Treatment Bacterial Vaginosis in Pregnancy

Initial infection: 7 days
Recurrent infection (confirm diagnosis):

10-14 days

Systemic rather than topical treatment is recommended in pregnancy, as vaginal treatment has not been shown to decrease the risk of adverse pregnancy outcomes

Testing should be repeated after 1 month to ensure that therapy was effective

Rescreening and re-treating may be advisable in women with high-risk pregnancies (i.e., previous preterm labour, delivery or preterm premature rupture of membranes)

Note: Evidence supports the safety and lack of teratogenicity of systemic metronidazole use in pregnancy

Note: It is important to note that clindamycin has been associated with increased risk of pseudomembranous colitis and should be used only when alternatives are not possible.

Clindamycin topical treatment has been associated with adverse outcomes in the newborn when used in pregnancy.