Cytological and cultural evaluation of abnormal vaginal discharge in pregnancy and its co-relation with maternal and neonatal outcome

Background: Pregnancy represents a risk factor in the occurrence of vaginal infection. This study was undertaken to define the persistence of vaginal flora in 280 pregnant women at 14 to 34 weeks' gestation and to evaluate the role of cytology in diagnosis of vaginal infections. It aims to study the maternal and neonatal outcome in pregnancy with vaginal discharge.Methods: High vaginal swab samples and data on epidemiological characteristics were collected from 280 pregnant women between 14-34 weeks with complaints of abnormal vaginal discharge at booking clinic of Indira Gandhi Government Medical College, Nagpur. Vaginal swab was collected and sent to laboratory for further investigation to establish etiological diagnosis. After diagnosis by vaginal swab report, subjects were treated with the specific treatment to individual infection. Subjects were followed up during antenatal period for complications. A birth weight of delivered baby was noted. The data was analysed using software Graph Pad in stat 3.Results: The incidence of abnormal vaginal discharge in pregnancy was 23.9% in one year. The frequency of abnormal discharge was 53% among those aged 20-24 years (97/183), 49.2% in primigravida (65/132). Pain in lower abdomen and back was the most common symptoms i.e. 88.19% in Cases, while 17.36% had vulval pruritus and 14.58% had dysuria.Conclusions: This study recommend that women complaining of vaginal discharge in pregnancy should be evaluated for infections. this study supports CDC-P recommendation as all women who have symptomatic vaginitis, should be treated regardless of pregnancy status.

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Gram stain and Giemsa stain as a rapid diagnostic tool for diagnosis of vaginal infections” in Western Nepal

Journal of Lumbini Medical College ◽

10.22502/jlmc.v5i1.105 ◽

2017 ◽

Vol 5 (1) ◽

pp. 5

Author(s):

Kishor Bajracharya ◽

Narinder Kaur ◽

Sushama Suresh Pant

Keyword(s):

Bacterial Vaginosis ◽

Vaginal Discharge ◽

Specific Treatment ◽

Vaginal Swab ◽

Giemsa Stain ◽

Reproductive Age ◽

Vaginal Infections ◽

Medical College ◽

Child Bearing ◽

Litmus Paper

Abstract: Introduction: Infective vaginitis accounts for about 90% of all the cases of vaginal discharge in the women of reproductive age group. This includes triad of bacterial vaginosis, candidiasis and trichomoniasis. Method: The study was carried out in Lumbini Medical College and Teaching Hospital, Palpa, Nepal for a time period of 4 months. Total 125 high vaginal swabs from posterior fornix of vagina were collected from November 2014 to February 2015 in the department of Obstetrics and Gynecology, in the patients complaining of vaginal discharge. PH of the vaginal discharge was also determined by using litmus paper. Gram’s and Giemsa stain of vaginal swab smear were done to diagnose Bacterial vaginosis, Candidiasis and Trichomoniasis. Age, parity and pregnancy status of the patients were noted. Result: Out of 125 patient, bacterial vaginosis was found in 16% and candidiasis in 37%.Candidiasis and bacterial vaginosis were observed in child bearing sexually active women. Surprisingly bacterial vaginosis was not observed in pregnant women. Trichomoniasis infection was present in one case (0.8%) while severe invasive Candidiasis was observed in one woman. Conclusion: A definitive diagnosis can easily be made by Gram’s and Giemsa stain and microscopic examination of high vaginal swab. This may help in specific treatment and prevent associated morbidity and recurrence. Key words: Bacterial vaginosis, candidiasis, high vaginal swab, Gram’s stain, Giemsa stain.

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Asymptomatic Bacterial Vaginosis in Pregnancy and Missed Opportunities for Treatment: A Cross-Sectional Observational Study

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/2019/7808179 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

Nkosinathi Joyisa ◽

Dhayendre Moodley ◽

Thandeka Nkosi ◽

Raesetja Talakgale ◽

Motshedisi Sebitloane ◽

...

