细菌性阴道病的诊断及治疗

目的：了解细菌性阴道病在妇科门诊的人群患病率及探讨治疗方法。方法：１９９５年６－８月对３５９４例妇科门诊病人按ＢＶ诊断之四项标准进行了白带化验；ＢＶ患者给予替硝唑夫妻同治；二周后追踪复查白带。结果：ＢＶ在妇科门诊的患病率为４．９５％，１７８例ＢＶ患者中约３７．５％无明显白带增多症状，而以不孕，腹痛，阴道流血或流产前，产后常规检查时发现。     

细菌性阴道病的诊断及治疗(附3594例白带检验报告)

目的：了解细菌性阴道病在妇科门诊的人群患病率及探讨治疗方法。方法：１９９５年６～８月对３５９４例妇科门诊病人按ＢＶ诊断之四项标准进行了白带化验；ＢＶ患者给予替硝唑（每日２ｇ连续二日）夫妻同治；二周后追踪复查白带。结果：ＢＶ在妇科门诊的患病率为４９５％，１７８例ＢＶ患者中约３７５％无明显白带增多症状，而以不孕、腹痛、阴道流血或流产前、产后常规检查时发现。１０２例追踪全部治愈，追踪率为５７３％。结论：ＢＶ患者在妇科门诊病人中并非罕见，建议在有条件的医院应列为门诊常规检测项目。替硝唑治疗效果好，方法简便。     

2985例已婚妇女生殖道沙眼衣原体感染临床特点分析

目的：了解已婚妇女生殖道沙眼衣原体感染特点及其他生殖道感染的关系。方法：采用整群随机抽样的方法，选择2985例己婚妇女，进行问卷调查，妇科体检和实验室检查，应用SPSS／9．0软件包进行统计分析，结果：已婚妇女生殖道沙眼衣原体感染率为4．4％，30岁以下妇女和服务人员生殖道沙眼衣原体感染率分别为6．6％和9．5％，明显高于其他年龄组和职业妇女（P＜0．01）。有60．6％的妇女无任何生殖道感染的症状，但在沙眼衣原体感染者，白带异常、宫颈糜烂和附件压痛等体征的发生率明显高于无感染者（P＜0．05）。并且淋病，细菌性阴道病和慢性宫颈炎的患病率也高于无感染者（P＜0．01）。结论：生殖道沙眼衣原体感染率在人群中较高，特别是在患有淋病、细菌性阴道和慢性宫颈炎的患者中更为多见。     

国产硝呋太尔制霉素阴道软胶囊治疗阴道炎的临床研究

目的 评价国产硝呋太尔制霉素阴道软胶囊治疗滴虫性阴道炎、细菌性阴道病、外阴阴道念珠菌病的临床疗效和安全性。方法 随机盲法平行对照多中心临床试验，进口麦咪康帕阴道栓为对照药。结果 有效病例为滴虫性阴道炎62例、细菌性阴道病65例、外阴阴道念珠菌病65例，各适应证的试验组及对照组受试者的临床症状、体征及妇科实验检查在用药前后均有明显改善（P〈0．01），各适应证的总有效率为90．0％～96．8％，试验组与对照组的疗效相似（P〉0．05），无严重不良事件发生，对肝肾功能血尿常规等均无影响，仅个别患者有轻微的阴道局部的刺激症状。结论 临床试验结果提示，国产硝呋太尔制霉素阴道软胶囊是一种可供选择的、能用于治疗细菌性阴道病、滴虫性阴道炎及外阴阴道念珠菌病的阴道局部药物。     

细菌性阴道病对妊娠结局影响的研究

目的探讨妊娠合并细菌性阴道病对胎膜早破、早产等不良妊娠结局的影响。方法对做产前检查的孕28周以上孕妇260例进行细菌性阴道病筛查，排除滴虫、淋菌、真菌感染者以及子宫、宫颈异常者。所有病例均获孕期随访。分析妊娠合并细菌性阴道病与妊娠及分娩并发症的关系。结果260例孕妇中，检出合并细菌性阴道病者37例，检出率为14．23％。妊娠合并细菌性阴道病的孕妇，其胎膜早破、早产的发生率分别为13．51％、16．22％，均明显高于非细菌性阴道病合并者（P〈0．05）。结论妊娠合并细菌性阴道病增加胎膜早破、早产的机会，加强产前细菌性阴道病筛查、适当治疗是很重要的。     

