Prevalence Of Bacterial Vaginosis Research Articles

Comparison of the effects of Pueraria mirifica gel and of placebo gel on the vaginal microenvironment of postmenopausal women with Genitourinary Syndrome of Menopause (GSM)

ObjectiveTo compare the effects of a 12-week course of 5%Pueraria mirifica gel and placebo gel on the prevalence of bacterial vaginosis, vaginal fungi, vaginal pH, vaginal health index (VHI), and genitourinary symptoms in postmenopausal women. Study designIn a randomized, double-blinded, placebo-controlled study (TCTR20160517002), 60 postmenopausal women were randomly assigned to a 12-week course of eitherP. mirifica gel or identical placebo gel. Main outcome measureVaginal Nugent score, fungal culture, pH, VHI, and genitourinary symptoms were evaluated at baseline and after 12 weeks of treatment. ResultsAfter 12 weeks of treatment, the proportion of participants with an abnormal Nugent score in the P. mirifica and the placebo groups were 6.7 % (2/30) and 23.3 % (7/30), respectively (p = 0.006). The mean changes in Nugent scores and VHI were significantly higher in the P. mirifica group (p < 0.05). There were no significant decreases in the prevalence of symptoms between the two groups after treatment (p > 0.05). ConclusionA 12-week course of treatment with 5 % P. mirifica vaginal gel in postmenopausal women with GSM has been proved to be effective in reducing indicators of bacterial vaginosis compared with placebo gel. Nevertheless, the effect on alleviating genital symptoms was not demonstrated.

Vaginitis in women of reproductive age group: A hospital-based study from North India

Background: Vaginal discharge is a common problem faced by women of the reproductive age group seeking consultation in the gynecology outpatient department (GOPD). If not treated, it can lead to pelvic inflammatory disease, infertility and further complicate pregnancy. Objective: The present study explores the etiology and clinical presentations of vaginal discharge among women of reproductive age presenting to the GOPD of our tertiary care hospital. Materials and Methods: The study group comprised of 200 sexually active women of age group ?18 years attending our GOPD. Four vaginal swabs were taken from the posterior fornix under aseptic condition. Direct wet mount microscopy, gram stain, and culture on Sabaroud’s dextrose agar and Kupferberg media were carried out. Results: Prevalence of vulvovaginal candidiasis, bacterial vaginosis, trichomoniasis, and mixed infection was 30%, 20%, 2%, and 2%, respectively. Candida albicans were present in 55% patients and non-albicans Candida in 45%. The most common associated presenting symptom of patients presenting with the discharge was lower abdominal pain. Conclusion: Simple diagnostic techniques such as microscopy and culture help in diagnosis and the precise managementprocess of such women presenting with discharge and thus circumvent impending complication.

Prevalence of Bacterial Vaginosis in Females of Child-Bearing Age and Utility of pH and Whiff Test in Diagnosis

Background: To determine the prevalence of bacterial vaginosis among females of reproductive age and assessment of the effectiveness of pH and the Whiff test in its diagnosis. Methods: This was a cross-sectional study. A total of 100 subjects were included, coming with a complaint of vaginal discharge. The bacterial vaginosis was diagnosed by using the Nugent scoring system, Whiff and pH tests. The prevalence was calculated by descriptive statistics and using the Chi-square test and results were shown in percentages and mean with standard deviation. Results: The estimated prevalence of bacterial vaginosis among the local population of females of child-bearing age was found to be 39%. The mean age of females with bacterial vaginosis was 33.33±10.46 years. The Whiff test was positive in 89.74% cases, while pH was elevated in 94.87% females with bacterial vaginosis. Conclusion: Bacterial vaginosis is a frequent cause of vaginal discharge in females of reproductive age in Pakistan. The diagnosis can be easily made by using Whiff and pH tests even at resource-poor settings. Keywords: Bacterial vaginosis, Child-bearing age, pH test, Whiff test.

Associations of sexually transmitted infections and bacterial vaginosis with abnormal cervical cytology: A cross-sectional survey with 9090 community women in China.