Keyword(s):

Bacterial Vaginosis ◽

Pregnant Women ◽

South African ◽

Vaginal Discharge ◽

Unprotected Sex ◽

Cross Sectional ◽

Predictive Values ◽

Vaginal Ph ◽

Abnormal Vaginal Discharge ◽

In Pregnancy

Background. High rates of bacterial vaginosis (BV) have been described in nonpregnant South African women. Studies of BV in South African pregnant women are sparse. Diagnosis and prompt treatment of BV in pregnancy are expected to have a positive impact on pregnancy outcomes and HIV prevention. This study was undertaken to determine the prevalence of BV in pregnant women in a high HIV burden periurban setting in KwaZulu-Natal and explore how to enhance BV diagnosis in this setting where syndromic management of sexually transmitted diseases is the standard of care.Methods. In this cross-sectional study, consenting HIV uninfected pregnant women were examined for abnormal vaginal discharge; nurses determined the vaginal pH and collected a vaginal swab for Gram-stain and Nugent scoring.Findings. Among 750 HIV uninfected pregnant women, 280 (37.3%; 95%CI 33.9-40.9) tested positive for BV. Using a vaginal pH > 4.4, 65% of women with BV were correctly identified, while an abnormal vaginal discharge correctly identified a significantly lower proportion (52.9%) of women with BV (p=0.005). The sensitivity, specificity, and positive and negative predictive values of vaginal pH testing were 65.9% (95%CI 60.0 – 71.5%), 61.4% (95%CI 56.8 – 65.9%), and 50.1% and 75.4%, respectively. The 20-24 year-old pregnant women were twice more likely to test positive for BV than the adolescent pregnant women (43.6% vs 21.1%) (p = 0.037) and BV was not associated with the duration of a sexual relationship, frequency of unprotected sex during pregnancy, number of lifetime sex partners, or the partner’s age.Conclusion. There is a high burden of primarily asymptomatic BV in HIV uninfected pregnant women in this periurban setting. Both the sensitivity and specificity of vaginal pH testing are superior to the symptomatic diagnosis of BV but not good enough to be used as a screening tool.

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Functional Status of Maternal Thyroid Gland in Eclampsia

TAJ Journal of Teachers Association ◽

10.3329/taj.v31i1.41567 ◽

2019 ◽

Vol 31 (1) ◽

pp. 9-14

Author(s):

M Hafizur Rahman ◽

Mahbub Ara Chowdhury ◽

Shahin Mahmuda

Keyword(s):

Pregnant Women ◽

Normal Pregnancy ◽

Hormonal Changes ◽

Free Triiodothyronine ◽

College Hospital ◽

Medical College ◽

The Mean ◽

Maternal Thyroid ◽

Complicated Pregnancy ◽

In Pregnancy

Marked changes in maternal thyroid activity occur in pregnancy. During pregnancy bodily hormonal changes and metabolic demands result in complex alteration in the bio-chemical parameters of thyroid activities. Besides these, thyroid enlargement, increased thyroid capability for iodine uptake and increase in basal metabolic rate are evidential though these findings are not usually associated with symptoms of hyperthyroidism in pregnancy. Serum concentration of thyroid hormone thyroxine and triiodothyronine in complicated pregnancy like eclamptic toxemia is another field of controversy. To evaluate the changes in thyroid function in normal pregnancy and eclamptic toxemia, a study was undertaken in Rajshahi Medical College Hospital. We collected serum specimens from non pregnant but married women, normal 3rd trimester pregnant women and patients with eclampsia at 3rd trimester of pregnancy and measured serum concentrations of total and free thyroxine (TT4 & FT4) and total and free triiodothyronine (TT3 & FT3 ) by using RIA. Among the study subjects, 10 women were married but non pregnant, 12 women were in their 3rd trimester of normal pregnancy and 32 patients of eclamptic toxemia with 3rd trimester of pregnancy. In normal pregnancy, FT4 and FT3 levels remained normal while TT4 and TT3 levels were elevated. In patients with toxemia of pregnancy, the mean serum TT3 concentration was significantly lower than that of normal pregnancy and the serum FT3 concentrations were below the normal pregnancy range. The mean serum TT4 and FT4 concentrations in patients with eclampsia were however, significantly higher than those in normal pregnant women. TAJ 2018; 31(1): 9-14

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Rapid Detection of Bacterial Vaginosis (BV) by BVBlue test

Bangladesh Journal of Medical Microbiology ◽

10.3329/bjmm.v4i1.8465 ◽

1970 ◽

Vol 4 (1) ◽

pp. 24-27

Author(s):

Shameem Akhter ◽

Humayun Satter ◽

Shirin Tarafder ◽

Ruhul Amin Miah ◽

Sohely Sharmin ◽

...

