Abnormal Vaginal Flora in Low-Risk Pregnant Women Cared for by a Public Health Service: prevalence and Association with Symptoms and Findings from Gynecological Exams

Abstract

This study identifies the prevalence of vaginal flora alterations in low-risk pregnant women and their association with reported symptoms and gynecological exams. This quantitative, descriptive, cross-sectional study was conducted in public primary care service units Considering undesirable maternal and perinatal outcomes and feasible laboratory practices, the establishment of a routine for diagnosing vaginal flora alterations in low-risk pregnant women is suggested. Los datos apuntan elevada prevalencia de las alteraciones de flora vaginal, con poca asociación a la sintomatología, pero con asociación a hallazgos del examen ginecológico.Considerándose las repercusiones maternas y perinatales indeseables y la práctica de laboratorio ejecutable, se sugiere el establecimiento de rutina para diagnóstico de las alteraciones de flora vaginal en gestantes de bajo riesgo.Descriptores: Vaginosis Bacteriana; Candidíasis Vulvovaginal; Embarazo; Prevalencia. IntroductionBacterial vaginosis (BV) is a relevant issue during pregnancy because it is associated with a higher risk of late miscarriage, infection of the amniotic cavity, premature rupture of membranes, preterm labor, prematurity, and infant low birth weight (1) . The mechanism through which these obstetrical complications occur is not yet totally The metabolism resulting from the proliferation of these bacteria promote increased production of aromatic amines, the putrescine and cadaverine, which evaporate and induce a bad genital odor (6) . Another frequent symptom is a grayish and fluid vaginal discharge with small bubbles (7) .The Lactobacillus SP is a gram-positive bacillus that produces components such as lactic acid, bacteriocins and hydrogen, and which has properties that protect the vaginal flora. These components determine an acidic vaginal pH, lower than 4.5, inhibiting the growth of pathogenic bacteria. The vaginal flora is also composed of other commensal microorganisms, which in certain situations can become pathogenic (8) .We must take into account that under normal Its most common symptoms are itching, urinary discomfort, perineal irritation, and whitish discharge in plates, while between 25% and 40% of women are asymptomatic (10) . Although it is highly prevalent, it is not related to relevant perinatal complications (11) .Vaginal trichomoniasis is an important sexually Based on a prevalence of altered vaginal flora of 20% with confidence interval of 95% and a margin of error of 5%, the sample minimum size was determined by: Patients included in the study were submitted to speculum examination using a bi-valve vaginal Collins speculum, sterilized and without any lubricating.After this procedure, the macroscopic characteristics of the vaginal content were noted, followed by a pH measurement with Merk  tape graduated between four and seven, pressed against the middle third of the lateral vaginal wall for one minute, then proceeding to the reading according to the manufacturer's instructions.Then, the material of the lateral vaginal wall was collected ...

Prevalence of Trichomonas vaginalis in Pregnant Women in Zanjan, Northwest of Iran

“…Some comparative studies showed that the pregnant women with trichomoniasis have 30% higher risk of delivering baby with low birth weight or delivering preterm than those without the infection (26). Also more prevalence of some STIs has been reported from pregnant women in some areas (11,29); alteration of vaginal flora during pregnancy may be of relevant consecutive concerns (30). These indicate the importance of trichomoniasis in this group of women.…”

Perfil do conhecimento de mulheres quanto aos fatores predisponentes ao desenvolvimento da candidíase vulvovaginal

“…Boatto et al (2007) em seu estudo aborda que os sinais e sintomas clínicos mais relevantes na CVV foram prurido e corrimento, seguidos por eritema e edema. Os achados de Gondo et al (2010) apontam elevada prevalência das alterações de flora vaginal, com pouca associação à sintomatologia, mas associação com achados do exame ginecológico. Outro ponto relevante para este estudo é sobre as orientações prestadas às participantes.…”

Trichomoniasis in Pregnant Sudanese Pregnant Women at Tertiary Obstetric Facility, Khartoum, Sudan

“…Consistent with other research the affected age group is the younger population who are at risk for sexually transmitted infections. In a study from Brazil the mean affected age is 25 years [9].…”