History Of Abnormal Vaginal Discharge Research Articles

Knowledge and Practice Regarding Abnormal Vaginal Discharge Among Adolescent Females in Riyadh City: An Observational Study.

Introduction Vaginal discharge (VD) is a common condition that affects women during their childbearing years and often requires medical attention. It results from the physiological secretion of cervical and Bartholin's glands, as well as the shedding of vaginal epithelial cells caused by bacterial action in the vagina, which alters the acidic environment of the vagina.Experiencing vaginal symptoms is a common reason for seeking medical attention, especially among women during their reproductive years. This often leads to a visit to an obstetrician or a gynecologist. Accordingly,addressing such issues becomes even more crucial. The aim of this study is to assess the knowledge and practice regarding abnormal VD (AVD) among adolescent females in Riyadh City, Saudi Arabia. Methods The present study utilized a correlational cross-sectional survey methodology conducted in Riyadh City. The questionnaire was employed as thedata collection instrument from November 2022 to November 2023. Eligibility for inclusion was limited to adolescent femalesand students living in Riyadh City, aged from 14 to 20 years. Electronic consent was obtained from participants aged 18 years and above, while consent from guardians was sought for those below 18 years. This sample size was determined with a minimum requirement of 500 participants, and 824 were involved. The questionnaire encompassed several sections, including demographic characteristics (gender, age, education, and menstruation history), history of AVD, knowledge regarding VD, and students' practices and behaviors related to VD. Cronbach's alpha values for all the sections were more than 0.7. Data analysis was performed using statistical software, employing descriptive analysis, chi-square tests, and t-tests. Results A total of 824 girls were included, and their ages ranged from 14 to 20 years, with a mean age of (16 years ± 5) years old. Exactly 697 (84.6%) were high school students. Most of the study students (85.1%; 701) complained of an AVD at any point in their lives. Only 97 (11.8%) of the study students had a good knowledge level of VD. Higher age, marriage, late menarche, and seeking medical care for complaints of VD were the factors associated with a high knowledge level about VD (P<0.05). Additionally, 44.2% of school-age females sought medical care when experiencing AVD, with reasons including worsening symptoms over time and fear of serious diseases. However, a significant portion of participants opted for self-treatment using herbal remedies, medication from pharmacies, or leaving VD untreated, citing reasons such as perceiving it as a simple condition or fearing examination and disclosure. Conclusion In summary, the current study revealed that adolescent femalesdemonstrate a sub-optimal level of knowledge regarding AVD. These findings are primarily observed among adolescent girls and individuals who exhibit a reluctance to seek appropriate medical intervention when having AVD.

Stillbirth rates and their determinants in a national maternity hospital in Phnom Penh, Cambodia in 2017–2020: a cross-sectional assessment with a nested case–control study

BackgroundIn Cambodia, stillbirths and their underlying factors have not been systematically studied. This study aimed to assess the proportion and trends in stillbirths between 2017 and 2020 in a large maternity referral hospital in the country and identify their key determinants to inform future prevention efforts.MethodsThis was a retrospective cross-sectional analysis with a nested case–control study of women giving birth at the National Maternal and Child Health Centre (NMCHC) in Phnom Penh, 2017–2020. We calculated percentages of singleton births at ≥ 22 weeks’ gestation resulting in stillbirth and annual stillbirth rates by timing: intrapartum (fresh) or antepartum (macerated). Multivariable logistic regression was used to explore factors associated with stillbirth, where cases were all women who gave birth to a singleton stillborn baby in the 4-year period. One singleton live birth immediately following each case served as an unmatched control. Multiple imputation was used to handle missing data for gestational age.ResultsBetween 2017 and 2020, 3.2% of singleton births ended in stillbirth (938/29,742). The stillbirth rate increased from 24.8 per 1000 births in 2017 to 38.1 per 1000 births in 2020, largely due to an increase in intrapartum stillbirth rates which rose from 18.8 to 27.4 per 1000 births in the same period. The case–control study included 938 cases (stillbirth) and 938 controls (livebirths). Factors independently associated with stillbirth were maternal age ≥ 35 years compared to < 20 years (aOR: 1.82, 95%CI: 1.39, 2.38), extreme (aOR: 3.29, 95%CI: 2.37, 4.55) or moderate (aOR: 2.45, 95%CI: 1.74, 3.46) prematurity compared with full term, and small-for-gestational age (SGA) (aOR: 2.32, 1.71, 3.14) compared to average size-for-age. Breech/transverse births had nearly four times greater odds of stillbirth (aOR: 3.84, 95%CI: 2.78, 5.29), while caesarean section reduced the odds by half compared with vaginal birth (aOR: 0.50, 95%CI: 0.39, 0.64). A history of abnormal vaginal discharge increased odds of stillbirth (aOR: 1.42, 95%CI: 1.11, 1.81) as did a history of stillbirth (aOR: 3.08, 95%CI: 1.5, 6.5).ConclusionsStillbirth prevention in this maternity referral hospital in Cambodia requires strengthening preterm birth detection and management of SGA, intrapartum care, monitoring women with stillbirth history, management of breech births, and further investigation of high-risk referral cases.