Keyword(s):

Bacterial Vaginosis ◽

Vaginal Discharge ◽

Vaginal Swab ◽

Reproductive Age ◽

Gram Stain ◽

Clinical Criteria ◽

Healthy Control ◽

History Of ◽

Study Population ◽

Abnormal Vaginal Discharge

Bacterial vaginosis is the commonest cause of abnormal vaginal discharge in women of reproductive age and require laboratory test for diagnosis . A total 200 women aged 15-45 years with history of abnormal vaginal discharge were included as study population. Fifty women without such history of discharge were taken as healthy control. Three vaginal swab samples were taken from each case and control. These swab samples were subjected to test by conventional methods such as Amsel clinical criteria, Gram stain Nugent method, culture and by newly developed BV Blue test. The results of the BVBlue test were compared with these methods to find out the efficacy of BVBlue test. Rate of detection of bacterial vaginosis (BV) cases was 21.5% by Amsel clinical criteria, 21.0% by Gram stain Nugent method, 21.0% by culture and 22% by BVBlue test among the study population. When comparing with the conventional test and culture, BVBlue test was 100% sensitive and 98% specific. It is rapid, technically simple and is suitable for screening large number of patient in short time where laboratory facilities are not developed. Key words: Bacterial Vaginosis, BVBlue test, Nugent method, Abnormal vaginal discharge. DOI: http://dx.doi.org/10.3329/bjmm.v4i1.8465 BJMM 2011; 4(1): 24-27

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Maternal Outcome of Anemic Pregnant Mother at Private Hospitals in Dhaka City

Medicine Today ◽

10.3329/medtoday.v33i2.56053 ◽

2021 ◽

Vol 33 (2) ◽

pp. 102-107

Author(s):

Muhammad Zahangir

Keyword(s):

Pregnant Women ◽

Total Sample ◽

Fetal Outcome ◽

Maternal Outcome ◽

Dhaka City ◽

College Hospital ◽

Private Hospitals ◽

Medical College ◽

Medicine Today ◽

In Pregnancy

Introduction: The study carried out among the pregnant women who had anemia during pregnancy with the objectives to determine their maternal outcome at private hospitals in Dhaka city. Materials and Methods: The total sample size was 110. Data was collected by interviewing the respondents with a structured pre-tested questionnaire. The study was conducted in pregnant women with anemia at or after 28 weeks of gestation and had delivered at Obstetrics Department of Ad-Din Barrister Rafique ul-Huq Hospital, Jurain and Bashundhara Ad-Din Medical College Hospital South Keranigonj. Results: Most of the respondents (38.2%) belonged to the age group between 16-20 years. The mean age was 23.74±5.127 years. Almost (49.1%) up to primary & (38.2%) were up to secondary/higher secondary level. Most of the respondents were homemaker (87.3%); Monthly income means was 19340.91±12459.647. Most (90.9%) of the respondents had received ANC and 79.1% respondent’s hemoglobin level was below 10 gm. /dl. Among them 90.9% of the respondent’s fetal outcome were healthy & alive baby. More than half (51.8%) of the respondent’s baby were _ 2.5 kg birth weight. Study also shows that 55.5% respondents had anemia after delivery, 28.2% had sickness and 22.7% were sulfured with complications after delivery. There was a significant relationship with low birth weights (LBW) to less high education. Conclusion: All women should be given advice regarding diet in pregnancy with details of foods rich in iron. Dietary changes alone are not sufficient to correct an existing iron deficiency in pregnancy and iron supplements are necessary. Medicine Today 2021 Vol.33(2): 102-107

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A study on bacterial vaginosis in pregnancy and its effect on pregnancy outcome

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193050 ◽

2019 ◽

Vol 8 (7) ◽

pp. 2826

Author(s):

Sai Deepthi Chikicherla ◽

V. Sitalakshmi

Keyword(s):

