Bacterial vaginosis in pregnancy: prevalence and outcomes in a tertiary care hospital

Vidya Bhakta(1), Sadia Aslam(2), Aseel Aljaghwani(3),


(1) Department of Laboratory Medicine, Dr. Sulaiman Al Habib Medical Group, Olaya Riyadh,
(2) Department of Obstetrics and Gynecology, Dr. Sulaiman Al Habib Medical Group, Olaya, Riyadh, Saudi Arabia
(3) Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
Corresponding Author

Abstract


Bacterial Vaginosis (BV) has recently emerged as a global health issue especially in pregnant women because of its adverse outcomes. Various studies have shown the impact of BV on both mother and baby as well as overall reproductive health of women. The study intended to assess the prevalence of BV in pregnant women visiting our hospital and estimate the risk of associated complications. A retrospective study was done on pregnant women who underwent vaginal swab for BV during the period January 2018- July 2019. BV was diagnosed by Nugent score and obstetric details until delivery were noted for pregnancy outcomes. Out of 217 women included in the study, 44 were diagnosed as positive for BV. Variables were compared between BV positive and negative groups by Chi square and t- test and risk ratios calculated for adverse pregnancy outcomes. Statistical analysis was done using SPSS 20.0 version.  Prevalence of BV was found to be 20.3%. BV was significantly associated with preterm labour, premature rupture of membranes, preterm delivery, miscarriage, birth asphyxia, low birth weight, and neonatal intensive care unit admission. The study substantiated the evidence from previous studies that pregnant women with BV are at much higher risk for adverse maternal and fetal outcomes. Early Screening and awareness amongst women may help to prevent this. (Afr J Reprod Health 2021; 25[1]: 49-55).


References


Rein M and Holmes K. Non-specific vaginitis,

vulvovaginal candidiasis, and trichomoniasis: clinical features, diagnosis and management. Curr Clin Top Infect Dis. 1983;4:281-315.

Alvarez-Olmos MI, Barousse MM, Rajan L, Van Der Pol

BJ, Fortenberry D, Orr D and Fidel Jr PL. Vaginal lactobacilli in adolescents: presence and relationship to local and systemic immunity, and to bacterial vaginosis. Sexually transmitted diseases. 2004;31:393-400.

Verstraelen H and Swidsinski A. The biofilm in bacterial

vaginosis: implications for epidemiology, diagnosis and treatment: 2018 update. Current opinion in infectious diseases. 2019;32:38-42.

Eschenbach DA, Hillier S, Critchlow C, Stevens C,

DeRouen T and Holmes KK. Diagnosis and clinical manifestations of bacterial vaginosis. American journal of obstetrics and gynecology. 1988;158:819-828.

Aduloju OP, Akintayo AA and Aduloju T. Prevalence of

bacterial vaginosis in pregnancy in a tertiary health institution, south western Nigeria. The Pan African Medical Journal. 2019;33.

Ibrahim S, Bukar M, Galadima G, Audu B and Ibrahim

H. Prevalence of bacterial vaginosis in pregnant women in Maiduguri, North‑Eastern Nigeria. Nigerian journal of clinical practice. 2014;17:154-158.

Svare J, Schmidt H, Hansen B and Lose G. Bacterial

vaginosis in a cohort of Danish pregnant women: prevalence and relationship with preterm delivery, low birthweight and perinatal infections. BJOG: An International Journal of Obstetrics & Gynaecology. 2006;113:1419-1425.

Leitich H and Kiss H. Asymptomatic bacterial vaginosis

and intermediate flora as risk factors for adverse pregnancy outcome. Best practice & research Clinical obstetrics & gynaecology. 2007;21:375-390.

Flynn CA, Helwig AL and Meurer LN. Bacterial

vaginosis in pregnancy and the risk of prematurity. Journal of Family Practice. 1999;48:885-92.

Bejar R, Curbelo V, Davis C and Gluck L. Premature

labor. II. Bacterial sources of phospholipase. Obstetrics and Gynecology. 1981;57:479-482.

Cox S, MacDonald P and Casey M. Cytokines and

prostaglandins in amniotic fluid of preterm labor pregnancies: decidual origin in response to bacterial toxins (lipopolysaccharide {LPS} and lipotechnoic acid {LTA}. 36th Annual Meeting of the Society for Gynecologic Investigation. 1989:16-16.

Verstraelen H and Verhelst R. Bacterial vaginosis: an

update on diagnosis and treatment. Expert review of anti-infective therapy. 2009;7:1109-1124.

Brocklehurst P, Gordon A, Heatley E and Milan SJ.

Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database of Systematic Reviews. 2013.

Ugwumadu A. Role of antibiotic therapy for bacterial

vaginosis and intermediate flora in pregnancy. Best Practice & Research Clinical Obstetrics & Gynaecology. 2007;21:391-402.

Guerra B, Ghi T, Quarta S, Morselli-Labate AM,

Lazzarotto T, Pilu G and Rizzo N. Pregnancy outcome after early detection of bacterial vaginosis. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2006;128:40-45.

