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Interventions for trichomoniasis in pregnancy.

A M Gülmezoglu¹

¹UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and, Research Training in Human Reproduction (HRP), World Health Organization, Geneva 27, Switzerland. gulmezoglum@who.ch

The Cochrane Database of Systematic Reviews

|July 26, 2002

Summary

Metronidazole effectively treats vaginal trichomoniasis in pregnant women, but evidence does not support its use for preventing preterm birth. Further research is needed on pregnancy outcomes with trichomoniasis treatment.

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Area of Science:

Obstetrics and Gynecology
Infectious Diseases
Clinical Trials

Background:

Trichomoniasis, a common sexually transmitted infection, affects pregnant women.
The impact of trichomoniasis on pregnancy complications like preterm birth remains unclear.

Purpose of the Study:

To review the efficacy of various treatments for trichomoniasis during pregnancy.
To assess the impact of these treatments on pregnancy outcomes.

Main Methods:

A systematic review of randomized controlled trials was conducted.
Searched the Cochrane Pregnancy and Childbirth Group trials register (March 2002).
Included trials comparing antitrichomonas agents in symptomatic or asymptomatic pregnant women.

Main Results:

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Two trials involving 842 pregnant women were analyzed.
Metronidazole treatment achieved a high cure rate (around 90%) for vaginal trichomoniasis.
One trial indicated metronidazole did not reduce preterm birth and showed a potential increased risk (RR 1.8; 95% CI 1.2 to 2.7).

Conclusions:

Single-dose metronidazole likely cures trichomoniasis but its effect on pregnancy outcomes is unknown.
Treatment of male partners may improve cure rates.
Current evidence does not support metronidazole for preventing preterm birth in pregnant women.