BV Flashcards
What is BV
Overgrowth of bacteria that are usually only present in the vagina in small numbers. This can cause abnormal discharge and odour.
BV is the most common cause of ________________ in people of childbearing age
Abnormal discharge
Up to ________% of people with BV are asymptomatic
50%
Is BV an STI?
No
But some evidence to support contribution of sexual transmission to its pathogenesis
Risk factors for BV
Sexual partner change
Vaginal douching
Presence of IUD
Protective factors for BV
Hormonal contraception (regardless of type)
Condom use
Male partner who is circumcised
Can BV recur?
Recurrence is common
Symptoms of BV
White vaginal discharge
Offensive fishy odour
Complications of BV
Spontaneous abortion, premature labour, chorioamnionitis, postpartum endometritis
PID
Endometritis, post termination of pregnancy or IUD insertion
Often associated with STIs
HIV transmission and acquisition
Does routine screening and treatment help reduce the risk of complications of BV?
No
Indications for testing for BV
Vaginal discharge
Vaginal odour
Treatment of BV is predominantly aimed at ____________ and is indicated in ___________ people
alleviating symptoms
symptomatic
1st line treatment for BV
Metronidazole BD for 7 days
2nd line treatment for BV
Metronidazole 2g stat
Ornidazole BD for 5 days
Clindamycin BD for 7 days
Treatment for BV in pregnancy or breastfeeding
Metronidazole BD for 7 days
Recommended treatment in post menopausal women
Menopause alters the vaginal microbiome, which affects the validity of laboratory diagnostic criteria for BV. Symptoms may be related to atrophic vaginitis. Consider the use of topical oestrogen
Recommendation if IUD in place and positive BV
Leave IUD in place and treat as recommended
When to refer if recurrences
> 3 recurrences in 12 month period
Is contact tracing required?
No
Should you treat male partners?
Not been shown to reduce risk of recurrence so not recommended
Should you treat female partners?
Assessment and treatment of positive female partners reasonable - but no evidence that it will reduce recurrences
Follow up or test of cure required?
No - only if symptoms persist or recur