Swidsinski A, Mendling W, Loening-Baucke V,

Swidsinski S, Dörffel Y, Scholze J, Lochs H and Verstraelen H. An adherent Gardnerella vaginalis biofilm persists on the vaginal epithelium after standard therapy with oral metronidazole. American journal of obstetrics and gynecology. 2008;198:97. e1-97. e6.

Kenyon C, Colebunders R and Crucitti T. The global

epidemiology of bacterial vaginosis: a systematic review. American journal of obstetrics and gynecology. 2013;209:505-523.

Nugent RP, Krohn MA and Hillier SL. Reliability of

diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. Journal of clinical microbiology. 1991;29:297-301.

Lata I, Pradeep Y and Sujata AJ. Estimation of the

incidence of bacterial vaginosis and other vaginal infections and its consequences on maternal/fetal outcome in pregnant women attending an antenatal clinic in a tertiary care hospital in North India. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine. 2010;35:285.

Thorsen P, Vogel I, Molsted K, Jacobsson B, Arpi M,

Møller BR and Jeune B. Risk factors for bacterial vaginosis in pregnancy: a population-based study on Danish women. Acta obstetricia et gynecologica Scandinavica. 2006;85:906-911.

Romoren M, Velauthapillai M, Rahman M, Sundby J,

Klouman E and Hjortdahl P. Trichomoniasis and bacterial vaginosis in pregnancy: inadequately managed with the syndromic approach. Bulletin of the World Health Organization. 2007;85:297-304.

Marx G, John-Stewart G, Bosire R, Wamalwa D, Otieno

P and Farquhar C. Diagnosis of sexually transmitted infections and bacterial vaginosis among HIV-1-infected pregnant women in Nairobi. International journal of STD & AIDS. 2010;21:549-552.

Kurewa NE, Mapingure MP, Munjoma MW, Chirenje

MZ, Rusakaniko S and Stray-Pedersen B. The burden and risk factors of sexually transmitted infections and reproductive tract infections among pregnant women in Zimbabwe. BMC infectious diseases. 2010;10:127.

Kirakoya-Samadoulougou F, Nagot N, Defer M-C, Yaro

S, Meda N and Robert A. Bacterial vaginosis among pregnant women in Burkina Faso. Sexually transmitted diseases. 2008;35:985-989.

Larsson P, Fåhraeus L, Carlsson B, Jakobsson T and

Forsum U. Predisposing factors for bacterial vaginosis, treatment efficacy and pregnancy outcome among term deliveries; results from a preterm delivery study. Bmc women's health. 2007;7:20.

Delaney ML, Onderdonk AB, Microbiology and Group

PS. Nugent score related to vaginal culture in pregnant women. Obstetrics & Gynecology. 2001;98:79-84.

Krohn MA, Hillier S and Eschenbach D. Comparison of

methods for diagnosing bacterial vaginosis among pregnant women. Journal of clinical microbiology. 1989;27:1266-1271.

Mengistie Z, Woldeamanuel Y, Asrat D and Adera A.

Prevalence of bacterial vaginosis among pregnant women attending antenatal care in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. BMC research notes. 2014;7:822.

Ghattargi S, Sheela N and Dias M. Prevalence and risk

factors for bacterial vaginosis in sexually active females in age group 20-45 years and comparison of Amsel's criteria with Nugent's score. Int J Reprod Contracept Obstet Gynecol. 2018;7:3478-3484.

Omole-Ohonsi A, Mohammed Z and Ihesiulor U.

Vaginal discharge in pregnancy in Kano, Northern Nigeria. Nigerian Medical Practitioner. 2006;50: 68-71.

Priestley CJ and Kinghorn GR. Bacterial vaginosis. The

British journal of clinical practice. 1996;50:331-4.

Adal KA RM. Vaginitis. Infect Dis Pract Rev Clin.

:1-6.

Awoniyi A, Komolafe O, Bifarin O and Olaniran O.

Bacterial vaginosis among pregnant women attending a primary health care centre in Ile-Ife, Nigeria. Glo Adv Res J Med Med Sci. 2015;4:057-060.

Morison L, Ekpo G, West B, Demba E, Mayaud P,

Coleman R, Bailey R and Walraven G. Bacterial vaginosis in relation to menstrual cycle, menstrual protection method, and sexual intercourse in rural Gambian women. Sexually transmitted infections. 2005;81:242-247.

Riduan JM, Hillier S, Utomo B, Wiknjosastro G, Linnan

M and Kandun N. Bacterial vaginosis and prematurity in Indonesia: association in early and late pregnancy. American journal of obstetrics and gynecology. 1993;169:175-178.

Hay P, Morgan D, Ison C, Bhide S, Romney M,

McKenzie P, Pearson J, Lamont R and Taylor‐Robinson D. A longitudinal study of bacterial vaginosis during pregnancy. BJOG: An International Journal of Obstetrics & Gynaecology. 1994;101:1048-1053.


Full Text: PDF

Article Metrics

Abstract View : 1087 times
PDF Download : 443 times

Refbacks

  • There are currently no refbacks.