BackgroundAlthough it is well acknowledged that persistent infection with high-risk human papillomavirus types in genital sites plays a crucial role in the development of squamous cell cervical carcinoma, there is no unanimous consensus on the association between non-HPV sexually transmitted infections and abnormal cervical cytology.MethodsIn the present study, we evaluated cervical cytology status, sexually transmitted infections and bacterial vaginosis status, and collected social-demographic information among recruited participants to explore the association of STIs and bacterial vaginosis with abnormal cervical cytology.Results9,090 women’s specimens were successfully tested, with a total of 8,733 (96.1%) women had normal cytology and 357 (3.9%) women exhibited abnormal cytology. The prevalence of HPV, Chlamydia trachomatis, Neisseria gonorrhoeae, and bacterial vaginosis was significantly higher in the ≥ASC-US group than the NILM group (P<0.05). Women with Neisseria gonorrhoeae infection (AOR = 5.30, 95% CIs = 1.30–21.51, P = 0.020) or bacterial vaginosis (AOR = 1.94, 95% CIs = 1.08–3.47, P = 0.026) exhibited an increased risk of abnormal cervical cytology after adjusted for carcinogenic HPV-positive status.ConclusionsOur results demonstrated that Neisseria gonorrhoeae infection in genital sites and/or bacterial vaginosis may independently increase the risk for cervical cytology abnormalities after adjusted for carcinogenic HPV-positive status. Besides, these results improved our understanding of the etiology of abnormal cervical cytology and may be useful for the management of women with ASC-US cytology.

Protease inhibitor effects on prevalence of bacterial vaginosis and human papillomavirus-related lesions.

Antiretrovirals of the protease inhibitor (PI) class tend to achieve low concentrations in biological fluids. This study aimed to analyze possible changes in the vaginal microbiome and frequency of cervical human papillomavirus (HPV)-DNA and HPV-related lesions associated with the use of PI in antiretroviral therapy (ART). Eighty-eight women with human immunodeficiency virus infection were divided in two groups: ART with PI and without PI. All the participants underwent anamnesis with demographic data collection. The total DNA, used as the template in the polymerase chain reaction-based assays for the detection of HPV-DNA, was extracted from cervical samples during cervical cytopathology. There were no differences between the groups with respect to HPV-related lesions. Despite the higher prevalence of bacterial vaginosis (BV) in the PI group (33.96% vs 17.14%), the difference was insignificant when considering all women (P = 0.066). When women with a detectable viral load and a CD4+ T-cell count <200 were excluded in both groups, BV was found to be more prevalent in the PI group (odds ratio, 3.349; 95% confidence interval, 1.113-11.41, P = 0.049). No associations were found between BV and age, condom use, cervical HPV, time with current ART regimen, unprotected receptive anal intercourse and cervical HPV-related lesions. The use of PI did not alter the frequencies of HPV-DNA and HPV-related lesions. However, an increased frequency of BV was found in women using PI after excluding women with a detectable viral load and a CD4+ T-cell count of <200.

Bacterial vaginosis, representation of endocervical and/or metaplastic cells, and cytological abnormalities in different age groups: Association study.

Studies have indicated that bacterial vaginosis (BV) might be a cofactor for the acquisition and persistence of high-risk papillomavirus, enabling the development of cytological abnormalities. The presence of endocervical and metaplastic cells makes the smear more adequate for the detection of these abnormalities once these cell types are representative of the transformation zone, a site of increased susceptibility to viral infection. The purpose of this study was to evaluate the patterns of vaginal microbiota, the representation of endocervical and/or metaplastic cells, and the detection of cytological abnormalities in cervical smears from women 15 to 64 years old. Results from satisfactory cytological smears performed in a laboratory school from the Federal University of Goiás were analyzed. The degree of association between the categorical variables was evaluated by the χ2 test, Fisher's Exact test, and stratified analysis through the estimation of the prevalence ratio, with 95% confidence intervals and 5% statistical significance level (P < .05). The global prevalence of BV and cytological abnormalities was 22.02% and 8.21%, respectively. BV and the representation of endocervical and/or metaplastic cells were independently associated with the detection of high-grade cytological abnormalities in the cervical smears of women between 25 and 64 years old. BV and representation of endocervical and/or metaplastic cells were independently associated with the detection of high-grade cytological abnormalities reinforcing the importance of specimen adequacy and microbiota in the cervical microenvironment.

