Wet Smear Compared with Gram Stain Diagnosis of Bacterial Vaginosis in Asymptomatic Pregnant Women

Obstet Gynecol 2000;96:504–6 The purpose of this study was to compare vaginal wet-smear diagnosis and gram-stain diagnosis of bacterial vaginosis among asymptomatic pregnant women. Sixty-nine asymptomatic women had samples obtained for each technique. Eighteen of the study participants had a diagnosis of bacterial vaginosis by gram stain; however, only slightly more than on-half of these cases were detected by clinical diagnosis. The sensitivity of the clinical diagnosis was 56%, but the specificity was 96%. In obstetrics there may be a role for the laboratory diagnosis of bacterial vaginosis in the absence of symptoms—if it is ever convincingly established that the presence of these changes lead to obstetrical problems. I think that issue is still open to debate; however, if it becomes clear that women should be screened for these changes, gram staining appears to be a far superior method when compared to clinical diagnosis. (KLN)