Therapeutic Effect Of Metronidazole Combined With Vitamin C On Bacterial Vaginosis During Pregnancy

Objective:Bacterial vaginosis(BV)is a disease of vaginal flora.Normal vaginal lactobacilli as the dominant flora,when the high concentration of vaginal Gardnerella,a variety of anaerobic bacteria and Mycoplasma homologs to replace the main flora will occur when the disease.The incidence of BV during pregnancy is about 10% ‐50%,and the detection rate of BV in pregnancy is much higher than vaginal trichomoniasis and vaginal candidiasis,is the most common vaginal infection during pregnancy.The study found that BV and premature rupture of the membrane(PROM),premature delivery,chorioamnionitis,amniotic cavity infection,postpartum endometritis,fetal distress,neonatal intrauterine infection and other adverse outcomes The The traditional method of treatment of bacterial vaginosis during pregnancy is oral metronidazole treatment,this treatment has an unavoidable side effects,the most common complaint is the mouth of a special metal odor,but also headache dizziness,nausea and vomiting,lower abdominal pain And other discomfort.Patients with oral metronidazole during pregnancy is generally unacceptable,and oral metronidazole treatment can lead to secondary vaginal candidiasis,the incidence is 5% to 22%.There is a need for a safe,effective and highly responsive treatment.In this study,metronidazole vaginal drugs combined with vitamin C oral treatment of bacterial vaginosis,to observe the cure rate and maternal outcome changes.Methods: A retrospective analysis was conducted to find a total of 244 cases of gestational bacterial vaginosis in the outpatient department of the Second Affiliated Hospital of Dalian Medical University from February 2013 to June 2016.The average age(29 ± 3)years(26 ± 2)weeks;healthy pregnant women(56 cases,mean age 28 ± 2 years old,follow‐up from 28 weeks of gestation).The patients were divided into three groups: group A was treated with metronidazole vaginal drugs combined with vitamin C oral administration of 115 cases,the average age(30 ± 3)years,the average treatment of the first week of pregnancy(25 ± 6)weeks;Group B was treated with metronidazole vaginal drug 82 patients,the average age(27 ± 3)years,the average treatment of the first week of gestational age(26 ± 1)weeks,C group alone application of vitamin C oral 47 cases,the average age(29 ± 2)years old,the average treatment of the beginning of gestational age(26 ± 4)weeks;compare A,B,C three groups of cure rate.D group as the control group,56 healthy pregnant women(mean age 28 ± 2 years old,since 28 weeks of pregnancy follow‐up).The incidence of premature rupture of membranes,premature delivery,chorioamnionitis,amniotic cavity infection,postpartum endometritis,and the incidence of fetal distress and neonatal infection were statistically significant.Of the 300 patients,180 were selected under the following conditions.⑷ no history of abdominal surgery;⑸ found no other cesarean section indications,consistent with the vaginal trial production standards.Including 61 cases in group A,29 cases in group B,42 cases in group C and 48 cases in group D Comparison of four groups of patients with gestational age.All data were analyzed by SPSS 20.0 statistical software.The data were calculated by χ 2 test.The rank data were analyzed by rank sum test,P <0.05 was statistically significant.Results:1.The cure rate of group A was 92%,the cure rate of group B was 41%,and the cure rate of group C was 83%.The cure rate of group A,B and C was statistically different.The cure rate of group A was higher than that of group B,2.1The incidence of endometriosis in premature rupture of membranes,premature delivery,chorioamniositis,amniotic cavity infection and postpartum endometriosis was 7.83%,0.87%,0.00%,1.74% and 0.87%,respectively.The incidence of endometrial inflammation was 48.9%,10.64%,4.26%,8.51% and 6.38%,respectively.The incidence of premature rupture,premature delivery,chorioamniositis,amniotic cavity infection and postpartum endometritis were The incidence of amniotic inflammation,amniotic cavity infection and postpartum endometritis were 17.07%,2.44%,1.22%,2.44% and 1.22% respectively.Group D was treated with premature rupture of membranes,premature delivery,chorioamnionitis,amniotic fluid The incidence of endometrial infection was 5.36%,0.00%,0.00%,1.79% and 0.00% respectively.A group of premature rupture of membranes,premature delivery,chorioamnionitis,amniotic cavity infection,postpartum endometritis and other adverse pregnancy outcomes lower than B,C group.There was no significant difference between group A and group D in premature rupture of membranes,premature delivery,chorioamnionitis,amniotic cavity infection,postpartum endometritis and other adverse pregnancy outcomes.B and D,C and D in premature rupture of membranes,premature delivery,chorioamnionitis,amniotic cavity infection,postpartum endometritis and other adverse pregnancy outcomes were statistically significant2.2 The incidence of fetal distress and neonatal infection in group A was 9.57% and 2.61%,respectively.The incidence of fetal distress and neonatal infection in group B was 31.91% and 17.02%,respectively.Group C was significantly higher in fetal distress and neonatal infection Of the incidence were 25.61%,12.20%;D group in fetal distress,neonatal infection rates were 7.15%,1.19%.Group A in the fetal distress,the incidence of neonatal infection was lower than the B group,C group,and D group was no significant difference.There were significant differences in the incidence of fetal distress and neonatal infection between group B and group D,group C and group D.3.The proportion of weeks of gestation week was more than 39 weeks in group A was 52.46%;the gestational age in group B was 65.52% at 37‐38 weeks;the proportion of week of delivery in group C was 59.52% The gestational age of the group was 64.58% greater than 39 weeks.Four groups of gestational age were different,four groups of gestational weeks were statistically significant differences.Conclusion: 1.Metronidazole combined with vitamin C treatment of bacterial vaginosis cure rate was higher than the application of metronidazole vaginal drugs alone,higher than the oral vitamin C alone.2.Metronidazole combined with vitamin C treatment of bacterial vaginitis effectively improve premature rupture of membranes,premature delivery,chorioamnionitis,amniotic cavity infection,postpartum endometritis and other adverse pregnancy outcomes,but also improve fetal distress and neonatal infection And other neonatal adverse outcomes,the treatment of adverse pregnancy outcomes and neonatal adverse outcomes similar to healthy pregnant women.3.Application of metronidazole combined with vitamin C treatment of bacterial vaginosis compared with the application of metronidazole alone,the use of vitamin C alone weeks of gestational age.