Abstract
Objectives: Vaginal and endocervical infections are considered a global health problem, especially after recent evidence of their association with preterm delivery and other adverse obstetric outcomes. Still, there is no consensus on the efficacy of a screening strategy for these infections in the first trimester of pregnancy. This study evaluated their prevalence and whether screening and treatment resulted as effective in reducing pregnancy and perinatal complications. Methods: A single-center prospective observational study was designed; a sample size of 400 first-trimester pregnant women was established and they were recruited between March 2016–October 2019 at the Puerta de Hierro University Hospital (Spain). They were screened for vaginal and endocervical infections and treated in case of abnormal flora. Pregnancy and delivery outcomes were compared between abnormal and normal flora groups by univariate analysis. Results: 109 patients had an abnormal flora result (27.2%). The most frequently detected infection was Ureaplasma urealyticum (12.3%), followed by Candida spp. (11.8%), bacterial vaginosis (5%), Mycoplasma hominis (1.2%) and Trichomonas vaginalis (0.8%). Patients with abnormal flora had a 5-fold increased risk of preterm premature rupture of membranes (5.3% vs. 1.1% of patients with normal flora, Odds Ratio 5.11, 95% Confidence Interval 1.20–21.71, p = 0.028). No significant differences were observed regarding preterm delivery or neonatal morbidity. Conclusions: Considering the morbimortality related to prematurity and that the results of our study suggest that the early treatment of abnormal flora could improve perinatal outcomes, the implementation of a screening program during the first trimester should be considered.
Highlights
From the total of the samples analyzed, we identified 100 patients with abnormal flora (Nugent score between 7 and 10 or another pathogen detected in the cultures) and 9 patients
21 patients; in all these cases, Ureaplasma urealyticum was present since it is a bacterium that characteristically displaces the rest of the usualSmears vaginal microbiota, favoring appearance
Total Percentage of Type of Flora tected in 21 patients;Number in all these cases, Ureaplasma urealyticum was present since it is a bacterium that characteristically displaces the rest of the usual vaginal microbiota, favor2.2 flora)
Summary
In 2005, the Institute of Medicine (IOM) estimated the cost of medical care for children born prematurely up to the age of 5 at $26 billion per year. This amount was underestimated because indirect costs were not included, such as the expenses that the families had to assume for hiring caregivers, transportation or home adaptations and the loss of income due to the fact that a parent in many cases was temporarily unavailable to return to work and the difficulty of employment in the case of premature children with disabilities [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
