Bacterial Vaginosis

Question 1

What is bacterial vaginosis?

Answer 1

Overgrowth of anaerobic bacteria due to loss of the lactobacilli

Question 2

Is bacterial vaginosis an STI?

Answer 2

No

But multiple sexual partners increases the risk

Can increase the risk of developing STIs

Question 3

What anaerobic bacteria cause bacterial vaginosis?

Answer 3

Gardnerella vaginalis(most common)
Mycoplasma hominis
Prevotella species

Question 4

What are the risk factors of bacterial vaginosis?

Answer 4

Multiple sexual partners
Excessive vaginal cleaning
Recent antibiotics
Smoking
Copper coil

Question 5

How does bacterial vaginosis present?

Answer 5

Fishy-smelling
Grey or white vaginal discharge

No itching, irritation or pain

Speculum can be used to confirm diagnosis

Question 6

What investigations are done for bacterial vaginosis?

Answer 6

Vaginal pH above 4.5, normal is 3.5-4.5

Vaginal swab

Clue cells on microscopy
Epithelial cells that have bacteria stuck inside them, usually Gardnerella vaginalis

Question 7

How is bacterial vaginosis managed?

Answer 7

Asymptomatic- no treatment

Metronidazole
Targets anaerobic bacteria
Oral or vaginal gel
Avoid alcohol, can cause disulfiram-like reaction

Clindamycin second line

Question 8

What is bacterial vaginosis associated with in pregnant women?

Answer 8

Miscarriage
Preterm delivery
Chorioamnionitis
Low birth weight
Postpartum endometriosis