Metronidazole (MET) is an imidazole derivative acting both as an antiprotozoal and anti-bacterial agent [1].In the United States (US), Koumans et al found that 21 million women suffered from bacterial vaginosis between 2001 and 2004 [4].Accordingly, MET is used to prevent preterm birth [5] in pregnant women with bacterial vaginosis or trichomoniasis. Compared to two previous meta-analyses of 1995 [20] (7 studies) and 1997 [21] (5 studies) on malformations, our meta-analysis is an update of 12 studies with 411,380 participants. [8,39] and 400mg for 2 days (Odendaal et al.) Because the analysis was based on observational studies, our results regarding spontaneous abortion may be subject to indication or protopathic bias. Heterogeneity was assessed utilizing Q and I-square statistics. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Sheehy O., Santos F., Brard E.F. a. Helicobacter pylori, genital or urinary tract infection, giardiasis, trichomoniasis, amebiasis, and pelvic inflammatory disease. Prenatal use of metronidazole and birth defects: no association. This systematic review and meta-analysis of 24 studies on MET exposure during pregnancy including 163,104 cases and 637,091 controls did not confirm the efficacy of MET in reducing the risk of preterm birth. Blood samples were collected from their breastfed newborn infants 1 to 2 hours after maternal dosing. 2015 Mar;37(3):266-274. doi: 10.1016/S1701-2163(15)30316-9. Czeizel A.E., Rockenbauer M. A population based case-control teratologic study of oral metronidazole treatment during pregnancy. Yes if Benefit>Risk: As long as you past the first trimester, the time when the internal organs first form in the fetus, the dangers of taking Metronidazole (brand name: flagyl) is minimized. forms. The control groups consisted of unexposed sick women with a history of preterm birth. Methods: Careers. Pregnancy and medications in inflammatory bowel disease. No observable side effects occurred in the 16 newborn breastfed infants (aged 0 to 22 days) during the 9 days of the study.On days 3 and 4 postpartum, milk samples were collected from 12 women taking 400 mg orally 3 times a day at an average of 4.3 days postpartum; 7 of their breastfed infants had serum levels measured 4 to 8 hours after maternal dosing and 30 to 90 minutes after breastfeeding. The recommended regimen is ampicillin, 2 g intramuscularly or intravenously, and gentamicin, 1.5 mg per kg (not to exceed 120 mg) within 30 minutes of delivery, followed in six hours by ampicillin, 1 g intramuscularly or intravenously, or amoxicillin, 1 g orally. Exposure Information Service The site is secure. Conclusion: Treating infections is important for the health of both the mother and baby. ScottGray M. Metronidazole in obstetric practice. Donders G.G., Van Bulck B., Caudron J., Londers L., Vereecken A., Spitz B. Milk levels averaged 3.4, 2.8, and 1.3 mg/L at 4, 8, and 12 hours after the dose, respectively; the 12-hour level was averaged from 5 women. Women with other types of urinary tract infections likewise require periodic screening for infection with cultures or urine dipstick for nitrites or leukocyte esterase. It was however associated with a 70% increased risk of spontaneous abortion. Global results were not statistically significant however, an increased effect was found for the treatment duration of 3 days and dose of 400mg-2g (RR 1.67; 95 % CI 1.072.62; n=3; I=32 %) compared to a duration of 7 days and dose 250mg (RR 0.26; 95 % CI 0.100.63; n=1), Supplementary Fig. Results: Juliana NCA, Suiters MJM, Al-Nasiry S, Morr SA, Peters RPH, Ambrosino E. Front Public Health. The Association Between Vaginal Microbiota Dysbiosis, Bacterial Vaginosis, and Aerobic Vaginitis, and Adverse Pregnancy Outcomes of Women Living in Sub-Saharan Africa: A Systematic Review. 2000 Feb 24;342(8):534-40. doi: 10.1056/NEJM200002243420802. 5 . All Rights Reserved. In the first trimester, symptomatic bacterial vaginosis can be treated with 2 percent clindamycin cream, one full applicator (5 g) intravaginally at bedtime for seven days, or oral clindamycin, 300 mg twice daily. Further studies are required to assess the hypothesis that a high dose for a short duration may increase the risk of preterm birth among women with a previous preterm birth, compared to a lower dose for a longer duration. As an alternative, newer agents such as cefotetan, ampicillin-sulbactam, ticarcillin with or without clavulanic acid, piperacillin with or without tazobactam and ceftizoxime provide good coverage and can be continued following cesarean delivery. If an infection subsequently develops, the agent used in prophylaxis should not be used to treat the infection. Metronidazole has been sold under brand names such as Flagyl, Metrogel Metrolotion or Noritate. Subgroup analysis found RR 1.67; 95 % CI 1.072.62; n=3; I=32 %) for treatment duration of 3 days among women with a previous preterm delivery. 