Study of role of bacterial vaginosis in pelvic inflammatory disease, infertility and preterm labor
Keywords:
Bacterial Vaginosis, Infertility, Pelvic Inflammatory Diseases, Preterm Labor
Abstract
Background and Objective: Prevention is better than cure. Bacterial vaginosis (BV) is associated with a two fold increased risk of preterm birth but its role in upper genital tract infection (pelvic inflammatory disease), tubal damage and infertility is less certain. Our study aimed at detecting the incidence of BV in infertility, preterm labour and pelvic inflammatory disease (PID).
Material and Methods: Study comprised of 50 preterm labor women subjects, 12 infertile women subjects and 12 women subjects with pelvic inflammatory disease. Gram staining, Giemsa staining, KOH mount, pH determination of vaginal swabs from posterior fornix of women subjects of reproductive age(15 – 45 years) group who attended Gynaecology and Obstetrics OPD/IPD of our tertiary care hospitals were carried out.
Results: Of the 50 preterm labor cases, 10 % (5) cases were of asymptomatic BV, 46% (23) case where of symptomatic BV. Of the 12 infertile women, 50% (6) cases were diagnosed to have BV. Of the 12 women with PID, 83 %( 10) cases were diagnosed to have BV.
Conclusion: Most of the complications due to BV like pelvic inflammatory disease, infertility, preterm labor can be prevented if BV is diagnosed early and treated. In view of the potentially serious complications associated with BV, a routine screening of these patients is essential and simple tests like Gram Stain, Giemsa Stain, monitoring of pH should be recommended to be included as a routine screening test as part of Ante-Natal Care.
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References
1. Hillier SL, Krohn MA, Rabe LK, et al: The normal vaginal flora,H2O2-producing lactobacilli , and bacterial vaginosis in pregnant women. Clin Infect Dis . 1993 ; 16(Supp 4); S 273. [PubMed]
2. Spiegel CA , Amsel R , Eschenbach DA , et al : Anaerobic Bacteria in nonspecific vaginitis . N Engl J Clin Med, 1998;303:601. [PubMed]
3. P..Rao , S.Devi , A.Shriyan, M.Rajaram, K. Jagdishchandra ; Diagnosis of Bacterial Vaginosis in a Rural Set up : Comparison of clinical Algorithm, Smear Scoring and Culture by Semiquantitave Technique, Indian Journal of Medical Microbiology, 2OO4 ;22(I) : 47- 50.
4. Eschenbach DA. Hillier S. Critchlow C. Stevens C. DE Rousen T.Holmes KK . Diagnosis and Clinical Manifestations of BV. Am J OBSTET GYNAECOL, 1998;158;819-28. [PubMed]
5. Ramani Bai JT, K R.Legori M. Prevalence of Bacterial Vaginosis in women attending Antenatal , Gynecology and STD Clinics of Medical College ,Thiruvananthapurum. J Academy Clinical Microbiologist. 1998;I;107-11. [PubMed]
6. B.Majeroni,MD State University of New York at Buffalo New York Bacterial Vaginosis –An Update, American Family Physician March 15 ,1998 ;Vol 57-6.
7. Eltabbakh GH, Eltabbakh GD, Broekhuizen FF, Griner BT. Value of wet mount and cervical cultures at the time of cervical cytology in asymptomatic women. Obstet Gynecol 1995;85:499-503.
8. Soper DE, Brockwell MJ, Dalton HP, Johnson D. Observations concerning the microbial etiology of acute salpingitis. Am J Obstet Gynecol 1994;170: 1008-14. [PubMed]
9. Korn AP, Bolan G, Padian N, Ohm-Smith M, Schachter J, Landers DV. Plasma cell endometritis in women with symptomatic bacterial vaginosis. Obstet Gynecol 1995;85:387-90. [PubMed]
10. Sobel JD. Vaginitis. N Engl J Med 1997;337:1896-903. [PubMed]
11. Kent HL. Epidemiology of vaginitis. Am J Obstet Gynecol 1991;165:1168-76. [PubMed]
12. Hill GB. The microbiology of bacterial vaginosis. Am J Obstet Gynecol 1993;169:450-4. [PubMed]
13. Morris M, Nicoll A, Simms I, Wilson J, Catchpole M. Bacterial vaginosis: a public health review. BJOG 2001; 108 : 439-50. [PubMed]
14. Nugent RP ,Krohn M A,Hillier SL : Reliability of diagnosing bacterial vaginosis is improved by a standardized method of Gram stain interpretation. J clin Microbiol. 1991; 29:297. [PubMed]
15. Hay PE, Lamont RF, Taylor-Robinson D, Morgan DJ, Ison C, Pearson J. Abnormal bacterial colonisation of the genital tract and subsequent preterm delivery and late miscarriage. BMJ 1994;308:295-8.
