Infection and preterm delivery

Preterm delivery is defined as delivery before the 37th completed week of pregnancy, and in 1996in Scotland 84% of neonatal deaths of normally formed infants were associated with preterm delivery.1 The aetiology of preterm delivery is poorly understood, though recent evidence suggests that infection may be implicated in a substantial proportion of cases.2 The part that infection plays in the development of preterm labour or preterm, pre-labour rupture of membranes leading to preterm delivery has been the focus of much research in recent years. One element of this work has been the finding of a strong association between the presence of bacterial vaginosis and preterm delivery. Bacterial vaginosis is a common infection of the female genital tract, caused by heavy concentrations of a mixed group of organisms, including Gardnerella vaginalis , Mycoplasma hominis , and anaerobes including curved rods and Mobiluncus species. Many of these organisms are present in small numbers in the vagina normally. Symptomatic infection is characterised by a grey vaginal discharge with a …