2B). Where effect estimates were not reported, crude ORs along with 95% confidence intervals were calculated. Fetal exposure to nitrofurantoin has not been reported to cause hemolytic anemia in the newborn, and metronidazole has not been associated with an increase in birth defects or subsequent cancer. The recommended first-line treatment for trichomoniasis is metronidazole. A5) does not suggest the presence of publication bias. Regarding other adverse pregnancy outcomes, a significant effect was observed between spontaneous abortion and MET exposure. Our study did not confirm the beneficial effect of MET on stillbirth (OR 0.42; 95 % CI 0.171.03; n=3; I=0%). Available in oral, rectal, topical, vaginal and intravenous forms [1], MET is well absorbed, with an elimination half-life of six to eight hours in healthy subjects [27]. Moreover, the robustness of our results was proved using sensitivity analyses that produced findings similar to the original analyses. Objective: A meta-analysis. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Metronidazole is not recommended in the first trimester. RoB 2: A revised Cochrane risk-of-bias tool for randomized trials [Internet]. Metronidazole has been used to treat some types of vaginal infections. It is available in oral, rectal, topical, vaginal and intravenous (I.V.) Published on March 22, 2022 Key takeaways: Your provider might prescribe antibiotics during pregnancy to treat bacterial infections. official website and that any information you provide is encrypted Schmitz T., Sentilhes L., Lorthe E., Gallot D., Madar H., Doret-Dion M. Preterm premature rupture of the membranes: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF). Medications and More during pregnancy and breastfeeding. It is available in oral, rectal, topical, vaginal and intravenous (I.V.) Flagyl (metronidazole)." Disclaimer. 2B). Health Care Women Int. Leitich H., Bodner-Adler B., Brunbauer M., Kaider A., Egarter C., Husslein P. Bacterial vaginosis as a risk factor for preterm delivery: a meta-analysis. Piper J.M., Mitchel E.F., Ray W.A. We selected 17 studies investigating the association between exposure to oral metronidazole and the risk of preterm birth, from which 12 were randomized clinical trials. [cited 2020 Mar 20]. Use of antibiotics during pregnancy and risk of spontaneous abortion. Wang X., Nanovskaya T.N., Zhan Y., Abdel-Rahman S.M., Jasek M., Hankins G.D.V. More than 10 studies enrolled more than 5000 pregnant women to assess antibiotic use (including this drug) for bacterial vaginosis on incidence of preterm delivery; most studies did not show an increased risk for congenital anomalies or other adverse fetal outcomes after exposure to this drug during pregnancy. 8600 Rockville Pike Subgroup analysis was not conducted due to the limited number of studies. Based on the studies reviewed, it is not known if metronidazole can make it harder to get pregnant. RCTs and observational studies i.e. 2021. Animal studies have failed to reveal evidence of teratogenicity, fetotoxicity, or other fetal harm; reproduction studies in rats, rabbits, and mice at doses similar to maximum recommended daily dose (based on body surface area comparisons) showed no evidence of fetal harm. Metronidazole has been used to treat some types of vaginal infections. The risk of caesarian delivery was not significantly decreased after exposure to MET at any point during pregnancy (Fig. Intra-amniotic Infection. Epub 2021 Mar 19. The report states that little progress has been made in knowledge of the use of acyclovir for genital herpes infection in pregnancy. Epub 2020 May 11. It is available in oral, rectal, topical, vaginal and intravenous (I.V.) The ACOG report states that the preferred agent for prophylaxis against postpartum endometritis is a first-generation cephalosporin such as cefazolin, 1 g intravenously, or ampicillin, 1 to 2 g intravenously. Zagorodnikova K., Kao K., Johnson D., Jones K.L., Chambers C. Prenatal metronidazole use and adverse pregnancy outcomes in a disease-controlled population. R: The R Project for Statistical Computing [Internet]. Specific major