Prevalence of Aerobic Bacterial Vaginosis and Trichomonas Vaginalis Associated with Socioeconomic Factors among Women in Misan Governorate

Vagina is an ecosystem balance, human vagina is dominated by lactobacillus spp which creates a vaginal acidity environment(3.8-4.5) to protect vagina from Vaginitis pathogen. Vaginitis is an inflammation of vagina caused by bacterial vaginosis and Trichomonas vaginalis . The aims of this study was investigated aerobic bacterial vaginosis, lactobacillus spp. and T.V in women with vaginitis. Study the clinical feature and demographic factors with vaginitis. 345 samples were collected from women with vaginitis. Study a demographic variables such as age, education level, socioeconomic state, residence, parity, in pregnant and non-pregnant women.

Role of Platelets, Bacterial Vaginosis, Serum Interleukinsand TNF In Genital Human Papillomavirus InfectionAmong Black Female Population in Nigeria

The study was aimed at evaluating the relationship between platelets count, bacterial vaginosis and immune response in cervical human Papillomavirus positive women in Bayelsa State. Cervical smears were collected from apparently healthy subjects attending clinics in Bayelsa State. Consensus primers GP5+/6+ and MY09/11 were used to detect HPV DNA in cervical smears and further subjected to multiplex PCR for molecular typing of HPV subtypes. Nugent method was used for scoring of bacterial vaginoses based on gram staining reaction. Interleukins were studied using sandwich ELISA kits. The prevalence of bacterial vaginosis among HPV positive, HPV negative and high-risk HPV was 35.9% and 18.2% and 51.7% respectively. Bacterial vaginosis expressed statistically significant relationship with high risk HPV (OR=9.64, P=0.002, 95%CI= 1.08-86.26).Interleukin 4 (IL-4), IL-6, IL-8, IL-10, IL-12, IL-17, IL-18, Tumor Necrotic Factor (TNF) and Interferon Gamma (INF-γ) were equally higher in HPV positive participants compared with negative participants and statistically significant.

Diagnostic evaluation of the BD Affirm VPIII assay as a point-of-care test for the diagnosis of bacterial vaginosis, trichomoniasis and candidiasis.

Untreated sexually transmitted infections and bacterial vaginosis (BV) pose a serious health risk to mother and child. Limited data exist on the use of the BD Affirm™ VPIII assay as a point-of-care test (POCT). The performance of the BD Affirm™ VPIII assay was compared with the BD Max™ vaginal assay for the diagnosis of BV, Trichomonas vaginalis (TV) and Candida spp. A total of 273 pregnant women were enrolled in this study and had provided two self-collected vaginal swabs. Sensitivity, specificity, positive predictive value, negative predictive value and prevalence were calculated. The prevalence of BV, candidiasis and trichomoniasis was 49.4, 57.2 and 10.3%, respectively. The BD Affirm™ VPIII assay showed a moderate sensitivity (79.8%) and a moderate specificity (80.3%) for diagnosing BV in all participants. The BD Affirm™ VPIII assay had an excellent specificity for Candida spp. and TV of 97.4 and 100%, respectively; however, the assay exhibited poor sensitivities of 52.9 and 46.4%, respectively. This study was the first to report on the performance of the BD Affirm™ VPIII assay as a POCT in an antenatal population. The assay was found to be unsuitable as a screening test for vaginal infections in pregnancy.

Prevalence of Aerobic Bacterial Vaginosis and Trichomonas Vaginalis Associated with Socioeconomic Factors among Women in Misan Governorate..

Prevalence of Aerobic Bacterial Vaginosis and Trichomonas Vaginalis Associated with Socioeconomic Factors among Women in Misan Governorate..

