Lower genital tract infections between 18 and 24 weeks of pregnancy and its association with adverse pregnancy outcome.

Introduction: Lower genital tract infection (LGTI) is common among apparently healthy-looking pregnant women, and its overall prevalence is 40%-54%. LGTI is strongly associated with major adverse pregnancy outcomes such as spontaneous preterm delivery (SPTD), premature rupture of membranes (PROM), and neonatal morbidities.

Materials and methods: A prospective cohort study was performed in a tertiary care hospital in Gujarat with the objective of finding out the presence of LGTI in the second trimester and looking for its association with various adverse pregnancy outcomes. Two hundred and fifty pregnant women were screened for the presence of vaginal discharge. Various microbiological examinations were done. Diagnosis of specific LGTI was made based on the predecided criteria. Patients were followed up till delivery and maternal and neonatal outcomes were recorded. Data were compared to find out a possible association between LGTI and various adverse pregnancy outcomes such as SPTD, PROM, and neonatal deaths.

Results: Out of 194 LGTI cases diagnosed, 54% were having bacterial vaginosis (BV), while 3% were diagnosed having trichomonas. While observing an association of LGTIs and adverse pregnancy outcomes, a maximum number of PROM were observed in the BV and beta Streptococcus infections group. Neonatal admissions were required in 60% of cases. Intrauterine fetal deaths and neonatal deaths were observed in only laboratory-positive cases mainly associated with beta Streptococcus infection and trichomonas.

Conclusion: In this study, the most common LGTI prevalent in pregnant women was BV and the least common was trichomoniasis. There was a significant positive association present between LGTIs and adverse pregnancy outcomes such as SPTD and PROM.