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Prevention of Very Preterm Delivery by Testing for and Treatment of Bacterial Vaginosis

Phase 4
Completed
Conditions
Pregnancy
Interventions
Drug: Placebo
Registration Number
NCT00642980
Lead Sponsor
University Hospital, Lille
Brief Summary

Background. Anomalies of the vaginal flora (bacterial vaginosis, BV) are associated with an increased risk of late abortions and preterm birth. Studies of antibiotic treatment of BV to reduce the risk of prematurity have not found a statistically significant diminution of risk (\<= 32 wks: OR=0.49 \[0.05-5.1\], \< 37 wks: OR=0.83 \[0.59-1.17\]).A partial explanation of these findings is that some of these treatment were administered vaginally, most often during the second or third trimester

Aim: To reduce the frequency of late abortions and very preterm birth by prescribing clindamycin vs placebo to patients diagnosed with BV before 13 weeks.

Detailed Description

Patients diagnosed with BV before 13 weeks will be divided into two groups. They will be defined as at low risk when they have no history of spontaneous preterm delivery or late abortion. Women with such histories will be defined as at high risk.

Low risk patients will be asked to participate in a trial with 3 equal parallel groups, comparing two regimes of clindamycin (one or three 4-day treatments of clindamycin 300 mgx2/d) and placebo.

High-risk patients will be asked to participate in a trial with 2 parallel groups to assess the usefulness of repeating antibiotic treatment monthly by comparing the administration of one 4-day treatment of clindamycin (300 mgx2/d) to three 4-day treatments, one month apart.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
3105
Inclusion Criteria
  • Nugent score >= 7
  • pregnant women < 15 weeks (strictly)
  • signed informed consent
  • >=18 old
  • speaking and understanding French language
Exclusion Criteria
  • metrorrhagias during 7 days before
  • birth anticipated in an other area
  • clindamycin allergy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Clindamycin Cure 2ClindamycinArm 2
PlaceboPlaceboArm placebo
Clindamycin Cure 1ClindamycinArm 1
Primary Outcome Measures
NameTimeMethod
Premature delivery (16 to 32 weeks of gestation)At delivery
Secondary Outcome Measures
NameTimeMethod
Preterm labor, PPROM, Spontaneous preterm labor, PROM, Abruptio placentae, Chorioamnionitis, Fever > 38°C during labor, Post partum fever (> 38°), Post-partum wound infections, Perinatal death, NICU transfer, Bacterial neonatal colonisation.At delivery

Trial Locations

Locations (1)

Hopital Jeanne de Flandre

🇫🇷

Lille, France

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