Bacterial vaginosis

Question 1

Bacterial vaginosis (BV) describes

Answer 1

overgrowth of predominately anaerobic organisms such as - Gardnerella vaginalis.

Question 2

What type of bacteria is Bacterial vaginosis

Answer 2

Gram positive coccobacilli

Question 3

BV present in which type of women

Answer 3

Sexually active

Question 4

Features of bacterial vaginosis?

Answer 4

vaginal discharge: ‘fishy’, offensive
asymptomatic in 50%
White discharge

Question 5

Amsel’s criteria for diagnosis of BV - 3 of the following 4 points should be present

Answer 5

thin, white homogenous discharge
clue cells on microscopy: stippled vaginal epithelial cells
vaginal pH > 4.5
positive whiff test (addition of potassium hydroxide results in fishy odour)

Question 6

X

Question 7

X

Question 8

X

Question 9

X

Question 10

X

Question 11

X

Question 12

Management

Answer 12

if the woman is asymptomatic, treatment is not usually required

picked up on a swab done for different reasons

exceptions include if a woman is undergoing a termination of pregnancy

Question 13

Complication

Answer 13

Relapses occur in bacterial vaginosis in half of the case

Question 14

if pregnant?

Answer 14

increased risk of preterm labour, low birth weight and chorioamnionitis, late miscarriage

recommend that oral metronidazole is used throughout pregnancy
if asymptomatic: discuss with the woman’s obstetrician if treatment is indicated

if symptomatic: either oral metronidazole for 5-7 days or topical treatment.

The higher, stat dose of metronidazole mentioned above is not recommended