DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20213460

Prevelance, risk factors and adverse perinatal outcomes of bacterial vaginosis in pregnancy

Prasanna Kumar Shetty, Akhila G. Menon, Rekha Rai

Abstract


Background: Bacterial Vaginosis (BV) is the most common lower genital tract syndrome in women of age group 16 to 25years.BV is a disorder of the vaginal microbial ecosystem characterized by a shift in the vaginal flora, from the normally predominant Lactobacillus species to one dominated by a mixed flora. The prevalence of BV can be around 15-30% and upto 50% in pregnancy. This study aims to study the prevalence of BV and their adverse outcomes on pregnancy.

Methods: It is a Cross Sectional Study at Department of Obstetrics and Gynecology, at a tertiary care hospital, for a period of one and half year from November 2016-April 2018.Pregnant women attending antenatal clinic were enrolled after obtaining an informed consent and vaginal swab examination done. The sample size was 200.

Results: The prevalence of BV in pregnant females was 18%. The major risk factors for BV in pregnancy were young age, low socioeconomic status and recent sexual activity. All patients who took treatment for BV had good outcome. Amsel criteria had low sensitivity but very high specificity(95%).Individually vaginal PH had a very high sensitivity(91.6%) when compared to the gold standard Gram stain.

Conclusions: Routine screening is recommended for all pregnant women with risk factors and with symptoms. Early diagnosis and treatment in pregnant women who are asymptomatic and with no risk factors can prevent adverse outcome.


Keywords


Bacterial vaginosis, Amsel’s criteria, Preterm labour, Chorioamnionitis

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References


Hill GB. The microbiology of bacterial vaginosis. Am J Obstet Gynecol. 1993;169:450-4.

Shetty AK, DaviSB. Screening of bacterial vaginosis in pregnancy and its outcome on pregnancy. lntemational journal of A J Institute Of medical science. 2012;1:20-5.

Guise JM, Mahon SM, Aickin M, Helfand M, Peipert JF, Westhoffc. Screening for bacterial vaginosis in pregnancy. Am J Prev Med. 2001;20:62-72.

Deborah B, Nelson, Macones G. Bacterial Vaginosis in Pregnancy: Current Findings and Future Directions Epidemiol Rev. 2002;24:102-8.

Mittal V, Jain A, Pradeep Y. Development of modified diagnostic criteria for g countries. J Infect Dev ctries. 2012.

Yudin MH, Money DM, Boucher M, Cormier B, Gruslin A, Ogilvia G. Bacterial vaginosis Pregnancy. Sogc clinical practice guideline. 2008;211:702-8.

Romero R, Espinoza J, Gotsch F, Kusanovic JP, Friel LA, Erez O et al. The use of high dimensional biology (genomics, transcriptomics, proteomics and metabolomics) to understand the preterm parturition syndrome. Br J Obstet Gynaecol. 2006;113(S3):118.

De Seta A, Sartore M, Piccoli. Bacterial vaginosis and preterm delivery: an open question. J Reprod Med. 2005;50:313-8.

US Preventive Services Task Force. Screening for bacterial Vaginosis in pregnancy to prevent preterm delivery.US Preventive Services Task Force recommendation Statement. Ann Intern Med. 2008;148:214-9.

Gardner H, Dukes C D. Haemophilus vaginalis vaginitis. A newly defined specific infection previously classified "nonspecific" vaginitis. Am J Obstet Gynecol. 1955;69:962-76.

Gram' staining. www.microrao.coWmicronotes /pg/Gram%20stain.pdf. Accessed on 10th May, 2021.

Sobel JD. UpTODate. http://www.uptodate.com /contents/approach-to-women-with-smptoms-of-vaginitis. Accessed on 10th May, 2021.

Amsel R, Totten PA, Spiegel CA, Chen KCS, Eschenbach DA, Holmes KK. Nonspecific vaginitis. Am J Med.1983;74:14-22.

Rajeshwar SR, Pindi G, Rani U, Sasikala G, Kawle V. Diagnosis of Bacterial Vaginosis:Amsel’s Criteria vs Nugent’s scoring. Journal of Applied Medical Sciences. 2016;4(6C):2027-31.

Flynn CA. Bacterial Vaginosis in Pregnancy and the Risk of Prematurity A Meta-Analysis. J Fam Pract. 1999;48(11):885-92.

Svare JA, Ringvej DK. 2600. Glostrup, Denmark.

Schwebke JR. Vaginal infections. In: Goldman MB, Hatch MC, eds. Women and health. San Diego, CA: Academic. 2000.

Wenman WM, Tataryn IV, Joffres MR, Pearson R, Grace MOA, Albritton et al. Demographic, clinical and microbiological characteristics of matemity patients: a Canadian clinical cohort study. Can J Infect Dis. 2002;13(5):311-8.

Larsson PG, Fåhraeu L, Carlsson B, Jakobsson T, Forsum U. Predisposing factors for bacterial vaginosis, treatment efficacy and pregnancy outcome among term deliveries; results from a preterm delivery study. BMC Womens Health. 2007;7:20.

Purwar M, Ughade S, Bhagat B, Aganval V, Kulkarni H. Bacterial vaginosis in early pregnancy and adverse pregnancy Outcome. J Obstet Gynaecol Res. 2001;27(4):175-81.

Jones FR, Miller G, Gadea N, Meza R, Leon S, Perez J et al. Prevalence of bacterial vaginosis among young women in low-income populations of coastal Peru. Int J STD AIDS. 2007;18:188-92.

Lata I, Pradeep Y, Sujata, Jain. Estimation of the Incidence of Bacterial Vaginosis and other Vaginal Infections and its Consequences on Maternal/Fetal Outcome in Preplant Women Attending an Antenatal Clinic in a Tertiary Care Hospital in North India. Indian J Community Med. 2010;35(2):285-9

Flynn CA. Bacterial Vaginosis in Pregnancy and the Risk of Prematurity A Meta-Analysis. J Fam Pract. 1999;48(11):885-92.

Schwebke JR. Bacterial Vaginosis: Are We Coming Full Circle? JID. 2009;200:1662-70.

Morris M, Nicoll A, Simms I, Wilson J, Catchpole M. Bacterial vagnosis: A public health review. BJOG. 2001;108:439-50.

Hay PEI, Morgan DJ, IsonBhide SA, Romney M, McKenzie P, Pearson J et al. A longitudinal study of bacterial vaginosis during pregnancy.Br J Obstet Gymaecol. 1994;1048-53.

Sobel JD. UpTODate. http://www.uptodate.com/ contents/approach-to-women-with-smptoms-of-vaginitis. Accessed on 10th May, 2021.