16. Peipert JF, Montagno AB,Cooper AS, Sung CJ. Bacterial vaginosis as a risk factor for upper genital tract infection. Am J Obstet Gynecol 1997;177 :1184 –7. [PubMed]
17. Mercer BM, Goldenberg RL, Meis PJ, Moawad AH, Shellhaas C, Das A, et al. The Preterm Prediction Study: Prediction of preterm premature rupture of membranes through clinical findings and ancillary testing. The National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Am J Obstet Gynecol 2000;183:738–45. [PubMed]
18. Soper DE. Gynecologic sequelae of bacterial vaginosis. Int J Gynaecol Obstet 1999;67(Suppl 1):S25–8. [PubMed]
19. Donders GG, Van Bulck B, Caudron J, Londers L, Vereecken A, Spitz B. Relationship of bacterial vaginosis and mycoplasmas to the risk of spontaneous abortion. Am J Obstet Gynecol 2000;183:431–7. [PubMed]
20. Lin L, Song J, Kimber N, Shott S, Tangora J, Aroutcheva A, et al. The role of bacterial vaginosis in infection after major gynecologic surgery. Infect Dis Obstet Gynecol 1999;7:169–74. [PubMed]
21. Sonnex C. The amine test: a simple, rapid, inexpensive method for diagnosing bacterial vaginosis. Br J Obstet Gynaecol 1995;102:160–1.
22. Deborah B. Nelson and George Macones. Bacterial Vaginosis in Pregnancy: Current Findings and Future Directions. Epidemiologic Reviews, 2002; 24:102-108.
23. 17.Kurki T, Sivonen A, Renkonen OV, et al. Bacterial vaginosis in early pregnancy and pregnancy outcome. Obstet Gynecol. 1992;80:173–7. [PubMed]
24. Gratocos E, Figueras F, Barranco M, et al. Spontaneous recovery of bacterial vaginosis during pregnancy is not associated with an improved perinatal outcome. Acta Obstet Gynecol Scand. 1998;77:37–40. [PubMed]
25. Purwar M, Ughade S, Bhagat B, Agarwal V, Kulkarni H. Bacterial vaginosis in early pregnancy and adverse pregnancy outcome. J Obstet Gynaecol Res .2001; 27 : 175-81. [PubMed]
26. Mastrobattista JM, Bishop KD, Newton ER. Wet smear compared with Gram stain diagnosis of bacterial vaginosis in asymptomatic pregnant women. Obstet Gynecol 2000; 96:504–6.
27. Hauth JC, Goldenberg RL, Andrews WW, DuBard MB, Cooper RL. Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis. N Engl J Med 1995;333:1732-6. [PubMed]
28. Briselden, A., B. J. Moncla, C. E. Stevens, and S. Hillier. Sialidases (neuramidases) in bacterial vaginosis and bacterial vaginosis-associated microflora. J. Clin. Microbiol. 1992. 30:663-666. [PubMed]
29. McGregor, J. A., J. I. French, W. Jones, K. Milligan, P. J. McKinney, E. Patterson, and R. Parker. Bacterial vaginosis is associated with prematurity and vaginal fluid mucinase and sialidase: results of a controlled trial of topical clindamycin cream. Am. J. Obstet. Gynecol. 1994.; 170:1048-1060. [PubMed]
30. Cauci S, Monte R, Driussi S, et al. Impairment of the mucosal immune system: IgA and IgM cleavage detected in vaginal washings of a subgroup of patients with bacterial vaginosis. J Infect Dis 1998;178:1698–706.
