2016•Indian Journal of Obstetrics and Gynecology ResearchRequires access
Role of Bacterial Vaginosis in threatened preterm and preterm labour, and its screening
Chithra Jayakrishnan, M Rajalekshmi, R Nithya, Vijay S Narayanan
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Abstract
Background: 8-10% pregnancies end in preterm labour or threatened preterm labour which has maternal and foetal complications just due to infections such as bacterial vaginosis, which can be identified by simple tests like Amsel Criteria and treated at the earliest with appropriate antibiotics.
Aim: To establish the role of bacterial vaginosis in preterm labour and threatened preterm labour based on Amsel criteria.
Materials and Methods: 100 pregnant women with gestational age between 28 and 36 weeks, of which 50 women with symptoms of threatened preterm labour and preterm labour were kept as study group and another 50 pregnant women in the same gestational age without any symptoms of threatened preterm or preterm labour were kept as control group. Examination of vaginal discharge, vaginal pH, microscopy for clue cells and Whiff test, which are Amsel’s criteria, were done. Chi-square test was used to find out the association of variables and p value less than 0.05 was taken as statistically significant.
Results: The women in study group had higher incidence of vaginal discharge than control group. All the bacterial vaginosis cases had vaginal pH >4.5. The negative predictive value of vaginal fluid pH > 4.5 in our study is 100%. In our study 27% cases in all groups were found to have whiff test positive. 20% had clue cells on microscope examination. All the Amsel’s criterion was statistically highly significant between the study and the control group.
Conclusion: The strong correlation between presence of Bacterial Vaginosis and the incidence of threatened preterm and preterm labour is established. Amsel’s criteria are simple, inexpensive, easily reproducible method of diagnosing BV and can be used on a mass scale. By diagnosing and treating bacterial vaginosis in threatened preterm labour, preterm deliveries can be prevented to a certain extent, if not atleast in order to buy time for the inclusion of steroids which will decrease the perinatal m