Pre-labor rupture of membranes and associated factors among pregnant women admitted to the maternity ward, Northwest Ethiopia.

Pre-labor rupture of membranes (PROM) is the rupture of fetal membranes before the onset of labor. PROM is found in 3-15% of all pregnancies and 30-40% of preterm labor worldwide. The most serious complications are neonatal and prenatal mortality, which is higher in Africa, including Ethiopia. Despite a paucity of evidence on the magnitude and factors affecting PROM after 28 weeks of gestation but before the onset of labor (including both term and preterm PROM). Hence, the purpose of this study was to determine the magnitude and identify associated factors of the pre-labor rupture of membranes. An institutional-based cross-sectional study was conducted among 315 pregnant women from April 10, 2019 to June 30, 2019 at Debre Markos Referral Hospital. The samples were chosen using a systematic random sampling method among admitted pregnant women. The data were entered using EpiData entry version 4.2 and cleaned and analyzed using Stata/SE version 14.0. In binary logistic regressions, variables with a p-value <0.20 are selected for multivariable analysis. A multivariable logistic regression model with a 95% confidence interval and a p-value <0.05 was used to identify associated factors. In this study, the magnitude of PROM was 19%. Maternal monthly income ≤1000 birr [AOR: 3.33 (95%CI: 1.33, 8.33)], gestational age <37weeks [AOR: 3. 28 (95%CI: 1.53, 7.02)], multiple pregnancy [AOR: 4.14 (95%CI: 1.78, 9.62)], polyhydramnios [AOR: 5.06 (95%CI: 2.28, 11.23)] and history of abnormal vaginal discharge [AOR: 6.65 (95%CI: 2.62, 16.72)] were found significant associated factors. In conclusion, the magnitude of the pre-labor rapture of the membranes was higher than in previous studies. Hence, health professionals should strengthen counseling, early diagnosis, and treatment of infections, as well as focus on women with pregnancy-related risks, to reduce pre-labor rupture of membranes and improve fetal and perinatal health.

Prevalence, associated factors and clinical features of congenital syphilis among newborns in Mbarara hospital, Uganda

BackgroundWhile congenital syphilis is a significant public health problem that can cause severe disabilities, little is known about the situation in Uganda. We describe prevalence, associated factors and clinical presentation of congenital syphilis in Mbarara, Uganda.MethodsA cross sectional study was carried out among mother- newborn dyads from the postnatal ward of Mbarara Regional Referral Hospital (MRRH). After obtaining informed consent, a structured questionnaire was used to capture data on risk factors for congenital syphilis. A finger prick was performed on the mothers for Treponema Pallidum Haemagglutination Assay (TPHA). If TPHA was positive, a venous blood sample was collected from the mother to confirm active infection using Rapid Plasma Reagin (RPR). Venous blood was drawn from a newborn if the mother tested positive by TPHA and RPR. A newborn with RPR titres 4 times higher than the mother was considered to have congenital syphilis. We fit logistic regression models to determine factors associated with congenital syphilis.ResultsBetween June and September 2015, we enrolled 2500 mothers and 2502 newborns. Prevalence of syphilis was 3.8% (95% CI 3.1–4.6) among newborn infants and 4.1% (95% CI 3.4–5.0) among their mothers. Maternal age <25 years, past history of genital ulcer, a past history of abnormal vaginal discharge, and not receiving treatment of at least one of genital ulcer, genital itching, lower abdominal pain and abnormal vaginal discharge in the current pregnancy were the risk factors associated with congenital syphilis. The most common clinical feature was hepatosplenomegaly.ConclusionsWe found higher-than-expected syphilis sero-prevalence rates in a high risk population of postnatal mothers and their newborns in Uganda. Bridge populations for syphilis may include mothers not tested during pregnancy, who are usually married and not treated. In accordance with our results, the national policy for syphilis control in Uganda should be strengthened to include universal syphilis screening amongst mother-newborn pairs in postnatal clinics with subsequent partner notification.