31. Platz-Christensen JJ, Brandberg A, Wiqvist N. Increased prostaglandin concentrations in the cervical mucus of pregnant women with bacterial vaginosis. Prostaglandins 1992;43:133–4.
32. Platz-Christensen JJ, Mattsby-Baltzer I, Thomsen P, et al. Endotoxin and interleukin-1c in the cervical mucus and vaginal fluid of pregnant women with bacterial vaginosis. Am J Obstet Gynecol 1993;169:1161–6. [PubMed]
33. Spandorfer DS, Neuer A, Giraldo PC, et al. Relationship of abnormal vaginal flora, proinflammatory cytokines and idiopathic infertility in women undergoing IVF. J Reprod Med 2001;46:806–10. [PubMed]
34. Imseis HM, Greig PC, Livengood CH 3rd, et al. Characterization of the inflammatory cytokines in the vagina during pregnancy and labor and with bacterial vaginosis. J Soc Gynecol Investig 1997;4:90–4.
35. Ralph SG, Rutherford AJ, Wilson JD. Influence of bacterial vaginosis on conception and miscarriage in the first trimester: cohort study. BMJ 1999;319:220–3. [PubMed]
36. MacGregor JA, et al. Prevention of Premature Birth by Screening and Treatment for Common Genital Tract Infections: Results of a Prospective Controlled Evaluation. Am J Obstet Gynecol 1995;173:157-67. [PubMed]
37. Llahi-Camp JM, Rai R, Ison C, et al. Association of bacterial vaginosis with a history of second trimester miscarriage. Hum Reprod 1996;11:1575–8.
38. Paul J Keis, R Md, Goldenberg L, Mercer Brian et al:The preterm prediction study:Singnificance of vaginal infections. Am J Obstet Gynecol; 1995;173(4):1231.
39. Rice PA, Schachter J. Pathogenesis of pelvic inflammatory disease caused by Chlamydia trachomatis and Neisseria gonorrhoeae: where should research efforts focus? In: Joint Meeting of the Centers for Disease Control and National Institutes of Health about Pelvic Inflammatory Disease Prevention, Management, and Research in the 1990s, Bethesda, Maryland, September 4-5, 1990.
40. Westrom L. Incidence, prevalence, and trends of acute pelvic inflammatory disease and its consequences in industrialized countries. Am J Obstet Gynecol 1980;138:880-92.
41. Cates W, Rolfs RT, Aral SO. Sexually transmitted diseases, pelvic inflammatory disease, and infertility: an epidemiologic update. Epidemiol Rev 1990; 12:199-220.
42. Eschenbach DA, Buchanan RM, Pollock HM, et al. Polymicrobial etiology of acute pelvic inflammatory disease. N Engl J Med 1975;293:166-71.
2. Spiegel CA , Amsel R , Eschenbach DA , et al : Anaerobic Bacteria in nonspecific vaginitis . N Engl J Clin Med, 1998;303:601. [PubMed]
3. P..Rao , S.Devi , A.Shriyan, M.Rajaram, K. Jagdishchandra ; Diagnosis of Bacterial Vaginosis in a Rural Set up : Comparison of clinical Algorithm, Smear Scoring and Culture by Semiquantitave Technique, Indian Journal of Medical Microbiology, 2OO4 ;22(I) : 47- 50.
4. Eschenbach DA. Hillier S. Critchlow C. Stevens C. DE Rousen T.Holmes KK . Diagnosis and Clinical Manifestations of BV. Am J OBSTET GYNAECOL, 1998;158;819-28. [PubMed]
5. Ramani Bai JT, K R.Legori M. Prevalence of Bacterial Vaginosis in women attending Antenatal , Gynecology and STD Clinics of Medical College ,Thiruvananthapurum. J Academy Clinical Microbiologist. 1998;I;107-11. [PubMed]
6. B.Majeroni,MD State University of New York at Buffalo New York Bacterial Vaginosis –An Update, American Family Physician March 15 ,1998 ;Vol 57-6.