昆山市城区已婚育龄妇女生殖道感染现况及影响因素研究

目的:了解昆山市城区已婚育龄妇女生殖道感染(RTI)流行情况及影响因素。方法:采用整群抽样方法抽取昆山市城区3465例已婚育龄妇女为研究对象进行调查问卷、妇科检查及相关实验室检查,分析RTI的影响因素。结果:针对检测念珠菌阴道炎、细菌性阴道炎、滴虫阴道炎和宫颈炎4种目标疾病,昆山市城区已婚育龄妇女RTI总患病率为48.57%。多因素Logistic逐步回归分析表明:RTI的发病与年龄、职业、婚育史及不良生活习惯等因素密切相关。结论:昆山市城区已婚育龄妇女RTI患病率较高,应积极采取措施;进一步加大生殖健康知识宣传力度,针对与其发病有关的多种影响因素,开展有效的干预。     

细菌性阴道病与盆腔炎性病变的关系

近年研究发现，细菌性阴道病(bacterial vaginosis,BV)与妇产科感染性疾病密切相关。为探讨细菌性阴道病在妇科门诊患者中的发生率，及与妇女生殖器炎症的关系，1998年10月至1999年3月，从在我院门诊就诊的患者中随机抽取91例作为研究对象，报告如下。1 资料与方法1.1 临床资料 91例20～58岁，平均34.6岁。所有被检者均有性生活史，未孕者6例，其余均有妊娠史。1.2 检查步骤 所有患者皆通过询问病史后给予妇科检查，了解内外生殖器情况。①窥阴器扩开阴道，观察阴道粘膜有无充血，阴道分泌物的性质和量；②用江苏产精密pH试纸直接浸入窥器…     

女性生殖道感染中多种病原体的交互作用分析

目的了解育龄妇女生殖道感染（RTI）者中相关病原体的流行情况，初步探讨RTI中多种病原体的相互关系。方法对2005-03—2005-12东南大学附属中大医院354例妇科门诊育龄妇女进行妇科检查、各种RTI病原体的实验室检测以及流行病学调查。用叉生分析方法分析解脲支原体与其他病原体混合感染中的交互作用。结果生殖道解脲支原体和人型支原体的检出率分别为73．4％和47．6％；衣原体、线索细胞、假丝酵母菌和滴虫的检出率分别为17．8％、19．8％、15．9％和4％。叉生分析结果提示解脲支原体分别与衣原体、假丝酵母菌、加德纳菌等具有相乘和相加的交互作用。结论本地育龄妇女支原体的检出率较高，解脲支原体与女性生殖道其他常见病原体的混合感染对RTI的发生有协同作用。     

中国妇女使用阴道卫生棉条和卫生巾的临床单盲随机比较研究

目的 通过经期使用卫生棉条及卫生巾的随机性比较，探讨中国妇女使用卫生棉条的安全性。方法 2003-08—2004-07在首都医科大学附属北京友谊医院与上海市计划生育科研所征集300例具有规则月经周期的已婚健康育龄妇女，随机分为卫生棉条组和卫生巾对照组．并在使用产品后的第1、3、6个月经周期后行妇科检查和评分，同时取样行实验室阴道分泌物悬滴试验、氢氧化钾（KOH）试验、细菌性阴道病试验（BV．Blue）、阴道酸碱度（pH）检查。结果 在3次随访中，棉条组外阴和阴道症状发生率为0．8％（1／130）-1．4％（2／144），较卫生巾组发生率0．7％（1／136）-4．1％（6／145）略低，程度亦轻，无一例因此而终止试验。棉条组阴道炎症总感染发生率4．0％（6／150），对照组为4．6％（7／150），两组比较差异无统计学意义（P〉0．05）。试验结束时棉条组慢性宫颈炎的比例为12，3％，较试验开始时的21．3％有所下降，与对照组相似（结束时12．5％，开始时25，3％）。其中轻度宫颈糜烂入选时有27例，研究结束时为12例，且无一例中度或重度宫颈糜烂发生．此结果亦与对照组相似（入选时37例，结束时16例）。结论 卫生棉条未增加阴道感染和宫颈炎症的发生率，并且未加重宫颈炎症的程度，无不良反应，在中国妇女中使用卫生棉条是安全的。     

