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The use of metronidazole for the prevention of preterm labor in women with asymptomatic Trichomonas infection

Infections caused by Trichomonas vaginalis during pregnancy lead to premature birth. It is not yet known whether the risk of premature birth is reduced after treatment for asymptomatic trichomoniasis in pregnant women.

American scientists from 15 obstetrics and gynecology centers screened pregnant women for the presence of trichomoniasis (detection of Trichomonas vaginalis in vaginal secretion). Trichomonas were found in 617 women with a gestational age of 16 to 23 weeks. In all patients, the infection was asymptomatic. The women were randomized into 2 groups: the first received metronidazole 2 g x 2 times (320 women) (the second dose was prescribed after 48 hours), the second (297 patients) received a placebo. Treatment of this type has been prescribed for women (two doses of metronidazole with an interval of 48 hours) with a gestational age of 24 and 29 weeks. The main measure of effectiveness was delivery before 37 weeks of gestation.

At the end of treatment, a culture study was conducted in 269 women in the metronidazole group and 260 patients in the placebo group. Study results were negative in 249 of 269 women (92.6%) who received metronidazole and in 92 of 260 patients in the placebo group (35.4%).

Duration and nature of work were available for 315 patients in the metronidazole group and 289 women for placebo. Premature delivery (up to 37 weeks gestation) occurred in 60 women in the metronidazole group (19%) and in 31 patients (10.7%) in the placebo group, p = 0.004.

Thus, treatment with metronidazole of asymptomatic forms of trichomoniasis in pregnant women does not prevent premature birth, therefore, examination and routine treatment of pregnant women with this pathology are not recommended.