Publication:

Prevalence of bacterial vaginosis among pregnant women and its perinatal outcome: a descriptive, observational and prospective study

Background Pregnancy is commonly associated with increased vaginal discharge which is often non-pathological while bacterial vaginosis, candidiasis and trichomoniasis are associated with abnormal vaginal discharge. However, most cases of abnormal vaginal discharge in pregnant women are treated inappropriately as candidiasis as a result of inadequate investigation of other causes. Bacterial vaginosis is a polymicrobial syndrome characterized by loss of normal vaginal flora and increase in other species like Gardenella vaginalis, Ureaplasma urealyticum, Mobiluncus, Mycoplasma, Bacteriodes, Peptostreptococcus and Prevotella. It has severe adverse outcomes in pregnancy which include preterm labour, preterm premature rupture of membranes (PPROM), spontaneous abortion, increased risk of peripartum infections. Current study aims to evaluate the prevalence of bacterial vaginosis in pregnant women using easily available, rapid, inexpensive, diagnostic tests and its adverse maternal and fetal outcome in pregnancy.

Methods 150 antenatal women attending the outpatient clinic as well as the admitted patients in the Department of Obstetrics and Gynaecology satisfying the inclusion criteria and who had given well written and informed consent were enrolled for the study. We studied the prevalence of bacterial vaginosis in these women using Amsel’s criteria and Nugent scoring and correlated it with adverse pregnancy outcomes.

Results Out of the 150 pregnant women screened, 35 women were tested positive as per Amsel’s criteria (23.3%). According to Nugent scoring, 16 out 150 pregnant women screened had a score of more than 7(10.6%). Out of the 16 women tested positive, 12 of them had preterm delivery and PPROM (75%), 7 of them delivered small for gestational age (SGA) babies (43.75%), and 15 of the delivered babies required NICU admission (93.75%).

Conclusions The above results suggest that universal screening for all antenatal patients for bacterial vaginosis should be done during antenatal visits as they are rapid and inexpensive along with effective treatment of the same to avoid perinatal complications. More focus needs to be done on prevention of preterm labour and PPROM, rather than treatment of the same, once it occurs.