Clinical and Microbiological Correlates of Vaginal Trichomoniasis During Pregnancy

Abstract

Colonization with Trichomonas vaginalis is a possible cause of poor pregnancy outcome. To facilitate the diagnosis of this condition during pregnancy, we conducted a prospective, multicenter study of 13,816 gravid women who were between 23rd and 26th week of gestation. Findings significantly associated with T. vaginalis colonization included a yellow, green, or bloody discharge from the vagina or cervix; abnormal odor after KOH was added to a vaginal specimen; a vaginal pH of > 5.0; and cervical friability. The amount of vaginal discharge and abnormal consistency of the discharge were also associated with T. vaginalis colonization. These findings (except for cervical bleeding and odor after the addition of KOH to a vaginal specimen, which may be influenced by the presence of other flora) are consistent with those reported elsewhere. The clinical usefulness of these features is minimal, and it is more significant that other microorganisms are makers for trichomoniasis; therefore, controlling for other flora is important in the investigation of T. vaginalis colonization.

Methods for Detection of Trichomonas vaginalis in the Male Partners of Infected Women: Implications for Control of Trichomoniasis

“…Infection of the female genital tract can result in vaginitis, cervicitis, and urethritis, and trichomoniasis has been associated with adverse pregnancy outcomes (4,23,26). Though it was once virtually ignored, T. vaginalis infection in men is now recognized as an important cause of nongonococcal urethritis (9,27,29) and is associated with prostatitis (17,25,31) and male factor infertility (6,21).…”

Inducing Immune Protection Against Trichomonas vaginalis: A Novel Vaccine Approach to Prevent HIV Transmission

“…Rarely are all symptoms present nor are typical symptoms easily distinguishable from other urogenital infections. Additionally up to 50% of infected females and greater numbers in males are asymptomatic (Fouts & Kraus, 1980, as cited in Cudmore et al, 2004Pastorek et al, 1996). While men and women usually present with malodorous discharge from the infected areas the most significant burden is found in women who may present with any of the following; high vaginal pH, bloody mucus, colpitis macularis, and vulvitis.…”

“…While men and women usually present with malodorous discharge from the infected areas the most significant burden is found in women who may present with any of the following; high vaginal pH, bloody mucus, colpitis macularis, and vulvitis. Infection is associated with pelvic inflammatory disease, birth complications including premature rupture of the placental membrane, premature labour, low average birth-weight, and infertility, and increased transmission and contraction of HIV (Cotch et al, 1997;Mavedzenge et al, 2010;McClelland et al, 2008;Moodley et al, 2002;Pastorek et al, 1996;Wølner-Hanssen et al, 1989). Lossik (1990) describes the basics of metronidazole, a chemically modified form of the natural Streptomyces product azomycin from the family of nitroimidazoles, first synthesized in 1957 and finally marketed in 1960.…”

Use of Internal Transcribed Spacer Sequence Polymorphisms as a Method for Trichomonas vaginalis Genotyping

“…Recent reports have supported the idea that T. vaginalis may facilitate the transmission of HIV, particularly Type I (7)(8)(9). Trichomoniasis may cause profound health consequences, such as low birth weight infant, and preterm birth, in pregnancy (10,11). Metronidazole, a 5-nitro imidazole derivative, is the primary drug of choice for trichomoniosis treatment; however, resistant cases to this drug have been reported in the USA, Russia, Africa, and Europe (12)(13)(14)(15).…”