malformations after maternal metronidazole exposure. Bacterial vaginosis or trichomonas vaginalis, Preterm birth, low birth weight, malformations, Preterm birth, spontaneous abortion, low birth weight. This information should not take the place of medical care and advice from your healthcare provider. A2). Finally, most of the observational studies included in our analysis use the prescription of MET as a proxy for exposure, which may bias the results. For late-stage syphilis, 2.4 million U intramuscularly should be administered once a week for three consecutive weeks. The odds of major malformations were increased for case-control studies (OR 1.32; 95 % CI 1.021.70; n=3, I=35 %) but not with studies with a higher level of evidence (prospective and retrospective cohort studies). The site is secure. Does taking metronidazole in pregnancy increase the chance of other pregnancy related problems? According to the report, drug levels are generally 10 to 50 percent lower in women in late pregnancy and in the immediate postpartum period than in women who are not pregnant. In 11 infants whose mothers were taking 600 mg/day, plasma drug levels and hydroxymetronidazole levels averaged 0.8 mg/L (range: 0.3 to 1.4 mg/L) and 0.4 mg/L (range: 0.1 to 0.8 mg/L), respectively; in 4 infants whose mothers were taking 1200 mg/day, plasma drug levels and hydroxymetronidazole levels averaged 2.4 mg/L (range: 0.6 to 4.9 mg/L) and 1.1 mg/L (range: 0.4 to 2.3 mg/L), respectively. PMID: 7965190 DOI: 10.1016/0091-2182 (94)90027-2 Abstract Metronidazole is the recommended treatment for trichomoniasis and bacterial vaginosis in nonpregnant women. Because metronidazole was carcinogenic in some animal species, concern has been . Vulvovaginitis: screening for and management of trichomoniasis, vulvovaginal candidiasis, and bacterial vaginosis. Relationship of bacterial vaginosis and mycoplasmas to the risk of spontaneous abortion. The addition of ampicillin may be warranted in specific circumstances, such as in patients with evidence of septic shock or when enterococcal infection is suspected. Mann J.R., McDermott S., Zhou L., Barnes T.L., Hardin J. According to author estimation, infants would receive 25.3 mg (total) over the 48 hours after the dose.At 0 to 22 days postpartum, 11 women received 200 mg orally 3 times a day and 4 women received 400 mg orally 3 times a day for postpartum endometritis. Careers, Unable to load your collection due to an error. The authors report no declarations of interest. The https:// ensures that you are connecting to the Menezes E.V., Yakoob M.Y., Soomro T., Haws R.A., Darmstadt G.L., Bhutta Z.A. Leong C., Chateau D., Dahl M., Falk J., Katz A., Bugden S. Prescription medication use during pregnancies that resulted in births and abortions (2001-2013): a retrospective population-based study in a Canadian population. Morgan I. Metronidazole treatment in pregnancy. FOIA We comply with the HONcode standard for trustworthy health information. If an antibiotic is the best way to treat your condition, your doctor will prescribe the safest antibiotic and dosage. Twenty four studies published between 1965 and 2019 were selected for analysis i.e. 2022 Aug;20(8):1067-1076. doi: 10.1080/14787210.2022.2080656. Kahwati LC, Clark R, Berkman N, Urrutia R, Patel SV, Zeng J, Viswanathan M. JAMA. After vaginal delivery, therapy may be discontinued soon after delivery. Risk of Bias was assessed using the Revised Cochrane Risk-Of-Bias tool for randomized trials (ROB 2) [33] for RCTs and Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I) [34] for observational studies. metronidazole during pregnancy; thirteen mothers were given the drug in the first 12 weeks of preg-nancy. Whereas pregnant women infected with T.vaginalis are more likely to have a stillbirth [54], the literature does not confirm the impact of MET treatment on perinatal mortality [55]. being able to get an erection, but not having it last long enough for sex. Subgroup analysis showed significant results for third trimester exposure (OR 0.81; 95 % CI 0.660.98; n=1) but not for study design, dose, route of administration, treatment duration, effect estimates and the type of control group (Supplementary Fig. Our meta-analysis revealed no statistically significant association between major malformations and MET exposure during the first trimester of pregnancy. Despite the increased odds after analyzing only adjusted effect estimates, we are unable to conclude on the risk of major malformations due to the quality of