Determining the Prevalence of Bacterial Vaginosis &amp;amp; Vulvovaginal Candidiasis among Married and Unmarried Women &amp;amp; Evaluating the Association Socio-Demographic Risk Factors &amp;amp; Symptoms-Related Variables in Women Attending Gynecology Clinic in Hargeisa Group Hospital, Hargeisa City, Somaliland

Background: Vaginitis refers to any inflammation or infection of the vagina. This is a common gynecological problem found in women of all ages, with one-third of women having at least one form of vaginitis at some time during their lives. The vagina is the muscular passageway between the uterus and the external genital area. When the walls of the vagina become inflamed, because some irritant has disturbed the balance of the vaginal area, vaginitis can occur. The most common types of vaginitis are: Candida or “yeast” infection, Bacterial vaginosis, Trichomoniasis vaginitis. Objectives of Study: Therefore, the present study was carried out to determine the prevalence of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) among married and unmarried women and evaluate the association socio-demographic risk factors and symptoms-related variables in women attending gynecology clinic in Hargeisa group hospital. Methodology: A total of 150 married and unmarried women were investigated & diagnosed by a researcher in Hargeisa Group Hospital, Hargeisa City, Somaliland for determining of VVI prevalence in the present study. Vaginal swabs from these patients were processed for detection of bacterial vaginosis (BV), VVC and trichomoniasis based on guidelines of management of vagina infection. Species specific distribution of VVC was assessed by cultured of Candida on differential agar media, Germ tube test, rice meal agar and carbohydrates fermentation test and BV diagnosed by using gram staining test and biochemical testes. The nurse interviewers performed a comprehensive review of patients and completed the standardized baseline questionnaire containing information regarding the association socio-demographic risk factors and symptoms-related. Results & Discussion: The findings of the present study indicate that VVC was the most prevalent infection with 68 (45%) followed by BV 43 (29%). However, no case of trichomoniasis was detected. Candida albicans was found to be the most prevalent species with 47 (60.3%). Out of non-albicans Candida (NAC) species, C. tropicalis was found to be 9 (9.9%) and C. glabrata 7 (12.2%). On the other hand, the results of present study indicated that BV species Gardnerella vaginalis was most causative with 22 (19.5) and Lactobacillus spp. was 14 (9.3%). These results were also confirmed by gram staining test and biochemical testes. When VVI was compared among married and unmarried women, VVC was more prevalent in married women 47 (31.96) while, BV was more prevalent in unmarried women with 32 (13.76), discussed these results detected that prevalent found most highly with VVB and BV while, no case of trichomoniasis was detected. These findings are in consonance with various previous studies which have indicated VVC & BV to be the most prevalent in VI. Furthermore, the study showed statistical significant difference (P 0.005) & relationship among prevalence of VVV & BV and some socio-demographic risk factors and some symptoms which have been identified as causes of variation in the prevalence rates of bacterial vaginosis & vagina candidasis. Conclusion: VVC was the most prevalent VVI followed by BV in Hargeisa City. C. albicans was the most prevalent species in VVC while among BV species, Gardnerella vaginalis was found to occur at highest frequency. However, further studies are needed to assess specific diagnosis and role of clinical risk factors. Urgent action is required to improve vagina infection control measures to reduce the prevalence and make new policies for treatment of vagina infection in HGH.

Asymptomatic Bacterial Vaginosis in Cervical Cytology: A Preliminary Report of Incidental Finding in Routine Cervical Cancer Screening

