Living Preparation Of Lactobacillus For Treatment Of Vaginosis In Pregnancy: Two Systematic Review

PARTâ… LIVING PREPARATION OF LACTOBACILLUS VERSUS METRONIDAZOLE FOR TREATMENT OF BACTERIAL VAGINOSIS IN PREGNANCY: A SYSTEMATIC REVIEWObjective To analyze the effectiveness and the effect on pregnant outcome about living preparation of lactobacillus versus metronidazole for treatment of bacterial vaginosis in pregnancy.Methods We searched the PubMed, The Cochrane library, VIP, CNKI, Wangfang, CBM, FMJS, FEBMT to identify randomized controlled trials(RCT) of living preparation of lactobacillus versus metronidazole for treatment of bacterial vaginosis in pregnancy. The quality of the included trials was assessed. RevMan 5.0.24 software was used to conduct meta-analysis.Results Eight trials involving 1687 patients were included in the analysis. Meta-analysis showed no significant difference in the effectiveness of two groups[RR=1.04,95%CI(1.00,1.08),P=0.08]. Meta-analysis showed living preparation of lactobacillus had lower recurrence rate and lower premature delivery rate compared with metronidazole [RR=0.16,95%CI(0.06,0.43),P=0.0004;RR=0.56,95%CI(0.33,0.94),P=0.03]. Meta-analysis showed no significant difference in premature rupture of membrane, puerperal infection, infant of low-birth weight, infant infection, infant jaundice of two groups.Conclusion The effectiveness about living preparation of lactobacillus versus metronidazole for treatment of bacterial vaginosis in pregnancy was similar, but living preparation of lactobacillus had lower recurrence rate and lower premature delivery rate, the others of effect on pregnant outcome were similar. PARTâ…¡LIVING PREPARATION OF LACTOBACILLUS AS MONOTHERAPY OR COMBINED WITH ANTIFUNGAL AGENT FOR TREATMENT OF VULVOVAGINAL CANDIDIASIS DURING PREGNANCY: A SYSTEMATIC REVIEWObjective To analyze the effectiveness about living preparation of lactobacillus as monotherapy or combined with antifungal agent versus antifungal agent as monotherapy for treatment of vulvovaginal candidiasis(VVC) during pregnancy.Methods We searched the VIP, CNKI,PubMed, The Cochrane library, CBM, Wangfang, FMJS and Google Scholar search engine to identify randomized controlled trials(RCT) of living preparation of lactobacillus as monotherapy or combined with antifungal agent versus antifungal agent as monotherapy for treatment of VVC during Pregnancy. The quality of the included trials was assessed. RevMan 5.0.24 software was used to conduct meta-analysis.Results Ten trials involving 1718 patients were included in the analysis. Meta-analysis showed no significant difference in the effectiveness of living preparation of lactobacillus combined with antifungal agent group with antifungal agent as monotherapy group at the follow-up visit after one week(RR=1.09,95%CI 0.98 to 1.21,P=0.13), Meta-analysis showed combined treatment group had higher effective rate compared with antifungal agent as monotherapy group at the follow-up visit after one month(RR=1.18,95%CI 1.06 to 1.30,P=0.005). combined treatment group had lower premature delivery rate and premature rupture of membrane rate compared with antifungal agent as monotherapy group, but the two groups had no significant difference in puerperal infection and fetal distress. Meta-analysis showed no significant difference in the effectiveness of living preparation of lactobacillus as monotherapy group with antifungal agent as monotherapy group at the follow-up visit after one week and one month(RR=0.78,95%CI 0.54 to 1.11,P=0.17; RR=0.80,95%CI,0.59 to 1.08,P=0.14).Conclusionâ‘ The effectiveness about living preparation of lactobacillus combined with antifungal agent versus antifungal agent as monotherapy for treatment of VVC during pregnancy at the follow-up visit after a short time was similar, but combined treatment group had higher effective rate compared with antifungal agent as monotherapy group at the follow-up visit after the long time.â‘¡Combined treatment group had lower premature delivery rate and premature rupture of membrane rate compared with antifungal agent as monotherapy group, but the two groups had no significant difference in puerperal infection and fetal distress.â‘¢The effectiveness about living preparation of lactobacillus as monotherapy with antifungal agent as monotherapy for treatment of VVC during pregnancy at the follow-up visit after a short or a long time were similar.