Bacterial vaginosis Flashcards
What is the diagnostic criteria for bacterial vaginosis called?
Amsel criteria
What is Amsel’s criteria? How many of these points must be reached for a diagnosis of BV?
PC DW; 3/4 = positive for BV
pH over 4.5
Clue cells on microscopy
Discharge - homogenous, grey-white, non-viscous
Whiff test positive
How does BV discharge appear?
Greyish white, non-viscous, adherent to vaginal walls
What are clue cells? When are these found?
Clue cells are vaginal epithelial cells with bacteria inside, found in BV
What reagent is added in the Whiff test?
Potassium hydroxide - makes the BV smell fishy
Define bacterial vaginosis
Overgrowth of predominantly ANAEROBIC bacteria in the vagina, with loss of lactobacilli and loss of acidity.
Risk factors for BV
Having multiple sexual partners
IUCD (copper)
Douching
Smoking
Semen left in vagina
Complications of BV
Late miscarriage
Pre-term PROM
Pre-term labour
Pre-term birth
Low birthweight
Post-partum endometritis
What percentage of patients are asymptomatic with BV?
50%
When would you not just start empirical treatment?
If the patient is:
Post natal
Post miscarriage
High risk for STI
Post gynae procedure
Recurrent BV with different symptoms?
Pregnant
Mx of BV
Oral metronidazole
or Intravaginal metrondizaole gel / intravaginal clindamycin cream
actTreatment of BV for a pregnant person
Inform obstetrician - their decision
If treating: oral metronidazole