Background: Bacterial vaginosis is a complex pathogenic group of bacteria which can cause a wide range of symptoms in affected women in Obstetric and Gynaecological practice. Its occurrence usually indicates alteration in the normal vaginal flora expected in majority of the women of reproductive age. Amongst the maintenance agents of the vaginal health, lactobacilli occupy a prominent place. Asymptomatic bacterial vaginosis is postulated to be linked to the development of cervical intraepithelial neoplasia by some researchers while some differ in this regard. Objective: To determine the rate of occurrence of asymptomatic bacterial vaginosis and associated factors in women who underwent cervical cytology for cervical cancer screening. Study Design: A cross sectional study involving microscopic examination of cervical smears of eligible clients presenting for routine Pap smear. Setting: The study was carried out in a well woman’s facility established and manned by female medical doctors in Enugu state with the assistance of trained nursing staff. Various female cancers and other communicable and non-communicable disease screening are performed at the centre. The services are available to the general public including various parts of the state and other nearby states. Methods: This preliminary study was carried out on women presenting for cervical cancer screening between February and July 2018 in a well woman’s centre in Enugu. Information on the socio-demographic and gynaecological history of the study participants were obtained and recorded in designated proformas. Smears that showed changes suggestive of bacterial vaginosis on microscopy were set aside for further evaluation. Such changes included: a conspicuous absence of normal flora of lactobacilli; filmy background of coccobacilli replacing the lactobacilli, individual squamous cells covered by a layer of bacteria (clue cells); viable squamous cells showing reactive changes identified as increased nuclear size, perinuclear halo and binucleation. Data entry and analysis were done using statistical package for social sciences (SPSS) computer software version 21.0. Results: 285 eligible women had cervical smear done during the first six months of the 2-year project at the centre. 50.9% were above reproductive age (>45 years), 38.2% were in second half of reproductive age (31 - 45), 10.9% were in the early reproductive age (15 - 30). 13% of the women were nulliparous, 51.9% were para 1 - 4, and 35.1% were grand multiparous. Of the 285 Pap smear slides viewed, 31 had bacterial vaginosis by the above criteria. This gave a prevalence of 10.8% in the reviewed cytological smears. There was an association of bacterial vaginosis with reproductive age. There was however, no association with age at coitarche and parity. There was also, no association of bacterial vaginosis with contraceptive use. There was no association between abnormal cervical cytology and asymptomatic bacterial vaginosis with absent lactobacilli. Conclusion: Prevalence of bacterial vaginosis is significant in our study population who were asymptomatic. Cervical smear should be taken advantage of as a tool for both cervical pre-cancer and bacterial vaginosis screenings since same sample can simultaneously be used for both conditions during cytology. Bacterial vaginosis may be unlikely involved in pathogenesis of cervical intraepithelial neoplasia. Recommendation: Researchers should harmonise the standards/criteria for the diagnosis of bacterial vaginosis because there are varied criteria for the diagnosis in the literature. Given, the dual advantage of pap smear in diagnosing cervical pre cancer stages and infections, more elaborate studies are needed to determine the usefulness of treatment or otherwise of bacterial vaginosis which constitutes significant incidental findings.

Reliability of conventional Papanicolaou smear in diagnosing bacterial vaginosis among women with clinical genital infection.

Objective:Bacterial vaginosis (BV) is a common reproductive tract infection (RTI) reported among Indian women. BV can influence the persistence of high-risk oncogenic human papillomavirus, a causative factor for cervical cancer. BV and cervical cancer are major public health issues in a developing country like India. It becomes important for a resource-constrained country like India with poor healthcare access to implement control measures to screen and treat RTI in an attempt to prevent the risk for cervical cancer. Papanicolaou (Pap) smear is an established screening tool for cervical cancer and the diagnosis of RTIs, forms a part of its evaluation. The present study explores the validity of conventional Pap smear in diagnosing BV.Methodology:Pap smear and Gram stain smear were collected for 254 women with clinically evident cervicitis/cervicovaginitis (genital infection). Using the Nugent score on Gram stain as a gold standard, we determined the sensitivity and specificity of Pap smear to diagnose BV.Results:The overall prevalence of BV in the study population was 44% using the Nugent score. Pap smear showed sensitivity and specificity of 70.9%. (CI- 61.5% - 79.2%) and 56.8% (CI – 48.2%–65.2%), respectively. The positive predictive value of Pap smear to diagnose BV was 56.5% (CI – 47.8%–64.9%), and the negative predictive value was 71.2% (CI – 61.8%–79.4%).Conclusion:In the present study, conventional Pap smear demonstrates good accuracy to detect BV. Pap testing for cervical cancer screening can additionally serve as an effective screening tool for diagnosing BV among women with genital infection in healthcare settings.

Prevalence of cervical HPV and attitude towards cervical screening in IBD patients under immunomodulatory treatment: a multidisciplinary management experience.

