USE OF ORAL METRONIDAZOLE IN PREGNANCY: Risks, Benefits, and Practice Guidelines


  • Patricia Aikins Murphy CNM, DrPH,

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    • 1Patricia Aikins Murphy is Assistant Professor of Nursing in the Nurse-Midwifery Education Program at Columbia University. She is a graduate of that program, and holds a doctorate in epidemiology from the Columbia University School of Public Health. Her research interests include clinical preventive services in women's health.

  • Eileen Jones RN, BA, BSN, SNM

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    • 2Eileen Jones practices obstetrical nursing in an inner city hospital in Milwaukee, Wisconsin. She received her BA in theology in 1981 and a diploma in nursing in 1985. After graduating summa cum laude with her BSN from Marquette University in 1992, she entered the CNEP program of the Frontier School of Nurse-Midwifery and Family Nursing, where she is currently a student nurse-midwife. In addition to student and work responsibilities, she also manages a large family, which includes adopted special-needs children. She plans to work with underserved adolescents as a certified nurse-midwife.

Columbia University School of Nursing, 630 West 168th Street, New York, NY 10032.


Metronidazole is the recommended treatment for trichomoniasis and bacterial vaginosis in nonpregnant women. Reluctance to use this drug in pregnancy is related to concerns about possible adverse effects on the fetus. However, recent literature suggests associations between these infections during pregnancy and risk of preterm delivery; if such associations are causal and preterm birth is shown to be prevented by effective treatment, the risk-benefit equation may be altered. This article reviews the literature on the carcinogenic and teratogenic potential of metronidazole and discusses the evidence that associates trichomoniasis and bacterial vaginosis with perinatal outcomes. Current practice recommendations are summarized.