7. Eltabbakh GH, Eltabbakh GD, Broekhuizen FF, Griner BT. Value of wet mount and cervical cultures at the time of cervical cytology in asymptomatic women. Obstet Gynecol 1995;85:499-503.
8. Soper DE, Brockwell MJ, Dalton HP, Johnson D. Observations concerning the microbial etiology of acute salpingitis. Am J Obstet Gynecol 1994;170: 1008-14. [PubMed]
9. Korn AP, Bolan G, Padian N, Ohm-Smith M, Schachter J, Landers DV. Plasma cell endometritis in women with symptomatic bacterial vaginosis. Obstet Gynecol 1995;85:387-90. [PubMed]
10. Sobel JD. Vaginitis. N Engl J Med 1997;337:1896-903. [PubMed]
11. Kent HL. Epidemiology of vaginitis. Am J Obstet Gynecol 1991;165:1168-76. [PubMed]
12. Hill GB. The microbiology of bacterial vaginosis. Am J Obstet Gynecol 1993;169:450-4. [PubMed]
13. Morris M, Nicoll A, Simms I, Wilson J, Catchpole M. Bacterial vaginosis: a public health review. BJOG 2001; 108 : 439-50. [PubMed]
14. Nugent RP ,Krohn M A,Hillier SL : Reliability of diagnosing bacterial vaginosis is improved by a standardized method of Gram stain interpretation. J clin Microbiol. 1991; 29:297. [PubMed]
15. Hay PE, Lamont RF, Taylor-Robinson D, Morgan DJ, Ison C, Pearson J. Abnormal bacterial colonisation of the genital tract and subsequent preterm delivery and late miscarriage. BMJ 1994;308:295-8.
16. Peipert JF, Montagno AB,Cooper AS, Sung CJ. Bacterial vaginosis as a risk factor for upper genital tract infection. Am J Obstet Gynecol 1997;177 :1184 –7. [PubMed]
17. Mercer BM, Goldenberg RL, Meis PJ, Moawad AH, Shellhaas C, Das A, et al. The Preterm Prediction Study: Prediction of preterm premature rupture of membranes through clinical findings and ancillary testing. The National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Am J Obstet Gynecol 2000;183:738–45. [PubMed]
18. Soper DE. Gynecologic sequelae of bacterial vaginosis. Int J Gynaecol Obstet 1999;67(Suppl 1):S25–8. [PubMed]
19. Donders GG, Van Bulck B, Caudron J, Londers L, Vereecken A, Spitz B. Relationship of bacterial vaginosis and mycoplasmas to the risk of spontaneous abortion. Am J Obstet Gynecol 2000;183:431–7. [PubMed]
20. Lin L, Song J, Kimber N, Shott S, Tangora J, Aroutcheva A, et al. The role of bacterial vaginosis in infection after major gynecologic surgery. Infect Dis Obstet Gynecol 1999;7:169–74. [PubMed]
21. Sonnex C. The amine test: a simple, rapid, inexpensive method for diagnosing bacterial vaginosis. Br J Obstet Gynaecol 1995;102:160–1.
22. Deborah B. Nelson and George Macones. Bacterial Vaginosis in Pregnancy: Current Findings and Future Directions. Epidemiologic Reviews, 2002; 24:102-108.
23. 17.Kurki T, Sivonen A, Renkonen OV, et al. Bacterial vaginosis in early pregnancy and pregnancy outcome. Obstet Gynecol. 1992;80:173–7. [PubMed]
24. Gratocos E, Figueras F, Barranco M, et al. Spontaneous recovery of bacterial vaginosis during pregnancy is not associated with an improved perinatal outcome. Acta Obstet Gynecol Scand. 1998;77:37–40. [PubMed]
25. Purwar M, Ughade S, Bhagat B, Agarwal V, Kulkarni H. Bacterial vaginosis in early pregnancy and adverse pregnancy outcome. J Obstet Gynaecol Res .2001; 27 : 175-81. [PubMed]
26. Mastrobattista JM, Bishop KD, Newton ER. Wet smear compared with Gram stain diagnosis of bacterial vaginosis in asymptomatic pregnant women. Obstet Gynecol 2000; 96:504–6.
