Bacterial Vaginosis In Pregnancy
If you develop bacterial vaginosis in pregnancy, theres a small chance of complications, such as premature birth or miscarriage.
But BV causes no problems in the majority of pregnancies.
Speak to a GP or your midwife if youre pregnant and your vaginal discharge changes.
Page last reviewed: 22 November 2018 Next review due: 22 November 2021
Should You Treat Toothache During Pregnancy
Most pregnant women are worried about having their teeth treated during pregnancy. However, doctors and dentists still recommend having any dental problems treated during pregnancy, with some precautions using x-rays and taking medication for toothache pain relief.
- X-Rays During Pregnancy
Many women are concerned about getting any kind of x-ray during pregnancyeven dental x-rays. If you have a toothache during pregnancy, the dentist will try to take care of the problem without doing x-rays if this is possible. If it is necessary to do x-rays to take care of the problem, the dentist will ask you to wear a lead apron and a lead covering over your thyroid gland so that the x-rays do not get to these areas. The x-rays can then be safely done and the dentist will have more information available to help treat your dental problem.
- Medications During Pregnancy
There are a variety of medications available for toothache pain, some of which are not appropriate to be used in pregnancy. For example, research has indicated that taking Percocet or oxycodone during pregnancy can result in unwanted birth defects. Because of issues like this, it is important to tell the dentist that you are pregnant so that safe medications in pregnancy, such as acetaminophen can be used instead. Antibiotics may also be required. Some antibiotics, like penicillin, are safe to take in pregnancy and will be prescribed for you for the management of infections that need antibiotics during pregnancy.
Management Of Sex Partners
Data from earlier clinical trials indicate that a womans response to therapy and the likelihood of relapse or recurrence are not affected by treatment of her sex partner . Therefore, routine treatment of sex partners is not recommended. However, a pilot study reported that male partner treatment of women with recurrent BV had an immediate and sustained effect on the composition of the vaginal microbiota, with an overall decrease in bacterial diversity at day 28 . Male partner treatment also had an immediate effect on the composition of the penile microbiota however, this was not as pronounced at day 28, compared with that among women. A phase 3 multicenter randomized double-blinded trial evaluating the efficacy of a 7-day oral metronidazole regimen versus placebo for treatment of male sex partners of women with recurrent BV did not find that male partner treatment reduced BV recurrence in female partners, although women whose male partners adhered to multidose metronidazole were less likely to experience treatment failure .
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How Is Bacterial Vaginosis Treated
Your doctor may prescribe the following antibiotics:
- metronidazole, such as Flagyl and Metrogel-Vaginal, which can be taken orally
- tinidazole, such as Tindamax, which is another type of oral medication
These medications are usually effective in treating BV. They all have similar side effects, with the exception of metronidazole. This particular medication may cause severe nausea, vomiting, and headaches when taken with alcohol. Make sure to speak with your doctor if you have concerns about any of the possible side effects.
Once treatment is received, BV usually clears up within two to three days. However, treatment usually continues for at least one week. Dont stop taking your medications until your doctor tells you to do so. Its important to take the full course of antibiotics to prevent the infection from coming back. You may need long-term treatment if your symptoms persist or continue to come back.
How Can I Prevent A Yeast Infection Or Recurring Yeast Infections
Most yeast infections can usually be avoided by doing the following:
- Wear loose, breathable cotton clothing and cotton underwear.
- After regular, thorough washing , use your blow dryer on a low, cool setting to help dry the outside of your genital area.
- Always wipe from front to back after using the restroom.
- Shower immediately after you swim. Change out of your swimsuit, workout clothes, or other damp clothes as soon as possible.
- use sanitary pads and tampons that contain deodorant
- take a bubble bath/use scented soaps
- use colored or perfumed toilet paper
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Lactoferrin Treatment In Women With Bacterial And Yeast Vaginal Diseases
Even if the use of prebiotics for the treatment of vaginal infections has been investigated less than probiotics, the data available in the literature have highlighted prebiotic therapeutic potential. As far as lactoferrin is concerned , it has been reported that its oral and vaginal administration in women refractory to conventional treatment for vaginosis and with a history of late miscarriages and preterm delivery due to refractory vaginitis and chorioamnionitis resulted in a significant improvement of the vaginal bacterial flora.
How To Treat Gum Disease Naturally During Pregnancy
The good news is gum disease can be identified and treated early by consistently exercising a couple of at-home grooming habits or oral care practices.
- Brushing and Flossing Theres a reason the dentist always encourages us to brush and floss daily. Good brushing and flossing habits can rid the gums and mouth of bacteria, reducing or reversing the inflammation of gingivitis.
- Vitamin C If you want help battling the bacteria thats building up in your mouth, try eating more fruits. Vitamin C can help combat gingivitis.
- Vitamin A Another vitamin to add to your toolbox to fight gum disease is Vitamin A, which is essential in helping bones and teeth grow. Pay attention to the upper limits of Vitamin A.
