The Association of Bacterial Vaginosis With Adverse Pregnancy Outcomes

Abstract

BACKGROUND Bacterial Vaginosis (BV) is a vaginal disease in which lactobacilli-dominated vaginal flora is exchanged with an abundant complex flora dominated by strict and facultative anaerobic bacteria. It has been associated with significant obstetric complications such as preterm delivery, Premature Rupture of Membranes (PROM), chorioamnionitis and postpartum endometritis. The aim of the study is to assess the prevalence of BV and evaluate its correlation with adverse pregnancy outcomes. MATERIALS AND METHODS An observational study was conducted in a tertiary care hospital from February 2015 to January 2017. Seven hundred and fifty antenatal patients admitted or attending antenatal outpatient department of a tertiary care hospital were included in the study. Appropriate clinical evaluation of BV was made and gram-stained vaginal smears were examined by application of Nugent's criteria. Adverse pregnancy outcomes associated with BV was evaluated. RESULTS Among the 750 women evaluated, 542 (72.26%) women had normal vaginal microflora, 64 (8.53%) had intermediate flora and 144 (19.2%) had BV. The study of BV associated adverse pregnancy outcomes revealed 72% preterm cases, 90% of PROM and 100% of postpartum endometritis cases were associated with BV. CONCLUSION Bacterial vaginosis was significantly associated with preterm labour, PROM and postpartum endometritis. Therefore, the screening of antenatal cases for BV and maintaining a high index of suspicion for the obstetric complications is a must in antenatal BV cases.