27. Hauth JC, Goldenberg RL, Andrews WW, DuBard MB, Cooper RL. Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis. N Engl J Med 1995;333:1732-6. [PubMed]
28. Briselden, A., B. J. Moncla, C. E. Stevens, and S. Hillier. Sialidases (neuramidases) in bacterial vaginosis and bacterial vaginosis-associated microflora. J. Clin. Microbiol. 1992. 30:663-666. [PubMed]
29. McGregor, J. A., J. I. French, W. Jones, K. Milligan, P. J. McKinney, E. Patterson, and R. Parker. Bacterial vaginosis is associated with prematurity and vaginal fluid mucinase and sialidase: results of a controlled trial of topical clindamycin cream. Am. J. Obstet. Gynecol. 1994.; 170:1048-1060. [PubMed]
30. Cauci S, Monte R, Driussi S, et al. Impairment of the mucosal immune system: IgA and IgM cleavage detected in vaginal washings of a subgroup of patients with bacterial vaginosis. J Infect Dis 1998;178:1698–706.
31. Platz-Christensen JJ, Brandberg A, Wiqvist N. Increased prostaglandin concentrations in the cervical mucus of pregnant women with bacterial vaginosis. Prostaglandins 1992;43:133–4.
32. Platz-Christensen JJ, Mattsby-Baltzer I, Thomsen P, et al. Endotoxin and interleukin-1c in the cervical mucus and vaginal fluid of pregnant women with bacterial vaginosis. Am J Obstet Gynecol 1993;169:1161–6. [PubMed]
33. Spandorfer DS, Neuer A, Giraldo PC, et al. Relationship of abnormal vaginal flora, proinflammatory cytokines and idiopathic infertility in women undergoing IVF. J Reprod Med 2001;46:806–10. [PubMed]
34. Imseis HM, Greig PC, Livengood CH 3rd, et al. Characterization of the inflammatory cytokines in the vagina during pregnancy and labor and with bacterial vaginosis. J Soc Gynecol Investig 1997;4:90–4.
35. Ralph SG, Rutherford AJ, Wilson JD. Influence of bacterial vaginosis on conception and miscarriage in the first trimester: cohort study. BMJ 1999;319:220–3. [PubMed]
36. MacGregor JA, et al. Prevention of Premature Birth by Screening and Treatment for Common Genital Tract Infections: Results of a Prospective Controlled Evaluation. Am J Obstet Gynecol 1995;173:157-67. [PubMed]
37. Llahi-Camp JM, Rai R, Ison C, et al. Association of bacterial vaginosis with a history of second trimester miscarriage. Hum Reprod 1996;11:1575–8.
38. Paul J Keis, R Md, Goldenberg L, Mercer Brian et al:The preterm prediction study:Singnificance of vaginal infections. Am J Obstet Gynecol; 1995;173(4):1231.
39. Rice PA, Schachter J. Pathogenesis of pelvic inflammatory disease caused by Chlamydia trachomatis and Neisseria gonorrhoeae: where should research efforts focus? In: Joint Meeting of the Centers for Disease Control and National Institutes of Health about Pelvic Inflammatory Disease Prevention, Management, and Research in the 1990s, Bethesda, Maryland, September 4-5, 1990.
40. Westrom L. Incidence, prevalence, and trends of acute pelvic inflammatory disease and its consequences in industrialized countries. Am J Obstet Gynecol 1980;138:880-92.
41. Cates W, Rolfs RT, Aral SO. Sexually transmitted diseases, pelvic inflammatory disease, and infertility: an epidemiologic update. Epidemiol Rev 1990; 12:199-220.
42. Eschenbach DA, Buchanan RM, Pollock HM, et al. Polymicrobial etiology of acute pelvic inflammatory disease. N Engl J Med 1975;293:166-71.
CITATION
DOI: 10.17511/ijmrr.2015.i10.219
Published: 2015-11-30
How to Cite
1.
A Rangari A, Jakhar A. Study of role of bacterial vaginosis in pelvic inflammatory disease, infertility and preterm labor. Int J Med Res Rev [Internet]. 2015Nov.30 [cited 2024Nov.19];3(10):1201-8. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/391
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Original Article
OAI - Open Archives Initiative