- Sea Salt Gargling with sea salt might help reduce the inflammation of gingivitis as you work to heal your gums.
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How Can This Affect My Pregnancy
The U.S. Centers for Disease Control and Prevention estimates that 1 million pregnant women get BV each year. Pregnant women are at increased risk for BV because of hormone changes that happen during pregnancy. Hormones are chemicals made by the body.
If you have BV during pregnancy, your baby is at increased risk for premature birth and low birthweight. Premature birth is birth before 37 weeks of pregnancy. Low birthweight is when your baby is born weighing less than 5 pounds, 8 ounces. Being born too early or too small can cause health problems for your baby.
BV also can cause pelvic inflammatory diseases . PID is an infection in the uterus that can increase your risk for infertility .
What Are Effective Treatments Of Bacterial Vaginosis
Some antibiotics that have been effective in treating bacterial vaginosisinclude metronidazole , clindamycin , and tinidazole . Taking the medication in pill form can cause minor side effects, but this is considered to be the most effective treatment.
Many women who receive treatment for bacterial vaginosis will have recurrent symptoms and require another course of antibiotic therapy. It is not understood why this happens, but symptoms recur in over half of women within the year following treatment.
Your doctor can help you decide which treatment is right for you.
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Anesthesia And Pain Medicine During Pregnancy
The next common question expectant mothers ask regarding root canal treatment and pregnancy is about the safety of anesthesia and pain medication.
Thankfully, the American Dental Association says that local anesthesia does not pose a risk to a developing fetus. They recommend local anesthetics with epinephrine such as Bupivacaine, Lidocaine, and Mepivacaine.
The American Pregnancy Association recommends using as little anesthesia as possible, but still using enough to provide a comfortable level of pain relief.
Also, dental procedures like a root canal may require the use of antibiotics to prevent or treat an active infection. If that applies to your case, your dental professional will follow the current standard regarding which specific antibiotics are appropriate and their correct dosage. Most antibiotics like Amoxicillin are perfectly fine to use during pregnancy, but be sure to carefully follow each instruction to a T and reach out to the provider if any questions arise.
In more severe instances, patients may prefer to utilize pain management for a few days after their root canal therapy. While pregnant, ibuprofen and Advil must be avoided. You will want to stick with acetaminophen based medications like Tylenol. Be sure to discuss this with your dental professional since the correct dosage and medication vary depending on how far along you are, as well as individual concerns.
What Happens If I Take An Unsafe Antibiotic Before I Realize Im Pregnant
Sometimes you might not realize youre pregnant until further along into your pregnancy. In this case, its possible to have taken an unsafe antibiotic. As discussed above, unsafe antibiotics may have a higher chance of certain birth defects.
But its important to point out that about 1 out of every 33 babies born in the U.S. have some type of birth defect. Only a small portion of those are caused by medication use.
Untreated infections can cause birth defects as well. In some cases, they can be life-threatening or raise your risk of miscarriage. Treating an infection helps lower your risk of complications.
If you mistakenly took an unsafe antibiotic, contact your healthcare provider right away. You can talk with your healthcare provider about the concerns you have. They may recommend an ultrasound to look for any problems so you can make a plan together. Or, they might recommend supplementation with certain vitamins to lower the risk of complications.
If youre unable to reach your healthcare provider, you can visit the MotherToBaby website or call them toll-free at 1-866-626-6847. There, you can ask questions to an expert who specializes in medication use during pregnancy. They also have text, email, and live chat contact options.
Can We Do Everything And At Any Time
It depends on your pregnancy stage and the kind of intervention you will need to have.
During the first trimester of pregnancy, the risk of miscarriage is higher. It is better to do only emergency procedures: treat a cavity, an infection, In short, act only to reduce stress, pain, and control potential infectious risks.
Between the 3rd and 6th month, there are many things you can do, including treatment to control infectious or painful pathologies that are progressing or likely to progress. Then you need to do an assessment to see if it is better to wait until after delivery for more complex interventions.
At the end of pregnancy, as in the beginning, only emergency treatments that provide relief are performed. Women feel discomfort due to weight gain, their movements are limited, and the risk of childbirth increases as the term approaches.
The second trimester is therefore considered the safest and most recommended time to receive dental treatment.
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Is It Safe To Go For A Tooth Extraction
Extracting a problematic tooth is always a safe option, especially in the case of cavities. Because sometimes, decay can spread over the adjacent tooth due to angulation.
In addition, there is a good chance that food particles will clog between gum and tooth. But the situation is so different because your babys health is much more important right now.
Doctors recommend waiting until the 3rd month to start because 3 to 6 months is the safest time to have a dental procedure. If an x-ray is taken, make sure you are protected by a lead apron during exposure.
If there is no emergency, then it is a good idea to wait until you have delivered. But make sure you maintain excellent oral hygiene to prevent food from becoming clogged, as mentioned above.
