Screening of Vulvovaginal Infections during Pregnancy in Resource Constrained Settings: Implications on Preterm Delivery

Tellapragada, Chaitanya and Vandana, KE and Bhat, Parvati V and Kamath, Asha and Aletty, Sandhya and Mukhopadhyay, Chiranjay (2016) Screening of Vulvovaginal Infections during Pregnancy in Resource Constrained Settings: Implications on Preterm Delivery. Journal of Infection and Public Health. pp. 1-7. ISSN 1876-0341

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The present study was undertaken to evaluate the efficacy of clinical andmicrobiological investigations available in limited resource settings for an effectivediagnosis of vaginal infections/abnormal vaginal microbiota among pregnant women.As an outcome of the study we intended to find the association of various vaginalinfections during pregnancy with preterm delivery. Pregnant women presenting forroutine antenatal care at an antenatal clinic in south India were enrolled in thestudy. Each participant underwent clinical and microbiological examinations for thediagnosis of vaginal infections such as bacterial vaginosis (BV), vulvovaginal can-didiasis (VVC) and trichomoniasis. In addition, Gram’s stained high-vaginal smearswere evaluated for the presence of partial BV and vaginitis. Diagnostic accuracies ofclinical diagnosis for the aforementioned infections was determined in comparison with gold standard microbiological diagnosis. Proportion of women with vulvovagi-nal infections were estimated using descriptive statistics and incidence risk ratio forpreterm delivery with each form of the infection was estimated using univariate anal-ysis. A total of 790 pregnant women were recruited in the study. Positive predictivevalues of clinical diagnosis for BV, VVC and Trichomoniasis in comparison with refer-ence method were 72.7, 33.5 and 37.6% respectively. Partial BV (3.2%) and vaginitisdue to mixed bacterial etiology (9.4%) were per exclusionem diagnosed using themicrobiological smear examination. Microbiological diagnosis of BV and vaginitis werefound to have a statistically significant association with preterm delivery. Effectivediagnosis of vaginal infections/abnormal vaginal microbiota associated with pretermdelivery can be achieved by the adjunct of microbiological smear examination of thevaginal smears to the clinical examination in limited resource settings.

Item Type: Article
Uncontrolled Keywords: Bacterial vaginosis; Preterm delivery; Vaginitis; Abnormal vaginalmicrobiota; Vulvovaginal infections
Subjects: Medicine > KMC Manipal > Community Medicine
Medicine > KMC Manipal > Microbiology
Research > Research Center - Health Sciences
Depositing User: KMC Library
Date Deposited: 20 Mar 2017 04:47
Last Modified: 20 Mar 2017 04:47

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