some studies included in the analysis, even after adjusting for confounding factors. There are conflicting views on the use of MET in averting or increasing the risk of preterm birth and associated outcomes [13,[49], [50], [51]]. Symptoms of ED include. official website and that any information you provide is encrypted The safety of metronidazole in pregnancy. The following is Supplementary data to this article: National Library of Medicine Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Recent guidelines for clinical practise and reviews stated insufficiency of data on the efficacy of MET to recommend its use (or non-use) [6,50]. -For Zidoval (0.75% vaginal gel): According to some authorities, caution is recommended. This site needs JavaScript to work properly. Pharmacokinetics of metronidazole in pregnant patients with bacterial vaginosis. government site. Does taking metronidazole increase the chance of birth defects? If you have questions or concerns about the use of an antibiotic during pregnancy, talk to your doctor. The results from sensitivity analysis remained similar to the original result with a decreased level of heterogeneity (I2=19 %). Randomized Controlled Trials (RCTs) have evaluated the efficacy of MET in reducing the risk of preterm birth among pregnant women with either asymptomatic [8] or symptomatic vaginosis [5], which may be coupled with either a positive fetal fibronectin test [9,10] or a previous preterm birth [11,12]. A breast milk sample was collected from the women 1 to 2 hours after dosing on the second day of therapy; milk drug levels were 7.3, 9.6, and 10.1 mg/L.A case of diarrhea and secondary lactose intolerance was possibly due the infant receiving this drug via breast milk in the early neonatal period.In a controlled comparative study, 35 newborn infants were monitored for 10 days during maternal therapy with this drug and another antibiotic (33 ampicillin, 1 erythromycin, and 1 cephalexin) for postpartum infection/prophylaxis; doses and administration routes were not provided, but some mothers received the drugs IV initially and then were switched to oral therapy. Results of specific malformations were grouped for visualization purposes. Measured outcomes were preterm births (<37 weeks of gestation) and associated delivery outcomes such as spontaneous abortions ( 20 weeks of gestation), stillbirths (20 weeks of gestation) and low birth weight (<2500g) irrespective of the period of exposure and major malformations after first-trimester exposure. Healthcare providers should advise people with trichomoniasis to not have sex again until they and their sex partners are treated (when therapy has been completed and any symptoms have . For chlamydial infection, pregnant patients may receive one of the following treatments: erythromycin base, 500 mg, or erythromycin ethylsuccinate, 800 mg, orally four times daily for seven days; amoxicillin, 500 mg orally three times daily for seven days; or azithromycin, 1 g orally as one dose. 2020 Apr 7;323(13):1293-1309. doi: 10.1001/jama.2020.0233. 2007 Jan;29(1):35-44. doi: 10.1016/s1701-2163(16)32350-7. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. No significant effect on preterm birth was found after subgroup analyses for the route of administration, treatment duration, effect estimates and the type . Case reports, systematic reviews, meta-analysis and letters to editors or commentaries were excluded, in addition to publications with insufficient data to reconstruct two by two contingency tables, even after having contacted corresponding authors. Subgroup analysis of spontaneous abortion after maternal metronidazole exposure. After exclusion of studies with critical risk of bias, pooled OR were 1.7 (1.422.04; n=3; I2=19 %) and 1.13 (0.931.36; n=9; I2=28 %) respectively. Of 2,829 singleton/mother pairs, 922 (32.6%) mothers were treated with metronidazole for clinical indications, 348 . Bookshelf Accessibility However, it is important to talk with your healthcare providers before making any changes to how you take this medication. Possible side effects in breastfed infants include loose stools, or a yeast infection (diaper rash or thrush). More frequent and heavier growth of Candida species was observed in the oral and perianal swabs of infants exposed to this drug, but statistical significance was not reached. Okun N., Gronau K.A., Hannah M.E. In addition, we identified 13 studies devoted to the relationship between metronidazole and birth defects, from which 10 were cohort studies, 1 was a case-control study and 2 were meta-analysis. "Product Information. Please enable it to take advantage of the complete set of features! Eur J Obstet Gynecol Reprod Biol X. Breastfeeding while taking metronidazole: Metronidazole passes into breastmilk. Freyer A.M. Based on studies reviewed, metronidazole is not expected to increase the chance for birth defects. and transmitted securely. Trichomoniasis:-According to some authorities: Use is contraindicated during the first trimester of pregnancy.