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Bacterial vaginosis in pregnancy: diagnosis and treatment practices
of physicians in San Diego, California, 1999.
Sexually Transmitted Diseases 2003; 30(8):645-649.
Callahan DB, Weinberg M, Gunn RA.
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.