Prevalence and determinants of menstrual disorders and napkin usage among women in India using DLHS-4 data.

Introduction:Menstrual disorders and hygiene practices during the menstruation significantly affect the health of reproductive age-group women.Methods:The data from nationally representative survey, DLHS-4, was used. The outcome assessed were menstrual disorders and napkin usage. The predictor variables were socio-demographic characteristics such as age group, caste, religion, marital status, and education status; reproductive characteristics such as outcome of pregnancy, condom use, IUCD usage, and vaginal discharge. The descriptive analysis and logistic regression analysis were done on 1,70,632 women.Results:The most common problems experienced by women were pain (5.4%), irregular periods (4.2%), followed by frequent period, prolonged bleeding, no period, scanty bleeding, excessive bleeding, and intermenstrual bleeding. A large proportion (37%) women were using cloth during menstruation. The factors significantly associated with menstrual problems were age, 36-40 years (OR 1.26, P value < 0.001), marriage before 18 years (OR 1.16, P value < 0.001), no education (OR 1.24 P value < 0.001), BPL card holders (OR 1.14, P value < 0.001), non-users of sanitary napkin (OR 1.09, P value < 0.001). The socio-demographic factors significantly associated with napkin usage were women with secondary education and higher (OR 3.52, P value < 0.001), toilet use - using flush toilet (OR 1.97, P value < 0.001), not possessing BPL card (OR 1.42, P value < 0.001), marriage after the age of 18 years (OR 1.35, P value < 0.001). The reproductive characteristics significantly associated with menstrual problems were history of spontaneous abortion (OR 1.79, P value < 0.001), history of induced abortion (OR 2.29, P value < 0.001), women never used condoms (OR 1.09, P value < 0.001), ever used IUCD (OR 1.11, P value < 0.001), history of abnormal vaginal discharge during last three months (OR 5.32, P value < 0.001).Conclusion:The use of sanitary napkin should be promoted as it promotes dignity, and equality of women, apart from the public health aspect.

Risk Factors of Preinvasive and Invasive Cervical Cancer

Aims: The objective of this study was to assess the risk factors of preinvasive and invasive cervical cancer.Methods: This was a prospective hospital based case control study conducted from April 2012 to April 2013, which included 91 patients in each group. Among cases, 34 were Cervical Cancer and 57 were Cervical Intraepithelial Neoplasia. Simple random method was adopted for selecting patients. Prefixed questionnaire was used. Statistical analysis was done using SPSS 19.0.Results: In multivariate analysis, history of abnormal vaginal discharge and cigarette smoking were significantly associated with cervical cancer (p value of 0.001 and 0.003 respectively) and Cervical Intraepithelial Neoplasia (p &lt;0.001). Whereas, early age at first sexual intercourse ≤ 16 years and more than one sexual partner of husband had only borderline significance for Cervical cancer (p value 0.049 and 0.038 respectively).Conclusions: Cigarette smoking and abnormal vaginal discharge were significantly associated with cervical cancer.

Isolation, identification and susceptibility pattern of Gardnerella vaginalis in bacterial vaginosis

Bacterial vaginosis is the commonest cause of abnormal vaginal discharge in women of reproductive age. A total 200 women aged 15- 45 years with history of abnormal vaginal discharge were included as study population. Fifty women without such history of discharge were taken as healthy control. Two vaginal swab samples were taken from each case and control. These swab samples were subjected to test by Gram stain (Nugent method) and culture. 21.5 % of the cases were diagnosed as bacterial vaginosis by Gram stain (Nugent method) and 21 % by culture. Clindamycin was susceptible to G. vaginalis in (90.5%) followed by metronidazol (76.1 %), chloramphenicol (71.4 %) and erythromycin (66.7 %). Out of 50 cases of recurrent bacterial vaginosis, G. vaginalis was isolated from 15 (30 %) cases, of which 5 (33.3 %) were sensitive and 10 (66.7 %) were resistant to metronidazol, while all 15 cases were sensitive to clindamycin.DOI: http://dx.doi.org/10.3329/bjmm.v5i1.15814 Bangladesh J Med Microbiol 2011; 05 (01): 8-11