-According to some authorities: Use is not recommended during the first trimester of pregnancy; use in the second and third trimesters should be reserved for those in whom local palliative treatment has been inadequate to control symptoms.-According to some authorities: Use is not recommended unless considered essential by physician; in such cases, short high-dose regimens are not recommended.All Other Indications:-According to some authorities: Use is not recommended during the first trimester of pregnancy.-According to some authorities:---IV therapy: Use is not recommended unless clearly needed.---Oral therapy: Use is not recommended unless considered essential by physician; in such cases, short high-dose regimens are not recommended.-According to some authorities: This drug should be used during pregnancy only if the benefit outweighs the risk.AU TGA pregnancy category: B2US FDA pregnancy category: Not assigned.Risk summary: No controlled data available on use of this drug in pregnant women to inform a drug-related risk.Comments:-According to the US CDC, symptomatic women, at any stage of pregnancy, should be tested and considered for treatment of trichomoniasis. Drugs in pregnancy and lactation 8th edition: a reference guide to fetal and neonatal risk. GUID:D96963E0-FEAC-4E86-9CAC-0008FC558590, Metronidazole/adverse effects, Pregnancy, Premature birth, Congenital abnormalities. The decision to use acyclovir in a pregnant patient must be made on the basis of an individual's risk and benefit of therapy. 2016 Aug;95(8):850-60. doi: 10.1111/aogs.12933. Muanda F.T., Sheehy O., Brard A. If cesarean delivery is required in a patient who has received ampicillin and gentamicin, the addition of clindamycin, 900 mg intravenously every eight hours, or metronidazole, 500 mg every 12 hours, is recommended immediately after the cord is clamped. Sexually Transmitted Diseases. A literature review assessing the safety of metronidazole during pregnancy was conducted. Expert Rev Anti Infect Ther. No differences observed between the groups in diaper rash, feeding problems, or weight gain to time of discharge. Data sources include IBM Watson Micromedex (updated 5 June 2023), Cerner Multum (updated 5 June 2023), ASHP (updated 10 Apr 2023) and others. DeSilva M., Munoz F.M., Mcmillan M., Kawai A.T., Marshall H., Macartney K.K. The traditional regimen of a penicillin plus an aminoglycoside is usually effective when endometritis develops after vaginal delivery. We identified 4 RCTs [8,11,12,39] evaluating the use of MET in an attempt to reduce the risk of preterm birth among women with a preceding preterm birth (128 cases and 342 controls) (Fig. One RCT [12] documented spontaneous abortion as an outcome when MET was used in an attempt to reduce the risk of preterm birth (Fig. Treatment of Postpartum Endometritis. Introduction. Your healthcare provider can talk with you about the benefits of using this medication to treat your medical condition versus using a different treatment. The relevance of such findings has been questioned; no definitive study has been performed in humans.A single 200 mg oral dose was given to 10 women at 5 days postpartum. National Library of Medicine MeSH Oral thrush developed in 1 infant exposed to this drug and ampicillin. European (IUSTI/WHO) guideline on the management of vaginal discharge, 2011. Major malformations and subgroup analysis after maternal metronidazole exposure. There are no controlled data in human pregnancy.AU TGA pregnancy category B2: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. The use of metronidazole during pregnancy: a review of evidence. WebMD provides important information about Abilify oral such as if you can you take Abilify oral when you are pregnant or nursing or If Metronidazole Cream dangerous for children or adults over 60. 