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Preventing adverse sequelae of bacterial vaginosis: a public
health program and research agenda.
Sexually Transmitted Diseases 2001;28(5):292-297.
Koumans EH, Kendrick JS; CDC Bacterial Vaginosis Working Group.
Abstract
BACKGROUND: The cause of bacterial vaginosis remains poorly understood. Recent
evidence strengthens the association between bacterial vaginosis and serious
medical complications. GOAL: To review the evidence linking bacterial vaginosis
with adverse pregnancy outcomes, complications after gynecologic procedures,
and HIV infection, and to identify prevention strategies. METHODS: In March
1999, the Centers for Disease Control and Prevention organized a conference
to accomplish this goal. RESULTS: Better understanding is needed concerning
the etiology, epidemiology, and natural history of bacterial vaginosis. More
efficacious treatment of bacterial vaginosis and strategies to reduce maternal
complications associated with bacterial vaginosis, such as premature rupture
of the fetal membranes, chorioamnionitis, premature labor and delivery, postdelivery
endometritis, and postpartum infant complications should be developed. Recent
evidence shows that screening and treatment of bacterial vaginosis before
abortion reduces postabortion pelvic inflammatory disease, and that anaerobic
coverage during hysterectomy reduces postoperative complications. Better
understanding concerning the relation of bacterial vaginosis to acquisition
of sexually transmitted diseases and HIV infection are needed as well as
possible prevention strategies. CONCLUSIONS: A national prevention effort
should be guided by the results of research that addresses current knowledge
gaps.