Bacterial Vaginosis ◽

Pregnant Women ◽

Sampling Technique ◽

Exclusion Criteria ◽

Chi Square ◽

Medical College ◽

Significant Difference ◽

Adverse Pregnancy ◽

A Prospective Study ◽

In Pregnancy

Background: Bacterial vaginosis is an extremely prevalent vaginal condition and one of the causes of vaginitis among both pregnant and non pregnant women and associated with severe sequelae. Fifty percent of the women are asymptomatic. Current studies have found that the prevalence of BV ranges from 15% to 30% among non-pregnant women and 10% to 41% among pregnant women.Methods: This is a prospective study conducted among 150 pregnant women who attended the antenatal outpatient and inpatient clinic in the Department of Obstetrics and Gynaecology at Narayana Medical College and Hospital, Nellore over a period of two years from Oct 2016 to Oct 2018. Obstetric cases fulfilling the inclusion and exclusion criteria were enrolled in the study by convenient sampling technique. They were followed till the outcome of pregnancy. The data was subjected to usual statistical analysis by employing the chi-square tests.Results: Prevalence of the bacterial vaginosis was 20% in the present study. BV was significantly (p<0.05) associated with preterm delivery, PPROM, low birth weight, low APGAR and neonatal jaundice. Neonatal sepsis and congenital abnormalities showed no statistically significant difference (p>0.05) between BV positive and negative women.Conclusions: Considering the vast spectrum of maternal and fetal morbidity associated with this infection, and the availability of rapid inexpensive diagnostic tests it may be prudent to screen BV in pregnancy, so that it may be treated early and hence prevent the adverse pregnancy outcomes.

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Isolation, identification and susceptibility pattern of Gardnerella vaginalis in bacterial vaginosis

Bangladesh Journal of Medical Microbiology ◽

10.3329/bjmm.v5i1.15814 ◽

2013 ◽

Vol 5 (1) ◽

pp. 8-11 ◽

Cited By ~ 1

Author(s):

Shameem Akhter ◽

Humayun Sattar ◽

Ruhul Amin Miah ◽

Ahmed Abu Saleh ◽

Sharmeen Ahmed ◽

...

Keyword(s):

Bacterial Vaginosis ◽

Vaginal Discharge ◽

Vaginal Swab ◽

Reproductive Age ◽

Gardnerella Vaginalis ◽

Gram Stain ◽

Healthy Control ◽

History Of ◽

Abnormal Vaginal Discharge ◽

And Control

Bacterial vaginosis is the commonest cause of abnormal vaginal discharge in women of reproductive age. A total 200 women aged 15- 45 years with history of abnormal vaginal discharge were included as study population. Fifty women without such history of discharge were taken as healthy control. Two vaginal swab samples were taken from each case and control. These swab samples were subjected to test by Gram stain (Nugent method) and culture. 21.5 % of the cases were diagnosed as bacterial vaginosis by Gram stain (Nugent method) and 21 % by culture. Clindamycin was susceptible to G. vaginalis in (90.5%) followed by metronidazol (76.1 %), chloramphenicol (71.4 %) and erythromycin (66.7 %). Out of 50 cases of recurrent bacterial vaginosis, G. vaginalis was isolated from 15 (30 %) cases, of which 5 (33.3 %) were sensitive and 10 (66.7 %) were resistant to metronidazol, while all 15 cases were sensitive to clindamycin.DOI: http://dx.doi.org/10.3329/bjmm.v5i1.15814 Bangladesh J Med Microbiol 2011; 05 (01): 8-11

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AN EPIDEMIOLOGICAL STUDY ON THE PREVALENCE OF HYPOTHYROIDISM IN PREGNANT WOMEN AND ITS OUTCOME

10.36106/ijsr/4104609 ◽

2021 ◽

pp. 48-50

Author(s):