Therapeutic strategies for Inflammatory Bowel Diseases (IBD: Crohn's disease and Ulcerative Colitis) have improved but the risk for HPV infection in patients under immunomodulatory/biologic treatment is unclear. Objective of the study is to identify the attitude of patients and caregivers to cervical screening. To determine the prevalence of HPV and cervical lesions in IBD patients receiving immunomodulatory/biological treatment. IBD patients treated with immunomodulators were enrolled from November 2016 to September 2017, thanks to a multidisciplinary cooperation. A survey was administered to enrolled patients as well as to a selected network of IBD expert physicians. Patients who consented underwent gynecological examination, smear, HPV DNA test, colposcopy, vaginal and cervical microbiological swabs. 294 patients from AMICI Onlus Association, 119 patients from the hospital clinic, 30 doctors from national IBD centers participated to the survey. 19 patients from the IBD clinic underwent cervical screening. More than 90% of doctors consider their patients at risk of cervical cancer. A low prevalence of high-risk genotypes and related HPV lesions and an increased prevalence of bacterial vaginosis emerged in the studied population. Biological drugs could lead to a positive immunomodulation towards HPV infection. In IBD patients an alteration of the vaginal and intestinal microbiota seems to be coexisting.

Prevalence and risk factors of bacterial vaginosis among female sex workers in Surakarta

Background: Bacterial vaginosis (BV) is the most common vaginal infection in women of reproductive age and increases the risk of acquiring human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs). Data regarding the association between sexual activity and BV acquisition is contradictory. Thus, tracking the prevalence and associated risk factors of BV among female sex workers (FSWs) is necessary to improve our understanding and control of STDs and the HIV epidemic. Methods: The subjects of this study were FSWs in Surakarta. This study adopted a cross-sectional design, and diagnosis was established using Amsel criteria. Interviews were conducted using questionnaires to collect data of risk factors, including demographic factors (age, education level, daily income, marital status, location of sex), sociologic factors (age of first intercourse; age of first FSW encounter; duration of work as an FSW; number of clients/day; condom, contraceptive, and vaginal douching use; violence experienced as an FSW; smoking habits; alcohol consumption; and drug use), and knowledge factors (knowledge of STDs and HIV). Statistical analysis was performed by using bivariate analysis. Results: We interviewed 175 FSWs with an average age of 40.66 years. BV was detected in 28 subjects (16%). Risk factors associated with BV include alcohol (p = 0.022) and drug use (p = 0.022). Conclusion: Other than routine screening for STDs and HIV, FSWs should be encouraged to participate in prevention programs aiming to regulate alcohol and drug use to decrease the incidence of BV infection. Keywords: bacterial vaginosis, female sex workers, risk factors Normal 0 false false false IN X-NONE X-NONE

Prevalence of aerobic bacterial vaginosis among chronic IUD users among Egyptian women's

Prevalence of aerobic bacterial vaginosis among chronic IUD users among Egyptian women's

The Bacterial Vaginosis among Pregnant Women in Jatinangor

Background : Bacterial vaginosis (BV) is polymicrobial that causes superficial vaginitis due to a shift in vaginal flora. In pregnant women, BV can result in a significant risk of some serious consequences. The objective of this study was to identify the BV prevalence and to explore the characteristics and personal hygiene practices among pregnant women. Methods : This study was conducted in Desa Cipacing, Jatinangor, using the cross-sectional descriptive method, including pregnant women. The BV was detected by Gram-stained vaginal smears using Nugent Score. Furthermore, other microorganisms such as trichomoniasis and candidiasis were detected by direct microscopic observation. The questionnaire was distributed, consisting of details of personal hygiene practices. Results : In total, 17.9% of 52 pregnant women included were diagnosed with BV and 14.3% with mixed infection. Pregnant women with BV were predominantly aged younger than 25 years (61.1%), nullipara (50%) and in a second-trimester pregnancy (50%). Conclusions : Bacterial vaginosis (BV) is common among young pregnant women, predominantly in their first pregnancy. It is related to personal hygiene practices, indicating the need for targeted interventions of healthcare education among these young pregnant women to reduce the BV prevalence.

