Bacterial Vaginosis

Question 1

what is bacterial vaginosis?

Answer 1

bacterial imbalance of the vagina caused by an overgrowth of anaerobic bacteria and loss of lactobacilli

Question 2

what are the clinical features of bacterial vaginosis?

Answer 2

• increased vaginal discharge
• grey-white watery discharge
• characteristic ‘fishy’ smelling discharge (particularly after intercourse)

Question 3

what criteria is often used to diagnose bacterial vaginosis?

Answer 3

amstel criteria

Question 4

how is bacterial vaginosis diagnosed?

Answer 4

3/4 of:
* vaginal pH >4.5
* homogenous grey or milky discharge
* positive whiff test
* clue cells present on wet mount

Question 5

what is the whiff test?

Answer 5

addition of 10% potassium hydroxide to produce fishy odour

Question 6

what cells are present on wet mount in bacterial vaginosis?

Answer 6

clue cells

squamous epithelial cells coated with large amounts of bacilli

Question 7

what is the management of bacterial vaginosis?

Answer 7

1. oral metronidazole 400mg BD for 5-7 days
2. oral clindamycin

can be given intravaginally as well

Question 8

what condition are women with BV more likely to get?

Answer 8

chlamydia

Question 9

what is the causative organism in bacterial vaginosis?

Answer 9

gardnerella vaginalis

anaerobic organism

Question 10

what risk to pregnancy does bacterial vaginosis present?

Answer 10

• preterm rupture of membranes
• premature labour
• low birth weight
• chorioamnioitis
• late miscarriage

Question 11

what is the pathophysiology of bacterial vaginosis?

Answer 11

1. overgrowth of predominately anaerobic organisms
2. leads to a consequent fall in lactic acid producing aerobic lactobacilli
3. results in a raised vaginal pH