Vinita singh ◽

Sneha kumari

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Pregnant Women ◽

Neonatal Outcome ◽

Reproductive Age ◽

P Value ◽

Overt Hypothyroidism ◽

Thyroid Disorder ◽

Neonatal Complications ◽

In Pregnancy

Thyroid disorders are the most common endocrine disorders affecting women of reproductive age group Hypothyroidism is common in pregnancy with an estimated prevalence of 2-3% Maternal hypothyroidism leads to many maternal and perinatal complications like miscarriage, gestational diabetes mellitus, pre-eclampsia, pre-term labor, placental abruption, and fetal death. AIMS AND OBJECTIVE: To nd out the effect of hypothyroidism on the course of pregnancy, to study the neonatal outcome, to know the prevalence of subclinical and overt hypothyroidism in pregnant women. MATERIALS AND METHODS: This prospective study was conducted in the department of Obstetrics and Gynecology, Nalanda medical college and hospital, Patna. All pregnant women attending the obstetric unit during this period were included in the study after informed consent 10 ml of blood sample of pregnant women was drawn at the rst visit in the rst trimester; then it was centrifuged and stored at -70 degree Celsius until assays, which were done after delivery, TFT was assessed by quantitative analysis of serum TSH and FT4 (ELISA). The pregnancy outcome variables like miscarriages, preterm deliveries, IUGR, preeclampsia, anemia, low birth weight, intrauterine fetal demise, antepartum hemorrhage, stillbirth, postpartum hemorrhage, birth asphyxia were studied. The neonatal outcome was also studied. The statistical analysis was done using the odds ratio. P-value <0.05 was considered signicant. RESULTS: Out of the 250 pregnant women 25 had hypothyroidism (9.5%). The prevalence of subclinical hypothyroidism was more as compared to the overtone (Table 2). Abortions were seen in 12.5% of subclinical and 11.1% of overt hypothyroid women. PIH and abruptions were signicantly higher in subclinical cases (P<0.05) while in the overt group both complications were higher as compared to the normal women but the p-value was not signicant for abruption. More of the hypothyroid women had preterm delivery (37.5% in subclinical and 44.4% in the overt group), Regarding neonatal complications, IUD and Early neonatal deaths were signicantly higher in overt hypothyroidism (P<0.01) Hypothyroid women had more low birth weight babies (31.25% in subclinical and 35.5% in overt) and IUGR babies (18.70% in subclinical and 22.21% in overt), CONCLUSION: The present study shows that, though the occurrence of hypothyroidism in pregnancy is less yet it causes many maternal and neonatal complications therefore universal screening of thyroid disorder should be done in pregnancy.

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Management of Abnormal Vaginal Discharge in Pregnancy

Genital Infections and Infertility ◽

10.5772/62599 ◽

2016 ◽

Author(s):

Sanusi Mohammed Ibrahim ◽

Mohammed Bukar ◽

Bala Mohammed Audu

Keyword(s):

Vaginal Discharge ◽

Abnormal Vaginal Discharge ◽

In Pregnancy

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SARS-COV-2 infection in pregnant women and newborns in a Spanish cohort (GESNEO-COVID) during the first wave

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03784-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Itzíar Carrasco ◽

Mar Muñoz-Chapuli ◽

Sara Vigil-Vázquez ◽

David Aguilera-Alonso ◽

Concepción Hernández ◽

...

Keyword(s):

Pregnant Women ◽

Invasive Mechanical Ventilation ◽

Analytical Data ◽

Preterm Births ◽

Skin Contact ◽

Gestational Age At Delivery ◽

Skin To Skin ◽

Epidemiological Characteristics ◽

Spanish Cohort ◽

In Pregnancy

Abstract Background Knowledge about SARS-CoV-2 infection in pregnancy and newborns is scarce. The objective of this study is to analyse clinical and epidemiological characteristics of a cohort of women infected with SARS-CoV-2 during pregnancy and their newborns exposed to SARS-CoV-2 during gestation. Methods Multicentric observational study of Spanish hospitals from the GESNEO-COVD cohort, participants in RECLIP (Spanish Network of Paediatric Clinical Assays). Women with confirmed SARS-CoV-2 infection by PCR and/or serology during pregnancy, diagnosed and delivering during the period 15/03/2020–31/07/2020 were included. Epidemiological, clinical, and analytical data was collected. Results A total of 105 pregnant women with a median of 34.1 years old (IQR: 28.8–37.1) and 107 newborns were included. Globally, almost 65% of pregnant women had some COVID-19 symptoms and more than 43% were treated for SARS-COV-2. Overall, 30.8% of pregnant women had pneumonia and 5 (4.8%) women were admitted to the intensive care unit needing invasive mechanical ventilation. There was a rate of 36.2% of caesarean sections, which was associated with pneumonia during pregnancy (OR: 4.203, CI 95%: 1.473–11.995) and lower gestational age at delivery (OR: 0.724, CI 95%: 0.578–0.906). The prevalence of preterm birth was 20.6% and prematurity was associated with pneumonia during gestation (OR: 6.970, CI95%: 2.340–22.750) and having a positive SARS-CoV-2 PCR at delivery (OR: 6.520, CI95%: 1.840–31.790). All nasopharyngeal PCR in newborns were negative at birth and one positivized at 15 days of life. Two newborns died, one due to causes related to prematurity and another of unexpected sudden death during early skin-to-skin contact after delivery. Conclusions Although vertical transmission has not been reported in this cohort, the prognosis of newborns could be worsened by SARS-CoV-2 infection during pregnancy as COVID-19 pneumonia increased the risk of caesarean section deliveries and preterm births.

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