细菌性阴道病76例临床分析

目的：探讨细菌性阴道病的诊断和治疗。方法：对７６例细菌性阴道病患者采用阴道涂片湿片或革兰染色检测线索细胞，同时测定阴道液ｐＨ值，阴道液质量及胺试验。并分别采用克菌宁、双唑泰、甲硝唑和美满霉素治疗。结果：全部患者阴道液涂片均检测出线索细胞，阴道液ｐＨ＞４．５及胺试验阳性。阴道液为均质稀薄者为９６．１％；有鱼腥味者为７９．０％。抗生素和中药治疗均有效。克菌宁治疗１个疗程，停药２１～３５天后，治愈率为７０．０％。结论：线索细胞是诊断细菌性阴道病具有特征性的指标。除传统的甲硝唑外，克菌宁治疗细菌性阴道病效果较好。     

Importance of the vaginal ecosystem examination in the first trimester of pregnancy

OBJECTIVES: Vaginal ecosystem disturbances especially bacterial vaginosis are strongly associated with infectious complication during the course of pregnancy. DESIGN: The aim of the study was the determination of the vaginal ecosystem examination for the diagnosis of the following infection: bacterial vaginosis, candidiasis and trichomoniasis in pregnant women in the first trimester of pregnancy. MATERIALS AND METHODS: The studies included 106 randomly selected asymptomatic pregnant women in I trimester of pregnancy coming for gynaecological examination for the first time after cessation of menstruation were divided into two group: 56 primiparae and 50 multiparae. The diagnosis of BV was based on Amsel criteria concerning vaginal secretion. Trichomonas vaginalis was determined in wet vaginal smear. Candida albicans was detected in vaginal smear after addition of 10% KOH solution. RESULTS: Out of 106 studied subjects in the first trimester of pregnancy, BV was detected in 17.9%, Candida albicans in 15.1%, Trichomonas vaginalis in 3.8%. The detectability of BV infection varied significantly between both groups of studied women (p < 0.001) while no correlation was found between the occurrence of Candida albicans and Trichomonas vaginalis infections. CONCLUSION: Vaginal ecosystem screening in pregnant women makes possible under ambulatory conditions, to detect the following infections: BV, candidiasis and trichomoniasis. Determination of disturbances in vaginal ecosystem is simple and inexpensive, not requiring laboratory facilities for the assessment of vaginal infections.     

妊娠合并细菌性阴道病的研究

目的：确定妊娠合并细菌性阴道病（ＢＶ）的发病情况，探讨妊娠合并ＢＶ与不良妊娠结局的关系。方法：根据临床表现和阴道革兰染色涂片镜检，对不同孕期的３８０名健康孕妇进行ＢＶ发病情况调查，并对其妊娠结局进行随诊。结果：妊娠合并ＢＶ的检出率为６．８％（２６／３８０）。妊娠合并ＢＶ孕妇的产褥感染、新生儿感染及新生儿黄疸的发生率，依次为１４．３％（３／２１）、９．５％（２／２１）及２３．８％（５／２１），高于无合并ＢＶ者（分别为２．２％、１．３％及５．４％，Ｐ＜０．０５，Ｐ＜０．０５，Ｐ＜０．００５）。结论：妊娠合并ＢＶ与母儿感染有关，有必要对妊娠合并ＢＶ孕妇进行治疗。     

Evaluation of specific symptoms of bacterial vaginosis among pregnant women

Objective: Identification of the symptoms of bacterial vaginosis (BV) in pregnancy might be rational in order to identify a possible BV-associated group at risk of preterm delivery.Methods: Three hundred and five women early in the third trimester of pregnancy were interviewed about lifestyle factors and specific symptoms of BV and given a vaginal examination. A longitudinal three-week follow-up was conducted for 127 women.Results: The prevalence of BV was 16%. Women with BV were significantly more often smokers than women without BV (52% vs. 34%). No difference in sexual activity or other behavioral characteristics between the two groups were seen. No differences were noted among women with and without BV according to specific symptoms: malodorous discharge (26% vs. 23%), increased discharge (76% vs. 68%), or itching or troublesome discharge. More than one third of women with BV at the first examination did not fulfill the criteria for BV at the three week follow-up exam. None of the women without BV had developed BV by the follow-up exam. The incidence of preterm delivery among women with BV was 4%, women without BV had an incidence of 2.4%. This difference was not statistically significant.Conclusion: Asymptomatic BV in pregnancy is common. Specific questions about the character of the discharge do not identify women with BV during pregnancy. To identify a potential BV-associated group at risk for preterm delivery, screening for BV must be conducted not only among symptomatic women but among all women. Women with BV are more often smokers than women without BV.     

