Abordaje terapéutico de vaginosis bacteriana en gestantes y riesgo de parto prematuro.

Abstract

Introduction: Bacterial vaginosis has a high prevalence in women of childbearing age. In Ecuador, genitourinary infections are among the ten main causes of female morbidity and of these, vaginosis is associated with neonatal mortality in 5-12% of cases, representing a greater tendency in developing countries. Objective: To describe the therapeutic approach to bacterial vaginosis in pregnant women and the risk of preterm delivery. Methodology: Descriptive, documentary study based on the systematic collection and analysis of articles from journals annexed to scientific databases, for which priority was given to those with an updated therapeutic approach within the last 5 years. Conclusions: Gardnerella Vaginalis is a facultative anaerobic pathogen isolated in 85-95% of cases of bacterial vaginosis, therefore, the use of nitroimidazoles such as metronidazole is justified for its bactericidal effect, its oral administration is preferred over intravaginal treatment for its greater bacterial eradication effect at the level of the lower genital tract. Clindamycin is used as an alternative therapy in case of contraindication to metronidazole, the scarce evidence of the teratogenic effect of metronidazole provides safety for its administration during pregnancy. The use of oral probiotics with Lactobacillus strains demonstrated its efficacy and safety in preventing recurrences of bacterial vaginosis in non-pregnant women.