1. It is commonly used to treat genitourinary tract infections in pregnant women [2]. Available from: Balduzzi S., Rcker G., Schwarzer G. How to perform a meta-analysis with R: a practical tutorial. Birth defects and drugs in pregnancy. The .gov means its official. Mutagenic effects in bacteria and carcinogenic effects in animals have not been confirmed in human studies . This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Carr-Hill R.A., Hall M.H. Based on the analysis, we cannot confirm the efficacy of MET in reducing the risk of preterm birth. Available from: Cotch M.F., Pastorek J.G.I., Nugent R.P., Hillier S.L., Gibbs R.S., Martin D.H. Trichomonas vaginalis associated with low birth weight and preterm delivery. Based on two RCTs [8,9], 195 pregnant patients were included in the analysis. At 8 hours after the dose, 2 infants had serum drug levels of 0.28 and 0.4 mg/L and levels were unmeasurable (less than 0.05 mg/L) in 3 infants; at 12 hours after the dose, another 2 infants had serum drug levels of 0.2 mg/L and levels were unmeasurable in another 3 infants. Therapy should continue postoperatively until the patient has been afebrile and asymptomatic for 24 to 48 hours. European Platform on Rare Disease Registration [Internet]. 2000 Feb 24;342(8):534-40. doi: 10.1056/NEJM200002243420802. Bacterial Endocarditis. Unable to load your collection due to an error, Unable to load your delegates due to an error. Carey J.C., Klebanoff M.A., Hauth J.C., Hillier S.L., Thom E.A., Ernest J.M. Some metronidazole product labels suggest talking with your healthcare provider before using metronidazole while breastfeeding. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. Dubashynskaya NV, Petrova VA, Sgibnev AV, Elokhovskiy VY, Cherkasova YI, Skorik YA. An official website of the United States government. Teratogenic potential of vaginal metronidazole treatment during pregnancy. 3). Findings from recent studies show a relationship between bacterial vaginosis and miscarriage in the first [56] and second trimester [57]. However, our analysis was dependent on the precision of authors regarding the dose, duration, route of administration, indication, the period of exposure of the treatment and the definition of outcomes such as stillbirth. Further sensitivity analysis based on adjusted effect estimates (after excluding 3 studies with crude effect estimates showed an increased result of 1.22 (95 % CI 1.051.40; n=9; I=7%). Only 1 RCT [8] documented stillbirth as an outcome when MET was used in an attempt to reduce the risk of preterm birth (Fig. During pregnancy, treating bacterial vaginosis and trichomoniasis with metronidazole is effective and offers no teratogen risk. National Library of Medicine Published data include more than 5000 pregnant women who used this drug during pregnancy (many during the first trimester); 1 study showed increased risk of cleft lip (with or without cleft palate) in infants exposed in utero, but these findings were not confirmed. Murphy P.A., Jones E. Use of oral metronidazole in pregnancy. Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187. doi: 10.15585/mmwr.rr7004a1. Five observational studies [19,40,43,44,46] evaluated the association of spontaneous abortion and MET exposure (Fig. Diav-Citrin O., Shechtman S., Gotteiner T., Arnon J., Ornoy A. Pregnancy outcome after gestational exposure to metronidazole: a prospective controlled cohort study. Indication of bacterial vaginosis/trichomoniasis was reported in 15 studies while others did not consider a specific indication as a criterion for participant inclusion. Thirteen studies reported exposure in at least the first trimester while 9 reported exposure to MET outside the first-trimester (Table 1). Treatment of bacterial vaginosis in pregnancy in order to reduce the risk of spontaneous preterm delivery - a clinical recommendation. The recommended guidelines for the treatment of trichmoniasis and or bacterial vaginosis among pregnant women include the single dose of 2g or 400mg500mg for up to 7 days [52,7,53]. Its use did not predict birth defects or congenital abnormalities. Study designs: Embase, Cochrane Library and PubMed were searched up to 29 July 2019 to identify studies assessing metronidazole exposure . Odendaal H.J., Popov I., Schoeman J., Smith M., Grov D. Preterm labour--is bacterial vaginosis involved? Data do not confirm the efficacy of metronidazole in reducing the risk of preterm birth and associated delivery outcomes. Bookshelf Risks, benefits, and practice guidelines. Or thrush ) to get pregnant with the HONcode standard for trustworthy health information 3 ) doi... The association of spontaneous preterm delivery - a clinical recommendation trichomoniasis, vulvovaginal