Assessment of the knowledge level and behaviors of students in school of nursing about genital hygiene

Data representing overall population about gynecological health problems of women in fertility period are limited in Turkey. In this study it was aimed to determine the knowledge level and behaviors of nursing students about genital hygiene. The study was designed as a cross-sectional study. Universe of the study comprised of 354 students attending to high school of nursing. Questionnaire was developed by researchers following a literature review. Although 50.5% of the junior students (n=55) described a history of abnormal vaginal discharge, only 19.3% (n=21) stated that the discharge was abnormal. Of all the students 5.4% (n=19) stated that “they never took a bath” during menstrual period. There was not a statistically significant difference between the history of vaginal discharge and post-defecation cleaning behaviors of students (x²=19.469, p=0.001). Type of post-defecation cleaning from back to front was more common in students who had a history of abnormal vaginal discharge. In conclusion habits that seem very simple in basic and are, however, frequently neglected are very important in protecting and developing urogenital health in the female.

Risk factors for invasive cervical cancer in Kenyan women.

Few epidemiological investigations of invasive cervical cancer have been conducted in Sub-Saharan African populations. Using information collected as part of the hospital-based World Health Organization (WHO) Collaborative Study of Neoplasia and Steroid Contraceptives, we examined potential risk factors for invasive cervical cancer among Kenyan women. In all 112 women with histologically confirmed invasive cervical cancer diagnosed at the Kenyatta National Hospital, Nairobi, Kenya, between June 1981 and September 1988 and 749 control subjects were included in the present analyses. All women were interviewed regarding their medical and reproductive history, methods of birth control, and history of sexual relationships and sexually transmitted infections. Multiple logistic regression procedures were used to derive maximum likelihood estimates of adjusted odds ratios (OR) and 95% confidence intervals (CI). After adjusting for age, several factors were found to be associated with invasive cervical cancer. These include multiple sexual partners, early age at first sexual intercourse (OR = 1.9 and 2.6 for women reporting first intercourse at age 16-17 years and < 15 years, respectively, compared to women with first intercourse > or = 18 years), history of abnormal vaginal discharge (OR = 13.8, 95% CI: 8.3-23.0), and history of gonorrhoeal infection (OR = 3.2, 95% CI: 1.6-6.2). Low educational attainment and multiparity were also associated with the risk of invasive cervical cancer. Although the Papanicolaou smear has been extensively used as a screening method for cervical cancer in many countries, only three cases and four controls reported ever having a Papanicolaou smear (2.6% cases and 0.5% of controls). As has been observed in other parts of the world, cervical neoplasia in Kenya appears to be a late consequence of venereally transmitted carcinogenic agents.

Rapid Detection of Bacterial Vaginosis (BV) by BVBlue test

Bacterial vaginosis is the commonest cause of abnormal vaginal discharge in women of reproductive age and require laboratory test for diagnosis . A total 200 women aged 15-45 years with history of abnormal vaginal discharge were included as study population. Fifty women without such history of discharge were taken as healthy control. Three vaginal swab samples were taken from each case and control. These swab samples were subjected to test by conventional methods such as Amsel clinical criteria, Gram stain Nugent method, culture and by newly developed BV Blue test. The results of the BVBlue test were compared with these methods to find out the efficacy of BVBlue test. Rate of detection of bacterial vaginosis (BV) cases was 21.5% by Amsel clinical criteria, 21.0% by Gram stain Nugent method, 21.0% by culture and 22% by BVBlue test among the study population. When comparing with the conventional test and culture, BVBlue test was 100% sensitive and 98% specific. It is rapid, technically simple and is suitable for screening large number of patient in short time where laboratory facilities are not developed. Key words: Bacterial Vaginosis, BVBlue test, Nugent method, Abnormal vaginal discharge. DOI: http://dx.doi.org/10.3329/bjmm.v4i1.8465 BJMM 2011; 4(1): 24-27