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How Is Bacterial Vaginosis Treated During Pregnancy
Even if BV symptoms are mild, its essential to seek treatment to prevent complications. During pregnancy, BV is typically treated with one of the following antibiotics:
- Clindacin, Cleocin, Clindesse
Your healthcare provider may prescribe pills to be taken by mouth or a gel or cream inserted intravaginally . Antibiotic treatment for BV is usually prescribed for five to seven days. Its best to abstain from sexual contact until the end of treatment and your symptoms have resolved.
Bacterial Vaginosis Vs Yeast Infection Symptoms
Both these forms of vaginitis are typically accompanied by vaginal itching, burning sensations and discomfort, with a few key differences in symptoms. There is one typical, major difference between symptoms of a yeast infection vs BV: discharge color. Beyond that, the other key difference is the odor.
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What Is Bacterial Vaginosis
BV is not a sexually transmitted infection , but it is common in sexually active women and it rarely happens to women who havent had sex. An STI is an infection you can get from having unprotected sex or intimate physical contact with someone who is infected. If you have BV thats not treated, it can increase your risk of getting an STI. Its important to have any infection treated during pregnancy to help protect you and your baby.
Breastfeeding During Maternal Oral Therapy
Metronidazole is secreted in breast milk however, breastfed infants receive it in lower doses than those used to treat infant infections. Although several studies identified no evidence of metronidazole-associated adverse effects in breastfed infants, certain clinicians recommend deferring breastfeeding for 12-24 hours after maternal treatment with a single 2 g dose of metronidazole. Lower doses, however, produce a lower concentration in breast milk and are considered compatible with breastfeeding.1
1. Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021 70:1187. DOI: .
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Will I Be Screened For Bv If I Dont Have Symptoms
If youre at low risk for premature delivery
If you dont have symptoms and are at low risk for giving birth prematurely, you wont be screened for BV.
Although women with BV may be more likely to have a preterm delivery and antibiotics can clear up the infection most of the time, almost all research to date shows that treating symptom-free cases of BV in women who havent had a previous preterm delivery doesnt lower their chances of delivering early.
For this reason, the U.S. Preventive Services Task Force , the Centers for Disease Control and Prevention , the American College of Obstetricians and Gynecologists , the American Academy of Family Physicians , and a number of other experts agree for now that screening isnt worthwhile for this group of women.
If youre at high risk for premature delivery
If you dont have symptoms of BV but are at high risk for preterm delivery, your caregiver may or may not screen you at your first prenatal visit. Experts debate whether its beneficial to do so because the evidence is conflicting.
In a 2020 statement, the USPSTF concluded, the current evidence is insufficient to assess the balance of benefits and harms of screening for bacterial vaginosis in pregnant persons at increased risk for preterm delivery. There are some specialists, though, who recommend screening for certain high-risk women. Everyone agrees that more research is needed in this area.
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Characteristics Of Excluded Studies
Any antibiotic versus placebo/no treatment
|Outcome or subgroup title|
|1 Failure of test of cure||10||Peto Odds Ratio||0.17|
|Peto Odds Ratio||0.67|
|Peto Odds Ratio||0.96|
|4 Incidence of preterm prelabour rupture of membranes||4||Peto Odds Ratio||1.10|
|Peto Odds Ratio||1.10|
|Peto Odds Ratio||Not estimable|
|5 Preterm birth < 37 weeks||12||Peto Odds Ratio||0.91|
|Peto Odds Ratio||1.06|
|Peto Odds Ratio||0.78|
|5.3 Intermediate flora and bacterial vaginosis||2||Peto Odds Ratio||0.51|
|6 Preterm birth < 34 weeks||4||Peto Odds Ratio||1.22|
|Peto Odds Ratio||0.95|
|Peto Odds Ratio||1.45|
|7 Preterm birth < 32 weeks||4||Peto Odds Ratio||1.14|
|Peto Odds Ratio||1.08|
|7.2 Intermediate flora and bacterial vaginosis||1||Peto Odds Ratio||1.49|
|8 Incidence of low birthweight||7||Peto Odds Ratio||0.95|
|Peto Odds Ratio||1.00|
|Peto Odds Ratio||0.33|
|8.3 Intermediate flora and bacterial vaginosis||2||Peto Odds Ratio||0.95|
|Peto Odds Ratio||1.40|
|10 Side-effects sufficient to stop treatment||3||Peto Odds Ratio||1.57|
|11 Side-effects not sufficient to stop treatment||3||Peto Odds Ratio||1.33|
|Peto Odds Ratio||0.96|
|13 Admission to neonatal unit||2||Peto Odds Ratio||1.11|
Oral antibiotics versus placebo/no treatment
Vaginal antibiotics versus placebo/no treatment
Previous preterm delivery: antibiotics versus placebo/no treatment
Single daily dose versus double daily dose vaginal antibiotic
|Outcome or subgroup title|
|Peto Odds Ratio||3.08|
|2 Preterm delivery < 37 weeks||1||Peto Odds Ratio||0.40|
|3 Incidence of low birthweight||1||Peto Odds Ratio||1.25|
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