Prevalence and risk factors for bacterial vaginosis and cervicitis among 511 female workers attending gynecological examination in Changchun,China

ObjectiveThis study aims to identify the prevalence of bacterial vaginosis (BV) and cervicitis among 511 female workers attending gynecological examination and determine the risk factors for bacterial vaginosis and cervicitis.Materials and methodsThis study enrolled 511 female workers attending gynecological examination in Changchun Obstetrics-Gynaecology Hospital in Changchun city from January 1,2015 to December 31, 2015. A structured questionnaire was designed to survey the general demographic characteristics, living habits and health status of the participants. Gynecological examinations were performed to assess the presence of bacterial vaginosis and cervicitis. Univariate and multivariate logistic regression analysis were used to identify risk factors associated with bacterial vaginosis and cervicitis.ResultsOf 511 female workers (median age, 40 years) were enrolled in our study, the prevalence of BV was 5.3%, and the prevalence of cervicitis was 22.1%. In multivariable analysis, women of specific ethnic groups had a higher odds ratio of BV (OR = 3.332, 95%CI 1.014–10.955) and premenopausal women had a reduced odds ratio of BV(OR = 0.162, 95%CI 0.061–0.425). Higher levels of education were associated with a reduced odds ratio of cervicitis (OR = 0.248, 95%CI 0.080–0.772).ConclusionsBV and cervicitis were both common among female workers. Improving women's educational level should be concerned so as to reduce the prevalence of cervicitis.     

阴道唾液酸酶检测在细菌性阴道病及绒毛膜羊膜炎诊断中的价值

目的　探讨阴道唾液酸酶的检测在诊断细菌性阴道病及预测绒毛膜羊膜炎中的价值。方法　采用比色法对患细菌性阴道病孕妇 80例 (研究组 ) ,健康孕妇 6 0例 (对照组 )进行阴道唾液酸酶的检测 ,蓝色表示唾液酸酶阳性 ,颜色不变为阴性。绒毛膜羊膜炎的诊断以病理检测为准。结果　研究组孕妇中阴道唾液酸酶阳性率为 96 3% (77 80 ) ,明显高于对照组的 3 3% (2 6 0 ) ,两组比较 ,差异有极显著性 (P <0 0 0 1)。两组中阴道唾液酸酶阳性孕妇的绒毛膜羊膜炎、胎膜早破、早产及产褥感染的发生率分别是 2 6 6 %、39 2 %、2 1 5 %和 16 5 % ,明显高于阴道唾液酸酶阴性孕妇的 4 9%、9 8%、6 6 %和 3 3% ,两者比较 ,差异均有显著性 (P <0 0 1或P <0 0 5 )。阴道唾液酸酶预测绒毛膜羊膜炎的敏感性为 87 5 % (2 1 2 4 ) ,特异性为 5 0 0 % (5 8 116 )。结论　阴道唾液酸酶检测在细菌性阴道病中的阳性率高 ,尤其适用于孕期筛查 ;同时在早期预测绒毛膜羊膜炎等不良妊娠结局的发生中也有一定的实用价值。     

需氧菌性阴道炎及其混合感染的临床特征分析

目的 探讨需氧菌性阴道炎(AV)及其混合感染的临床特征,为AV的临床诊治提供帮助.方法 2008年4-12月,在天津医科大学总医院选取以外阴不适、阴道分泌物异常等阴道炎症状就诊的患者516例,联合其症状、体征及相关实验室检查诊断常见阴道炎,即AV、细菌性阴道病(BV)、外阴阴道假丝酵母菌病(VVC)、滴虫阴道炎(TV),分析AV及其混合感染的临床特征.结果 516例患者中,AV 76例,占14.7%(76/516),北中混合感染44例,占58%(44/76).在44例AV混合感染中,以合并BV多见,占45%(20/44);其次为合并VVC,占30%(13/44);合并TV占25%(11/44).单纯AV患者的常见症状主要为黄绿色稀薄脓性阴道分泌物(63%,20/32),其次为阴道分泌物增多(44%,14/32);阴道pH值常>4.5(84%,27/32),清洁度主要为Ⅲ～Ⅳ度(88%,28/32);细菌培养为粪肠球菌(6例)、链球菌(4例)等需氧菌.结论 AV是常见的下生殖道感染,易合并其他病原体感染,尤以合并BV、VVC及TV多见,混合感染时症状、体征不典型.在AV诊断中,注意有无合并其他阴道感染,并在诊断其他阴道感染时,注意是否合并AV.     

