Estudo comparativo entre o teste do pH e do KOH versus escore de Nugent para diagnóstico da vaginose bacteriana em gestantes

Abstract

To assess the prevalence of bacterial vaginosis and to compare the accuracy of testing pH and KOH with the Nugent gradient, the gold standard for the diagnosis of bacterial vaginosis (BV) in asymptomatic and symptomatic pregnant women at low risk. We conducted a cross-sectional study on 321 pregnant women with gestational age between 14 and 26 weeks, 218 of them asymptomatic and 103 with vaginal complaints suggestive of bacterial vaginosis. All women were assessed by the criteria of Nugent and subjected to the measurement of vaginal pH and to the 10% KOH test. The Kappa coefficient was used to evaluate the methods in terms of diagnostic agreement. Most patients were adolescents (mean age 21.0 ± 5.6 years), nulliparous and mulattos. The prevalence of bacterial vaginosis was 33.3% as estimated by the pH and KOH method and 35.5% by the Nugent method. Excellent agreement of the methods was found among asymptomatic pregnant women, with 72.5% of them showing negative results to both tests, which resulted in a high Kappa coefficient (k=0.82). The group of symptomatic women showed 49.5% positivity to both diagnostic methods, with excellent agreement (k=0.74). The prevalence of bacterial vaginosis determined by both the pH and KOH method and the Nugent score was high. The pH and KOH method can diagnose bacterial vaginosis as accurately as the Nugent criterion.