Publication:

Clinical and microscopic correlation of abnormal vaginal discharge

Background Vaginal discharge in the reproductive age group is the most common complaint encountered everyday both by gynaecologists and general practitioners. The prevalence of vaginal discharge in India is estimated to be 30%. Bacterial vaginosis is the most common cause, followed by Candidiasis and Trichomonasis. Aims and objectives of the study were to correlate clinical and microscopic methods for diagnosing abnormal vaginal discharge and to find out the most common cause of abnormal vaginal discharge in our set up.

Methods The study was carried out in Gynaecological OPD of VIMS, Ballari. After thorough history and gynecological examination, three samples were collected from the posterior fornix of vagina using sterile cotton swabs. The first swab was used to detect trichomonas vaginalis using wet mount microscopy. The second swab was used to determine amine/fishy odour (Whiff test). The third swab was used for gram staining to diagnose Bacterial vaginosis and Candida. The Gram-stained slides was evaluated using Nugent’s scoring system for detection of BV.

Results Bacterial vaginosis constitutes the most common cause of vaginal discharge, followed by Candidiasis and then Trichomoniasis in our set up. The sensitivity of clinical diagnosis is 71.93%, 88.9%, and 33.3% and specificity are 54.65%, 92.15% and 99.49% for Bacterial vaginosis, Candidiasis, and Trichomoniasis respectively.

Conclusions The most ideal approach is the microbiological approach for the etiological diagnosis of symptomatic vaginal discharge. The most common cause of abnormal vaginal discharge is Bacterial vaginosis followed by Candidiasis and Trichomoniasis.