Bacterial Vaginosis

Question 1

What is bacterial vaginosis

Answer 1

Overgrowth of anaerobic bacteria in vagina caused by loss of lactobacilli resulting in alkaline pH

Question 2

What bacteria cause BV?

Which is the most common?

Answer 2

Gardnerella vaginalis
Mycoplasma hominis
Prevotella

Gardnerella vaginalis - most common

Question 3

Risk factors for BV?

Answer 3

Multiple sexual partners

Excessive vaginal cleaning e.g. cleaning products, vaginal washing, douching)

Recent antibiotics

Smoking

Copper coil

Question 4

Symptoms of BV?

Answer 4

FISHY SMELLING, watery, grey/white vaginal discharge

50% women are asymptomatic

No itch/pain/irritation

Question 5

Investigations for BV?

Answer 5

Clinical history usually
Speculum
Charcoal swab - high/low vaginal swab
Microscopy - clue cells

Question 6

Management of BV?

Answer 6

If aysmptomatic -> no treatment

If symptomatic -> metronidazole oral/gel
2nd line: clindamycin
Test for chlamydia and gonorrhea
Education on risks of too much vaginal cleaning

Question 7

What should you advise patients when taking metronidazole?

Answer 7

Don’t drink alcohol

Question 8

Complications of BV?

Answer 8

Increased risk of…

Chlamdydia
Gonorrhea
HIV
Miscarriage
Preterm delivery
Chorioamnionitis
Postpartum endometritis
Premature rupture of membranes