Prevalence of asymptomatic and symptomatic bacterial vaginosis in pregnant women attending antenatal clinic in a tertiary care rural hospital

Authors

  • Abhijit S. Ambike Department of Obstetrics and Gynecology, BKL Walawalkar Dervan, At Post Sawarda, Taluka Chiplun, District Ratnagiri, Maharashtra, India http://orcid.org/0000-0003-1684-4075
  • Yogendra Shelke Department of Microbiology, BKL Walawalkar Rural Medical College and Hospital, Dervan, At Post Sawarda, Taluka Chiplun, District Ratnagiri, Maharashtra, India
  • Prasanna Nakhate Department of Microbiology, BKL Walawalkar Rural Medical College and Hospital, Dervan, At Post Sawarda, Taluka Chiplun, District Ratnagiri, Maharashtra, India
  • Suvarna Patil Medical Director, BKL Walawalkar Rural Medical College and Hospital, Dervan, At Post Sawarda, Taluka Chiplun, District Ratnagiri, Maharashtra, India
  • Charvi Sankholkar III Year MBBS Student, BKL Walawalkar Rural Medical College and Hospital, Dervan, At Post Sawarda, Taluka Chiplun, District Ratnagiri, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20203838

Keywords:

Bacterial vaginosis, Clue cell, Nugent score

Abstract

Background: Bacterial vaginosis (BV) is one of the most common lower genital tract conditions, occurring in 35% of women attending sexually transmitted infection (STI) clinics, 15% to 20% of pregnant women, and 5% to 15% of women attending gynaecology clinic. It has been associated with serious pregnancy complications, including premature rupture of the membranes, preterm delivery and postpartum endometritis. The diagnosis of BV is usually based on clinical criteria including homogeneous vaginal discharge, an elevated vaginal pH, the presence of clue cells, and an amine odour. Objective of this study was to study the prevalence of asymptomatic and symptomatic BV in pregnant women attending antenatal clinic in a tertiary care rural teaching hospital.

Methods: Sample size of 301 patients over 6 months study duration in an observational cross sectioned prospective type of study. An unfixed vaginal smear was collected from pregnant women and sent to microbiology for staining and fixing and diagnosis was established.

Results: The age range in pregnant women enrolled was 18 to 42 with mean age 26.10 years. As per the Nugent score criteria, 68 (23%) women tested positive for BV (Nugent score 7-10) and 77 (25%) had an intermediate score (Nugent score 4-6). While in 156 (52%) pregnant women’s Nugent score was in between 0-3 indicating no BV but 10% cases amongst these were showing presence of fungal elements mainly budding yeast cells with or without hyphae. In only 53% of cases of BV characteristic clue cells were present. In this study 69% cases of BV were observed in multigravida while 31% were present in primigravida.

Conclusions: Screening of asymptomatic pregnant women’s by taking vaginal swab and evaluating gram smear using Nugent score system will play vital role early diagnosis of reproductive tract infections.

References

Mengistie Z, Woldeamanuel Y, Asrat D, Adera A. Prevalence of bacterial vaginosis among pregnant women attending antenatal care in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. BMC Res Notes. 2014;7(1):822.

Joyisa N, Moodley D, Nkosi T, Talakgale R, Sebitloane M, Naidoo M, Karim QA. Asymptomatic bacterial Vaginosis in pregnancy and missed opportunities for treatment: a cross-sectional observational study. Infect Dis Obstet Gynecol. 2019;ArticleID:7808179.

Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol. 1991;29:297-301.

Mengistie Z, Woldeamanuel Y, Asrat D, Adera A. Prevalence of bacterial vaginosis among pregnant women attending antenatal care in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. BMC Res Notes. 2014;7:822.

Tokyol Ç, Aktepe OC, Cevrioğlu AS, Altındiş M, Dilek FH. Bacterial vaginosis: comparison of Pap smear and microbiological test results. Modern Pathol. 2004;17(7):857-60.

Mathew R, Kalyani J, Bibi R, Mallika M. Prevalence of bacterial vaginosis in antenatal women. Indian J Pathol Microbiol. 2001;44(2):113‐6.

Bhalla P, Chawla R, Garg S, Singh MM, Raina U, Bhalla R, et al. Prevalence of bacterial vaginosis among women in Delhi, India. Indian J Med Res. 2007;125(2):167‐72.

Spiegel CA, Amsel R, Holmes KK. Diagnosis of bacterial vaginosis by direct gram stain of vaginal fluid. J Clin Microbiol. 1983;18(1):170-7.

Joesoef MR, Schmid G. Bacterial vaginosis. Clin Evid. 2005;13:1968-78.

Gellar M, Nelson A. Diagnosis and treatment of recurrent and persistent vaginitis. Womens Health Gynecol. 2004;4:137-46.

Nelson DB, Macones G. Bacterial vaginosis in pregnancy: current findings and future directions. Epidemiol Rev. 2002;24:102-8.

Downloads

Published

2020-08-27

Issue

Section

Original Research Articles