Screening and management of Bacterial Vaginosis in pregnancy (Replaces #14 (Mar 1997))
211 - Published August 2008
Disclaimer: This guideline was peer reviewed by the SOGC’s Infectious Disease Committee and/or principal author(s) in March, 2015, and has been reaffirmed for continued use until further notice.
Objective: To review the evidence and provide recommendations on
screening for and management of bacterial vaginosis in
Options: The clinical practice options considered in formulating the
Outcomes: Outcomes evaluated include antibiotic treatment efficacy
and cure rates, and the influence of the treatment of bacterial
vaginosis on the rates of adverse pregnancy outcomes such as
preterm labour and delivery and preterm premature rupture of
Evidence: Medline, EMBASE, CINAHL, and Cochrane databases
were searched for articles, published in English before the end of
June 2007 on the topic of bacterial vaginosis in pregnancy.
Values: The evidence obtained was rated using the criteria
developed by the Canadian Task Force on Preventive Health
Benefits, Harms, and Costs: Guideline implementation will assist
the practitioner in developing an approach to the diagnosis and
treatment of bacterial vaginosis in pregnant women. Patients will
benefit from appropriate management of this condition.
Validation: These guidelines have been prepared by the Infectious
Diseases Committee of the SOGC, and approved by the
Executive and Council of the SOGC.
Sponsors: The Society of Obstetricians and Gynaecologists of
There is currently no consensus as to whether to screen for or
treat bacterial vaginosis in the general pregnant population in
order to prevent adverse outcomes, such as preterm birth.
1. In symptomatic pregnant women, testing for and treatment of
bacterial vaginosis is recommended for symptom resolution.
Diagnostic criteria are the same for pregnant and non-pregnant
2. Treatment with either oral or vaginal antibiotics is acceptable for
achieving a cure in pregnant women with symptomatic bacterial
vaginosis who are at low risk of adverse obstetric outcomes. (I-A)
3. Asymptomatic women and women without identified risk factors for
preterm birth should not undergo routine screening for or
treatment of bacterial vaginosis. (I-B)
4. Women at increased risk for preterm birth may benefit from routine
screening for and treatment of bacterial vaginosis. (I-B)
5. If treatment for the prevention of adverse pregnancy outcomes is
undertaken, it should be with metronidazole 500 mg orally twice
daily for seven days or clindamycin 300 mg orally twice daily for
seven days. Topical (vaginal) therapy is not recommended for this
6. Testing should be repeated one month after treatment to ensure
that cure was achieved. (III-L)