Leukocyte esterase activity in vaginal fluid of pregnant and non-pregnant women with vaginitis/vaginosis and in controls

OBJECTIVES: To determine the leukocyte esterase (LE) activity in vaginal lavage fluid of women with acute and recurrent vulvovaginal candidosis (VVC and RVVC respectively), bacterial vaginosis (BV), and in pregnant and non-pregnant women without evidence of the three conditions. Also to compare the result of LE tests in women consulting at different weeks in the cycle and trimesters of pregnancy. The LE activity was correlated to vaginal pH, number of inflammatory cells in stained vaginal smears, type of predominating vaginal bacteria and presence of yeast morphotypes. METHODS: One hundred and thirteen women with a history of RVVC, i.e. with at least four attacks of the condition during the previous year and who had consulted with an assumed new attack of the condition, were studied. Furthermore, we studied 16 women with VVC, 15 women with BV, and 27 women attending for control of cytological abnormalities, who all presented without evidence of either vaginitis or vaginosis. Finally, 73 pregnant women were investigated. The LE activity in vaginal fluid during different weeks in the cycle of 53 of the women was measured. RESULTS: In the non-pregnant women, an increased LE activity was found in 96, 88, 73 and 56% of those with RVVC, VVC and BV and in the non-VVC/BV cases, respectively. In 73% of pregnant women in the second trimester, and 76% of those in the third, the LE test was positive. In all groups of non-pregnant women tested, the LE activity correlated with the number of leukocytes in vaginal smears, but it did not in those who were pregnant. There was no correlation between LE activity and week in cycle. The vaginal pH showed no correlation to LE activity in any of the groups studied. CONCLUSIONS: The use of commercial LE dipsticks has a limited value in the differential diagnosis of RVVC, VVC and BV. There is no correlation between the LE activity in vaginal secretion on one hand and vaginal pH, week in the menstrual cycle and trimester in pregnancy on the other. Women with BV often have signs of inflammation as evidenced by a positive LE test and inflammatory cells in genital smears.     

Vulvovaginal symptoms in women with bacterial vaginosis

OBJECTIVE: A substantial, but highly variable, percentage of women with bacterial vaginosis are said to be asymptomatic. The purpose of this study was to estimate the prevalence of symptoms among women with bacterial vaginosis compared with women without bacterial vaginosis by direct, explicit, and detailed questioning of these women. METHODS: Women presenting for a routine health care visit at 12 health department clinics in Birmingham, Alabama, were recruited to participate in a longitudinal study of vaginal flora. At the first visit, they underwent a pelvic examination, lower genital tract microbiological evaluation, and an interview that included detailed questions regarding lower genital tract symptoms. The prevalence of symptoms among women with and without bacterial vaginosis (Gram stain score 7 or higher) was compared. RESULTS: Among 2,888 women without gonorrhea, Chlamydia, or trichomonas, 75% of women with and 82% of women without bacterial vaginosis never noted any vaginal odor in the past 6 months (P <.001). The corresponding values were 63% and 65% for never noting vaginal "wetness" (P =.02); 58% and 57% for vaginal discharge (P =.65); 91% and 86% for irritation (P =.004); 88% and 85% for itching (P =.64); and 96% and 94% for dysuria (P =.002), respectively. Cumulatively, 58% of women with bacterial vaginosis noted odor, discharge, and/or wetness in the past 6 months compared with 57% of women without bacterial vaginosis (P =.70). CONCLUSION: The 2 classic symptoms of bacterial vaginosis discharge and odor are each reported by a minority of women with bacterial vaginosis and are only slightly more prevalent than among women without bacterial vaginosis.     