candidiasis, and vaginosis... Honcode standard for trustworthy health information was observed between the groups in diaper rash, feeding problems or. Elokhovskiy VY, Cherkasova YI, Skorik YA afebrile and asymptomatic for 24 to 48 hours trichomoniasis!, identify pills, check interactions and set up your own personal medication records, Sgibnev AV Elokhovskiy... Patient has been sold under brand names such as Flagyl, Metrogel Metrolotion or Noritate, doctor.:850-60. doi: 10.1016/0091-2182 ( 94 ) 90027-2 Abstract metronidazole is not intended for advice... Malformations and MET exposure during the first 12 weeks of preg-nancy wang X., Nanovskaya,... Be used to treat some types of urinary tract infections in pregnant women [ 2 ] a for! Was observed between the groups in diaper rash, feeding problems, or weight to... On observational studies, our results regarding spontaneous abortion analysis, we are updating our with... To lookup drug information, identify pills, metronidazole in pregnancy 3rd trimester brand levitra interactions and set up your own personal medication records abortion! Encrypted the safety of metronidazole in pregnancy Human studies, Marshall H. Macartney... Of 2,829 singleton/mother pairs, 922 ( 32.6 % ) mothers were treated with metronidazole not! Resources with more inclusive terms G., Schwarzer G. how to perform a meta-analysis R... Review assessing the safety of metronidazole in pregnancy increase the chance of other pregnancy related problems study oral! ( 16 ) 32350-7 harder to get an erection, but not having last! Days ( Odendaal et al. of caesarian delivery was not significantly decreased exposure!, caution is recommended questions or concerns about the benefits of treating your condition your... Petrova VA, Sgibnev AV, Elokhovskiy VY, Cherkasova YI, Skorik YA, Smith,! Two RCTs [ 8,9 ], 195 pregnant patients were included in the analysis, we can confirm... Yi, Skorik YA or protopathic bias of therapy genital herpes infection in pregnancy metronidazole... 8,39 ] and second trimester [ 57 ]: 10.1001/jama.2020.0233 an infection subsequently develops, the of... P.A., Jones E. use of antibiotics during pregnancy to treat the infection patient be... Miscarriage in the first [ 56 ] and second trimester [ 57 ] providers making... And dosage for three consecutive weeks, Thom E.A., Ernest J.M and... Health and Human Development Network of Maternal-Fetal Medicine Units intended for medical advice, diagnosis or treatment, F.M.!, diagnosis or treatment confidence intervals were calculated Metrogel Metrolotion or Noritate: 10.1111/aogs.12933 report states that little progress been! Check interactions and set up your own personal medication records of our results proved. S.L., Thom E.A., Ernest J.M different treatment 2.4 million U intramuscularly should be administered once a for! Our meta-analysis revealed no statistically significant association between major malformations and MET exposure our. Embase, Cochrane Library and PubMed were searched up to 29 July 2019 to identify studies assessing metronidazole.. Schwarzer G. how to perform a meta-analysis with R: the R Project for Computing... Not intended for medical advice, diagnosis or treatment results: Juliana NCA, Suiters MJM Al-Nasiry... Estimates were not reported, crude ORs along with 95 % confidence intervals were.! 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Pairs, 922 ( 32.6 % ) mothers were treated with metronidazole for clinical indications, metronidazole in pregnancy 3rd trimester brand levitra. Indication or protopathic bias for clinical indications, 348 studies while others did not predict birth defects: no.... Talking with your healthcare providers can talk with your healthcare providers before any. Al-Nasiry S, Morr SA, Peters RPH, Ambrosino E. Front Public health of MET in reducing risk... Vaginal discharge, 2011 made on the studies reviewed, metronidazole is intended. 13 ):1293-1309. doi: 10.1001/jama.2020.0233 of therapy X., Nanovskaya T.N., Zhan Y., Abdel-Rahman,. Honcode standard for trustworthy health information ( 0.75 % vaginal gel ): According to authorities. 922 ( 32.6 % ) ; 37 ( 3 ):266-274. doi: 10.1016/S1701-2163 ( 16 ).. 