Management Of Genital Tract Infections Research Articles

Comparison of visual, clinical, and microbiological diagnosis of symptomatic vaginal discharge in the reproductive age group

Background Symptomatic vaginal discharge is the most frequent symptom in women of reproductive age group. Discharge may be physiological or pathological, for which bacterial vaginosis is the most common cause, followed by candidiasis and trichomonas. Multiple infections can also coexist. Aim This study aimed to determine the microbiological and clinical profile of symptomatic vaginal discharge and its utility in the management of genital tract infection. Participants and methods This was a prospective study of 200 women with vaginal discharge referred for clinical examination and pelvic examination through a speculum examination according to the criteria of vaginal discharge. To determine the cause, high vaginal swab by Ayre’s spatula was obtained for the Microbiology Department through transport media. The collected data were tabulated and analyzed. Results Bacterial vaginosis is the most common cause of vaginal discharge, followed by candidiasis and trichomonas in our setup. For the etiological diagnosis of symptomatic vaginal discharge, the microbiological diagnostic approach is the best. A specific diagnosis was made in 83.5% of cases, whereas an etiology was not found in 16.5% of cases. Conclusion Treatment on the basis of a clinical diagnosis is not accurate. Thus, the most ideal approach in this study is the microbiological diagnostic approach for the etiological diagnosis of symptomatic vaginal discharge.

Colombian Consensus defining the criteria for admission of critically ill pregnant patients to the intensive care unit. A document aimed at reducing variability in the care provided to pregnant women with severe complications

Extreme maternal mortality and morbidity continue to be a serious public health issue in Colombia. In order to address this problem, it is essential to make an early diagnosis of severe pregnancy complications, provide initial management, ensure timely referral of patients with severe preeclampsia, post-partum bleeding, obstetric infection, pulmonary embolism and other pathologies with a poor prognosis when associated with pregnancy, delivery and post-partum, and which require a multidisciplinary approach in critical care units. For this reason, although it is not the policy of Revista Colombiana de Obstetricia y Ginecologia (RCOG) to publish manuscripts already brought to the public by other media, we have decided to publish the Clinical Practice Guidelines for prenatal control and management of partum and post-partum complications, as well as the Guidelines for the syndromic management of genital tract infections published by the Colombian Ministry of Health and Social Protection. The aim is to disseminate the recommendations for the management of pregnant women with severe complications among Obstetrics and Gynaecology specialists, general practitioners, and nurses practicing obstetrics in Colombia. Consequently, this issue of RCOG includes the “Consenso colombiano para la definicion de los criterios de ingreso a unidades de cuidados intensivos en la paciente embarazada criticamente enferma” (Colombian Consensus defining the criteria for admission of critically-ill pregnant women to the intensive care unit). This management guideline was published in September 2013 in Acta Colombiana de Cuidado Intensivo , vol. 13, supl. 5. In this way, we hope to contribute to the reduction of maternal mortality in Colombia.

Genital tract infections and the specialist gynaecologist: a survey of perception, diagnosis and treatment

The study was designed to investigate the attitude of gynaecologists to the management of genital tract infections in the North West Region of England. A postal questionnaire was sent to all members and fellows of The Royal College of Obstetricians and Gynaecologists with addresses in the region. A response rate of 71% was achieved. Of these 67% were male and more than 97% had been in the speciality for more than 5 years. Only 90.5% routinely obtain swabs from the posterior fornix; none from the pharynx. Forty-two per cent thought there might be a role for the genitourinary physician in the management of genital tract infections. Nineteen per cent engaged in consort tracing and only 22.6% carried out tests of cure before discharging the patients. Fifty-one per cent thought there could be grounds for litigation for not carrying out contact tracing and 27.4% agreed that not doing tests of cure may be regarded as negligence. This study revealed that there is a need for adequate training of gynaecologists with regards to the facilities available within the National Health Service.

The domiciliary management of genital tract infection

Present treatment schedules for lower genital tract infections are far from ideal. Members of the 4-quinolone antibiotic class are highly active against Neisseria gonorrhoeae, and some of the newer agents are active against Chlamydia trachomatis. Clinical success has been reported with, for example, a single daily dose of ofloxacin for one week. New macrolides are active against C. trachomatis and N. gonorrhoeae. Azithromycin has been shown to be effective in a single oral dose. The role of newer agents in the therapy of bacterial vaginosis is largely unproven, but there are encouraging signs. The importance of attempting to make a firm diagnosis is emphasized.