Bartholin gland abscess during pregnancy: Report on 40 patients.
OBJECTIVE
To study the clinical and bacterial characteristic of Bartholin gland abscesses during pregnancy and the obstetric and neonatal outcomes.


METHODS
Retrospective cohort study of all patients with surgical treatment of Bartholin gland abscesses between 2004 and 2015 in our university center. Clinical and bacterial characteristics between pregnant and non-pregnant women were compared.


RESULTS
During the period study, 156 patients were included (40 pregnant and 116 non pregnant). The incidence of Bartholin gland abscesses during pregnancy was 0.13%. Eight (20%) abscesses occurred in the first, 18 (45%) in the second, 11 (47.5%) in the third trimester and 3 (7.5%) in the post-partum course. No severe perineal and neonatal infections occurred during pregnancy. One late miscarriage and one preterm delivery were observed. We found more multiparity in the pregnant woman group than in non-pregnant women (62.5% versus 45%, p<0.05). A history of Bartholin gland abscesses were also more frequent in pregnant women (55% versus 30.1%, p<0.05). First line antibiotic therapy was more frequent in non-pregnant women (20% versus 45%, p<0.05). The rate of positive culture did not differ between the two groups (70% versus 55.2%). Among negative pus cultures, no patient in the pregnant woman group had received a first line antibiotic therapy, in contrast with non-pregnant women (0% versus 25%, p<0.05). E. coli was the most common pathogen in the two groups (48.9% of positive cultures and 28.2% of the overall population). The distribution of bacterial taxa was not different between the two groups.


CONCLUSIONS
Bacterial characteristics did not differ from non-pregnant women. Pregnancy could increase the occurrence of Bartholin gland abscesses in patients with previous surgical treatment of abscesses. When appropriate management is applied, maternal and neonatal outcomes are favorable, and severe infections are not to be expected.
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France. Electronic address: jeremy.boujenah@gmail.com.
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Boujenah
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, Bondy, France.
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Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, Bondy, France.
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Benbara
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France.
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Bricou
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, Bondy, France.
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Murtada
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France.
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Carbillon
D000038:Abscess / Q000382:microbiology / Q000628:therapy*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001472:Bartholin's Glands / Q000601:surgery*; D016022:Case-Control Studies; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000628:therapy*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000628:therapy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014845:Vulvar Diseases / Q000382:microbiology / Q000628:therapy*
D000900:Anti-Bacterial Agents
Abscesses; Bartholin gland; Pregnancy