Bacterial Vaginosis Flashcards
What is bacterial vaginosis?
It refers to an overgrowth of bacteria in the vagina
What type of bacteria overgrows in bacterial vaginosis?
Anaerobic
What is the cause of bacterial vaginosis?
It is caused by a loss of the lactobacilli, which is the normal, healthy bacteria present in the vagina
What two molecules do lactobacilli produce? Why?
Lactic acid
Hydrogen peroxide
To keep the vaginal pH < 4.5
What happens to the pH when the number of lactobacilli is reduced?
> 4.5
What four organisms are associated with bacterial vaginosis?
Gardnerella Vaginalis
Mycoplasma Hominis
Enterococcus Faecalis
Prevotella Species
What organism most commonly causes bacterial vaginosis?
Gardenella vaginalis
What are the two risk factors for bacterial vaginosis?
Multiple Sexual Partners
Vaginal Cleaning
Is bacterial vaginosis sexually transmitted?
No
How does bacterial vaginosis typically present?
Asymptomatically
What is the standard presenting clinical feature of bacterial vaginosis?
Vaginal discharge
What are the three features of vaginal discharge associated with bacterial vaginosis?
Thin
White/grey
Fishy smell
What two investigations are used to diagnose bacterial vaginosis?
Microscopy
Vaginal pH
What is a feature of bacterial vaginosis on microscopy?
Clue Cells
What are clue cells?
They are epithelial cells from the cervix that have bacteria stuck inside them
What other microscopic feature is present when gardenella vaginalis is the causative organism of bacterial vaginosis?
Stippled vaginal epithelial cells
What is the normal vaginal pH range?
3.5 - 4.5
What is the pH range in bacterial vaginosis?
> 4.5
What over the counter vaginal pH test can be purchased?
Canestest
What is another gynaecology condition associated with a rise in vaginal pH?
Trichomonas
When do we conservatively treat bacterial vaginosis?
When bacterial vaginosis is asymptomatic
What are the two conservative management options of bacterial vaginosis?
We advise individuals that it is a self-limiting condition that will resolve naturally
We advise individuals to avoid vaginal cleaning with soaps that may disrupt the natural flora, to prevent reoccurrence
What are the two pharmacological management options of bacterial vaginosis?
Metronidazole
Clindamycin
What is the first line pharmacological management option of bacterial vaginosis? What dose is administered?
Metronidazole
100mg for 7 days
What are the two administration methods of metronidazole?
Oral tablet
Gel
What advice is given to patients prescribed metronidazole? Why?
To avoid alcohol
This is due to the fact that alcohol reacts with metronidazole to cause a disulfiram-like reaction, with nausea, vomiting and abdominal pain
What is the second line pharmacological option of bacterial vaginosis?
Clindamycin
What is the administration method of clindamycin?
Vaginal cream
What advice is given to patients prescribed clindamycin?
It may weaken latex condoms during treatment and for at least three days after last application
What is the pharmacological management option of bacterial vaginosis during pregnancy? What dose is administered?
Metronidazole
400mg twice daily for 7 days
What is a complication associated with bacterial vaginosis?
Sexually transmitted infections
What are the five complications associated with bacterial vaginosis during pregnancy?
Miscarriage
Preterm Labour
Chorioamnionitis
Low Birth Weight
Postpartum Endometritis
