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Clindamycin vaginal cream reduces the risk of preterm delivery in pregnant women with bacterial vaginosis

According to most experts, violations of the microflora of the genital tract in pregnant women increase the risk of premature birth. Results of a recently completed study, published in the February issue of Obstetrics and Gynecology, showed that using vaginal cream with clindamycin for several days in early pregnancy significantly reduces frequency of this undesirable result in women with bacterial vaginosis.

This conclusion is based on the results of a study by Dr. RF Lamont and his colleagues at Saint Mark's Hospital in London, which examined 409 pregnant women with altered microflora of the genital tract (for example, anaerobes Gardnerella vaginalis and Mycoplasma hominis were found in smears). However, not all of the women examined were diagnosed with sexually transmitted infections caused by Neisseria gonorrhoeae and Chlamydia trachomatis.

All pregnant women were randomized into two groups, one of which received a placebo, and the second was treated with a 2% vaginal cream with clindamycin for 3 days from 13 to 20 weeks of gestation. If, after a follow-up examination after 3 weeks, G.vaginalis or M.hominis remained in the swabs of the genital tract, the patients were prescribed repeated treatment of 7 days with the drug studied (vaginal cream with clindamycin vs placebo) depending on the results of the randomization.

According to the researchers, the frequency of premature births in the group of patients receiving treatment with vaginal cream with clindamycin was 4%, which was significantly lower than that of the placebo group - 10% (p less than 0.03). In addition, scientists confirmed earlier data that babies born prematurely needed treatment more often than babies born full-term in the neonatal intensive care unit (p less than 0.001).

The authors argue that the use of vaginal cream with clindamycin can reduce the risk of preterm delivery by 60% in pregnant women with altered genital tract microflora. At the same time, it should be emphasized that the greatest effectiveness of treatment is obtained during treatment in early pregnancy, since the probability of penetration of microorganisms through the cervical canal and the occurrence of an inflammatory response, which can be a trigger for childbirth, are reduced.