Bacterial vaginosis and miscarriage

PURPOSE OF REVIEWThis review aims to summarize current knowledge about the relationship between bacterial vaginosis and miscarriage. RECENT FINDINGSStudies investigating the relationship between bacterial vaginosis and infertility, implantation and early pregnancy loss have produced conflicting results. One study demonstrated a beneficial effect of colonization with hydrogen peroxide producing lactobacilli. A community based study found no association between bacterial vaginosis and first trimester loss, but a positive association with early second trimester loss. In a randomized controlled trial, treatment of bacterial vaginosis with oral clindamycin was associated with a fivefold reduction in the incidence of late miscarriage. SUMMARYThe relationship between bacterial vaginosis and infertility and first trimester loss needs further elucidation. Measures to support a healthy lactobacillus flora such as probiotic therapy warrant study. The randomized controlled trials of clindamycin treatment need to be replicated in different settings.