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LOWER GENITAL TRACT INFECTIONS AMONG PREGNANT WOMEN: A REVIEW
Abstract
Objectives: To determine the prevalence of lower genital tract infections, discuss briefly
common maternal foetal complications associated with them and assess the usefulness of
diagnostic algorithms in their management among pregnant women in the developing
countries.
Data source: Articles published in English language since 1987 were looked through
MEDLmE and OVID using key words supplemented by manual search in libraries except
when full text of a subject was accessible via internet.
Study selection: Originill and review articles addressing genital tract infections, associated
complications and diagnostic evaluation in pregnant women were included. Emphasis was
given to articles reportt~d from developing countries.
Data extraction: A total 3f thirty five articles were retrieved and reviewed for information on
the performance of diagnostic algorithms, prevalence rates and adverse maternal-foetal
effects of lower genital :ract infections in pregnancy.
Data synthesis: Lower genital tract infections are very common among apparently healthy
looking pregnant womell with an overall prevalence of 40-54%. Specific pathogens that were
isolated from the vagina and/or cervix of asymptomatic pregnant women include: C. albicans
(14-42%), T. vaginalis (1 1-20%), C. trachomatis (7-31 %),N. gonorrhoea (0.5-14%) and group
B streptococcus (4-25 % I. Untreated, genital tract infections in pregnant women may result
in: foetal loss, preterm labour, preterm birth, premature rupture of the membranes, low
birthweight, eye and lung damage in the newborn. Although the feasibility is good, the
performance of clinical :: lgorithms in the evaluation and management of lower genital tract
infections is worse in pregnant women and better results are achieved for vaginal infections
than cervical infections.
Conclusion: Routine screening for clinically important pathogens should be considered
during antenatal service. There is a need to develop simple, cheap and reliable laboratory
tests and better clinical a gorithms for the diagnosis of reproductive tract infections among
pregnant women.
common maternal foetal complications associated with them and assess the usefulness of
diagnostic algorithms in their management among pregnant women in the developing
countries.
Data source: Articles published in English language since 1987 were looked through
MEDLmE and OVID using key words supplemented by manual search in libraries except
when full text of a subject was accessible via internet.
Study selection: Originill and review articles addressing genital tract infections, associated
complications and diagnostic evaluation in pregnant women were included. Emphasis was
given to articles reportt~d from developing countries.
Data extraction: A total 3f thirty five articles were retrieved and reviewed for information on
the performance of diagnostic algorithms, prevalence rates and adverse maternal-foetal
effects of lower genital :ract infections in pregnancy.
Data synthesis: Lower genital tract infections are very common among apparently healthy
looking pregnant womell with an overall prevalence of 40-54%. Specific pathogens that were
isolated from the vagina and/or cervix of asymptomatic pregnant women include: C. albicans
(14-42%), T. vaginalis (1 1-20%), C. trachomatis (7-31 %),N. gonorrhoea (0.5-14%) and group
B streptococcus (4-25 % I. Untreated, genital tract infections in pregnant women may result
in: foetal loss, preterm labour, preterm birth, premature rupture of the membranes, low
birthweight, eye and lung damage in the newborn. Although the feasibility is good, the
performance of clinical :: lgorithms in the evaluation and management of lower genital tract
infections is worse in pregnant women and better results are achieved for vaginal infections
than cervical infections.
Conclusion: Routine screening for clinically important pathogens should be considered
during antenatal service. There is a need to develop simple, cheap and reliable laboratory
tests and better clinical a gorithms for the diagnosis of reproductive tract infections among
pregnant women.
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