Bacterial vaginosis in pregnancy: Diagnosis and treatment practices of physicians in San Diego, California, 1999

Background: Treating symptomatic bacterial vaginosis (BV) early in pregnancy may decrease preterm birth (PTB). Understanding how physicians manage BV is important for the development of interventions. Goal. The goal was to determine the extent of knowledge and behaviors of physicians related to the diagnosis, treatment, and medical effects of BV in pregnant and nonpregnant patients. Study Design; This was a cross-sectional survey. Results: The study group consisted of 208 physicians who provided gynecologic care, including 102 (49%) who provided care to pregnant patients. Only 65% believed that there was a strong causal association between BV and PTB. Physicians who believed that BV causes PTB were much more likely to optimally manage vaginal infections (43% versus 7%). Only 12% of physicians prescribed oral metronidazole or clindamycin during the first trimester of pregnancy to treat BV. Conclusion: Physicians should be aware of the relation between symptomatic BV and PTB, seek a specific diagnosis for symptoms of vaginitis, use standard criteria to diagnose BV, and treat BV with effective regimens early in pregnancy.