I went to get my Flagyl (metronidazole) prescription filled on Saturday, and the pharmacist gave me a really ridiculously hard time about it. She was like, “you’re not supposed to have this when you’re pregnant – it’s a Category B drug” and “this drug crosses the blood barrier into the placenta.” Well, guess what, pharmacist: Category B is about as good as you’re going to get with a drug during pregnancy, and Flagyl is the treatment recommended by the CDC for BV when pregnant. About the only other treatment is clindamycin, also Category B (and possibly more effective at preventing pre-term labor – or it might be that metronidazole is just not as studied?).
The CDC website on treatment guidelines for BV says:
Whether treatment of asymptomatic pregnant women with BV who are at low risk for preterm delivery reduces adverse outcomes of pregnancy is unclear.
At this point, I am asymptomatic (I had a fishy smell and some extra discharge a few weeks ago, but not anymore) and at low risk for preterm delivery. My midwife says I should treat the BV, and then if symptoms do not recur we can just assume that it is gone. I am going to do that, but I also feel like it sucks to take drugs – extremely strong drugs – without knowing that they are even potentially mitigating a problem.
Thoughts?
