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Interventions for trichomoniasis in pregnancyGülmezoglu AM
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SummaryInterventions for trichomoniasis in pregnancyMetronidazole is effective against a trichomoniasis infection during pregnancy, but may increase the risk of preterm and low birthweight babies. Trichomoniasis is a very common sexually transmitted infection. Symptoms include vaginal itching and discharge. It is not clear if pregnant women with trichomoniasis are more likely to give birth preterm, or have other pregnancy complications. The review of trials found that the drug metronidazole is effective against trichomoniasis when taken by women and their partners during pregnancy, but it may harm the baby. Of the two clinical trials reviewed, one was stopped early because women taking metronidazole were more likely to give birth preterm and have low-birthweight babies. Further research into trichomoniasis treatments for pregnant women is needed.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
April 22. 1996 AbstractBackgroundVaginitis due to Trichomonas vaginalis is one of the most common of sexually transmitted diseases. Trichomoniasis affects women during pregnancy as well but it is not clearly established whether it causes preterm birth and other pregnancy complications. ObjectivesThe objective of this review was to assess the effects of various treatments for trichomoniasis during pregnancy. Search strategyWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 January 2004). We updated this search on 1 October 2009 and added the results to the awaiting classification section. Selection criteriaRandomized trials comparing antitrichomonas agents during pregnancy. Trials including symptomatic or asymptomatic women with trichomoniasis were eligible. Data collection and analysisEligibility and trial quality was assessed by one reviewer. Main resultsTwo trials with 842 pregnant women were included. In both trials around 90% of women were cleared of trichomonas in the vagina after treatment. In the US trial women with asymptomatic trichomoniasis between 16 to 23 weeks were treated with metronidazole on two occasions at least two weeks apart. The trial was stopped before reaching its target recruitment because metronidazole was not effective in reducing preterm birth and there was a likelihood of harm (relative risk: 1.8; 95% confidence interval: 1.2 to 2.7). The South African trial recruited women later in pregnancy and did not have the design and power to address adverse clinical outcomes. Authors' conclusionsMetronidazole, given as a single dose, is likely to provide parasitological cure for trichomoniasis, but it is not known whether this treatment will have any effect on pregnancy outcomes. The cure rate could probably be higher if more partners used the treatment. [Note: The citation in the awaiting classification section of the review may alter the conclusions of the review once assessed.] |