV in pregnancy; and outline current research findings and future research directions focusing exclusively on the consequences of BV in pregnancy.