Bacterial vaginosis in pregnancy: diagnosis and treatment practices of physicians in San Diego, California, 1999

Abstract

Background: Treating symptomatic bacterial vaginosis (BV) early in pregnancy may decrease preterm birth (PTB). Understanding how physicians manage BV is important for the development of interventions.

Goal: The goal was to determine the extent of knowledge and behaviors of physicians related to the diagnosis, treatment, and medical effects of BV in pregnant and nonpregnant patients.

Study design: This was a cross-sectional survey.

Results: The study group consisted of 208 physicians who provided gynecologic care, including 102 (49%) who provided care to pregnant patients. Only 65% believed that there was a strong causal association between BV and PTB. Physicians who believed that BV causes PTB were much more likely to optimally manage vaginal infections (43% versus 7%). Only 12% of physicians prescribed oral metronidazole or clindamycin during the first trimester of pregnancy to treat BV.

Conclusion: Physicians should be aware of the relation between symptomatic BV and PTB, seek a specific diagnosis for symptoms of vaginitis, use standard criteria to diagnose BV, and treat BV with effective regimens early in pregnancy.