Prevalence of Bacterial Vaginosis in Preterm and Term Labour-An Observational Study

Preterm labour (PTL) and delivery are among the most challenging obstetric complications encountered. PTL is the important single determinant of adverse infant outcome in terms of both survival and quality of life.

Bacterial vaginosis in pregnancy: a current view on diagnosis and therapy (literature review)

Bacterial vaginosis (BV) is the most prevalent lower genital tract disease in women of reproductive age (both pregnant and non-pregnant) and the most common cause of vaginal discharge and foul odor from the genital tract. To date, there is a lot of literature describing many different approaches to the diagnosis and treatment of BV during pregnancy. BV is common, and its precise prevalence varies widely depending on the patient population. Studies confirm that the prevalence of BV among pregnant women is the same as in the population of non-pregnant women, and ranges from 6 to 32%. The link between BV and a patient’s ethnicity, smoking, sexual behavior and douching was established. BV is more prevalent among African American women, smokers, sexually active women compared to virgins and those who use douching. Diagnosis of BV is based on clinical symptoms and the results of microbiological examination. Diagnostic criteria are the same for pregnant and non-pregnant women. If BV is confirmed, treat-ment is indicated. In most international guidelines on sexually transmitted infections, the use of either metronidazole 500 mg orally 2 times a day for 7 days, or clindamycin 300 mg orally 2 times a day for 7 days are recommended for the prevention of adverse obstetric outcomes. BV is considered as the risk factor for adverse obstetric outcomes, such as premature birth, premature rupture of membranes, spontaneous abortion, chorioamnionitis and postpartum infections, such as endometritis and infectious compli-cations in the area of the postoperative wound after cesarean section. Pregnant women with symptoms of BV are advised to be screened and treated to eliminate the symptoms. Treatment with oral or local antibiotics is acceptable to achieve recovery (cure) in pregnant women with a symptomatic course of BV and a low risk of adverse obstetric outcomes. Women without symptoms of BV and women without identified risk factors for preterm birth should not be routinely screened and treated for BV, while patients with an increased risk for premature birth may benefit from routine screening and treatment for BV.

Multimodality Screening for Lower Genital Tract Infections Between 18 and 24 Weeks of Pregnancy and its Efficacy in Predicting Spontaneous Preterm Delivery.

Predicting spontaneous preterm birth (SPTB) during mid-trimester would be very useful. We used a multimodality screening approach mainly focusing on urogenital infections among unselected obstetric population between 18 and 24weeks in a tertiary center. Diagnosis of lower genital tract infection (LGTI) was attempted among 228 pregnant women using several factors-symptom of vaginal discharge, characteristic appearance of discharge on speculum, point of care tests using Amsel's criteria and gram staining of vaginal swab. Nugent's scoring was taken as gold standard. Urine microscopy/culture was obtained. Serum inflammatory markers were done. Total leukocyte count, neutrophil/lymphocyte ratio and C-reactive protein were obtained. Data on cervical length were obtained from mid-trimester scan. Thirty patients complained of vaginal discharge. Speculum examination revealed discharge in 221 (96.92%), appearing pathological in 192 (86.87%). Amsel's criteria showed poor sensitivity to detect full (57%) and partial (24%) bacterial vaginosis (BV). On gram staining, 104 (45.61%) showed evidence of LGTI; 14 full BV (6.1%); 45 partial BV (19.5%); 40 candidiasis (17.5%); and two each of trichomoniasis and aerobic vaginitis. Appearance of vaginal discharge and microscopic diagnosis of LGTI were poorly correlated. Forty women (17.5%) had SPTB, 24 following membrane rupture and 16 following spontaneous labor. The presence of BV (specifically partial) increased the likelihood of SPTB with OR of 3.347 (CI 1.642, 6.823). Three of seven women with short cervix delivered preterm. No other screening modality was associated with SPTB. Active screening for LGTI between 18 and 24weeks shows high prevalence of BV in Indian setting. There is a strong link between partial BV and SPTB.