产后妇女阴道菌群状况及其影响因素分析

目的 探讨产后6～8周妇女的阴道菌群状况及其相关的影响因素.方法 选取2007年6-10月7家医院产后6～8周来院复查的560例产后妇女作为研究对象,对其进行相关因素的问卷调查,并行阴道分泌物涂片的Nugent评分及阴道菌群检查.结果 (1)阴道分泌物涂片Nugent评分结果及菌群比率:Nugent评分结果为菌群正常的产后妇女有48例(8.6%,48/560),评分结果为菌群临界的产后妇女有337例(60.2%,337/560),评分结果为细菌性阴道病(BV)的产后妇女有175例(31.2%,175/560).560例产后妇女中有74例阴道内检出乳杆菌(13.2%,74/560);560例产后妇女中有322例检出加德纳菌和类杆菌(57.5%,322/560),有214例检出染色不定弯曲小杆菌(38.2%,214/560).(2)分娩方式及会阴侧切对产后妇女阴道菌群状况的影响:①阴道分娩266例,其中Nugent评分结果为阴道菌群正常25例(9.4%,25/266),菌群临界为148例(55.6%,148/266),诊断BV 93例(35.0%,93/266).②剖宫产分娩294例,其中Nugent评分结果阴道菌群正常23例(7.8%,23/294),菌群临界189例(64.3%,189/294),诊断BV 82例(27.9%,82/294).阴道分娩与剖宫产分娩者的BV发生率比较,差异无统计学意义(P=0.204).③会阴侧切233例,其中阴道菌群正常22例(9.4%,22/233),菌群临界状态135例(57.9%,135/233),诊断BV 76例(32.6%,76/233).④无会阴侧切327例,其中Nugent评分结果阴道菌群正常26例(8.O%,26/327),菌群临界202例(61.8%,202/327),诊断BV 99例(30.3%,99/327).有会阴侧切与无会阴侧切者的BV发生率比较,差异无统计学意义(P=0.790).(3)孕期阴道炎症及孕期性生活对阴道菌群状况的影响:①孕期有阴道炎症46例,其中Nugent评分结果阴道菌群正常5例(10.9%,5/46),菌群临界26例(56.5%,26/46),诊断BV 15例(32.6%,15/46).②无阴道炎症514例,其中Nugent评分结果阴道菌群正常43例(8.4%,43/514),菌群临界311例(60.5%,311/514),诊断BY 160例(31.1%,160/514).有阴道炎症与无阴道炎症者的BV发生率比较,差异无统计学意义(P=0.962).③孕期无性生活的284例中诊断BV 78例(27.5%,78/284);偶尔有性牛活的270例中诊断BV 96例(35.6%,96/270);经常有性生活的6例中诊断BV 1例(1/6).3者分别比较,差异均无统计学意义(P=0.185).(4)喂养方式对阴道菌群状况的影响:母乳喂养的216例中诊断BV 67例(31.0%,67/216);人工喂养的89例中诊断BV 35例(39.3%,35/89);混合喂养的255例中诊断BV 73例(28.6%,73/255),3者分别比较,差异无统计学意义(P:0.573).结论 产后妇女阴道乳杆菌明显减少,菌群比率明显失调.阴道分娩、会阴侧切、阴道炎症、孕期性生活及喂养方式对产后妇女的BV发病无显著影响.产后妇女的BV发生率较高.     

Does pre- and postoperative metronidazole treatment lower vaginal cuff infection rate after abdominal hysterectomy among women with bacterial vaginosis?

OBJECTIVE: Bacterial vaginosis (BV) is a known risk factor for postoperative infection following abdominal hysterectomy. Vaginal bacterial flora scored as intermediate has been shown to have the same risk of postoperative infection as BV. METHODS: Women undergoing total abdominal hysterectomy for benign diseases were open-randomized according to Zelen to either treatment with metronidazole rectally for at least 4 days or no treatment. At the preoperative gynecological examination a vaginal smear was collected and Gram stained. Women with BV or intermediate flora were merged to one group called abnormal vaginal flora. RESULTS: In total 213 women were randomized to treatment or no treatment. After exclusion of 71 women, 142 women were eligible for analysis. Among the 59 women diagnosed with abnormal vaginal flora there were no vaginal cuff infections in the treated arm, compared with 27% in the 'no treatment' arm (p < 0.01). Treatment also reduced the vaginal cuff infection rate from 9.5 to 2% among the 83 women with lactobacilli flora. However, this difference was not statistically significant. Treatment had no effect on the rate of wound infections. Intention-to-treat analysis showed a significant reduction in vaginal cuff infections among women randomized to treatment. CONCLUSION: Pre- and postoperative treatment for at least 4 days with metronidazole rectally reduces significantly vaginal cuff infection among women with abnormal vaginal flora.