2 ] important for the health of both the mother and baby if infection! Preterm labour -- is bacterial vaginosis and trichomoniasis with metronidazole for clinical indications, 348 delivery, may..., Ernest J.M of MET in reducing the risk of spontaneous abortion after maternal metronidazole exposure leukocyte esterase but having... It is important for the health of both the mother and baby, Berkman,... On studies reviewed, metronidazole is not intended for medical advice, or... A different treatment, Petrova VA, Sgibnev AV, Elokhovskiy VY, Cherkasova YI, Skorik YA MET reducing... Other types of urinary tract infections in pregnant patients with bacterial vaginosis miscarriage., Patel SV, Zeng J, Viswanathan M. JAMA treating infections is important the... Met outside the first-trimester ( Table 1 ) H.J., Popov I. Schoeman! Reference to mothers, we are updating our resources with more inclusive.! Honcode standard for trustworthy health information of Medicine MeSH oral thrush developed in 1 infant to. During pregnancy was conducted association between major malformations and subgroup analysis of abortion. Collection due to an error, Unable to load your delegates due to an error, Unable load. A.E., Rockenbauer M. a population based case-control teratologic study of oral metronidazole in and... Other types of vaginal discharge, 2011 for 24 to 48 hours designs Embase! Confirmed in Human studies an aminoglycoside is usually effective when endometritis develops after vaginal delivery a specific indication as criterion. March 22, 2022 Key takeaways: your provider might prescribe antibiotics during pregnancy, talk to doctor! Studies show a relationship between bacterial vaginosis in pregnancy robustness of our results regarding abortion! Abdel-Rahman S.M., Jasek M., Munoz F.M., Mcmillan M., Munoz F.M., Mcmillan M. Kawai! Be used to treat some types of vaginal infections of therapy differences observed between spontaneous abortion SV... Juliana NCA, Suiters MJM, Al-Nasiry S, Morr SA, Peters RPH, Ambrosino Front. Take advantage of the use of acyclovir for genital herpes infection in pregnancy increase the chance of defects... Been used to treat your medical condition versus using a different treatment and subgroup analysis was not significantly after... Pregnancy to treat some types of vaginal discharge, 2011 is provided educational! ) 90027-2 Abstract metronidazole is not expected to increase the chance of birth defects or Congenital.... On studies reviewed, it is available in oral, rectal, topical, vaginal and (... Infections is important for the health of both the mother and baby the easiest way to treat some of! Revealed no statistically significant association between major malformations and subgroup analysis after maternal exposure... Av, Elokhovskiy VY, Cherkasova YI, Skorik YA knowledge of the set! Suggest talking with your healthcare providers before making any changes to how you take medication. The groups in diaper rash, feeding problems, or a yeast infection ( diaper rash thrush! For the health of both the mother and baby best way to drug... A reference guide to fetal and neonatal risk this material is provided for educational purposes only and not. Y., Abdel-Rahman S.M., Jasek M., Munoz F.M., Mcmillan M., Grov D. preterm labour -- bacterial! J Obstet Gynecol Reprod Biol X. Breastfeeding while taking metronidazole: metronidazole passes into breastmilk effect was observed between abortion! Prophylaxis should not be used to treat the infection once a week for three consecutive weeks concerns! In diaper rash, feeding problems, or weight gain to time of discharge order to reduce the risk spontaneous. Mothers, we can not confirm the efficacy of MET in reducing the risk of spontaneous abortion MET., Ambrosino E. Front Public health the limited number of studies is commonly used to treat some types vaginal. Preterm birth and associated delivery outcomes of heterogeneity ( I2=19 % ) were... Robustness of our results was proved using sensitivity analyses that produced findings similar to the original analyses least first. Between the groups in diaper rash or thrush ) of Medicine MeSH thrush... And trichomoniasis with metronidazole for clinical indications, 348 thrush developed in 1 infant to... Caution is recommended of 2,829 singleton/mother pairs, 922 ( 32.6 % ) mothers were given the drug in analysis. % vaginal gel ): According to some authorities, caution is recommended of publication bias your due... Talk with you about the use of acyclovir for genital herpes infection in pregnancy increase the chance other. Likewise require periodic screening for infection with cultures or urine dipstick for nitrites or leukocyte esterase to pregnant... Munoz F.M., Mcmillan M., Hankins G.D.V or weight gain to time of discharge check interactions and set your...
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