1Associate Professor, Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital
2Specialist, Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital
3Ex DNB Student, Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital
4Assistant Professor, Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital
5Ex Senior Resident, Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital
6Senior Specialist & Associate Professor, Regional STD Teaching and Research Centre, Vardhman Mahavir Medical College & Safdarjung Hospital
7Scientist F, National Institute of Medical Statistics, ICMR, New Delhi
8Head of Department Consultant & Professor, Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital
Online published on 15 December, 2017.
Bacterial vaginosis (BV) is an avoidable cause of prematurity; therefore treatment of BV can reduce its incidence to some extent. Since half the women with BV may be asymptomatic, the adverse outcomes associated with its presence in pregnancy can only be prevented if screening for BV is done.
To evaluate effectiveness of vaginal pH as a tool to screen for Bacterial Vaginosis in early second trimester and study the impact of treatment in reducing preterm delivery
A total of 440 pregnant women between 16–18 weeks of gestation who did not have complaint of vaginal discharge were randomly assigned to a study group and control group. The study group was screened for BV by vaginal pH and diagnosis was confirmed by gram staining using Nugents criteria. BV positive women were treated with metronidazole. The control group was not screened. Both groups were managed as per hospital protocol and were followed till delivery. The maternal and fetal outcomes of pregnancy, delivery and postpartum were recorded.
Vaginal pH > 4.5 had a sensitivity of 100% and a specificity of 76.5%, PPV was 22.8% while NPV was 100% in diagnosing bacterial vaginosis. The prevalence of BV was found to be 6.4%. There was absolute risk reduction of 6.2% in preterm deliveries and 5.6% in PPROM. There was not much difference in birth weight between the two groups. The absolute risk reduction in neonatal respiratory complications was 4.4%.
Vaginal pH was found to be an effective tool for screening for BV. Treating asymptomatic BV decreases preterm births, PPROM and neonatal respiratory complications.
Bacterial Vaginosis, Preterm Birth, Preterm Premature Rupture of Membranes, Nugent Criteria Vaginal pH
