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Bacterial vaginosis
  1. F Keane1,
  2. C A Ison2,
  3. H Noble3,
  4. C Estcourt4
  1. 1Department of Genito-urinary Medicine, Royal Cornwall Hospital, Truro, UK
  2. 2Health Protection Agency, Colindale, London, UK
  3. 3Ambrose King Centre, Barts and the London NHS Trust, London, UK
  4. 4Ambrose King Centre, Barts and the London NHS Trust, UK
  1. Correspondence to:
 Dr Frances Keane
 Department of GU Medicine, Royal Cornwall Hospital, Treliske, Truro, Cornwall TR1 3LJ, UK; frances.keane{at}rcht.cornwall.nhs.uk

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WHY TEST FOR BACTERIAL VAGINOSIS?

Bacterial vaginosis (BV) is a very common condition causing distressing vaginal symptoms, primarily a malodorous discharge. A high proportion of women with BV are asymptomatic.1 The aetiology is unknown but BV is associated with a change in vaginal ecology, resulting in overgrowth of certain bacteria such as Gardnerella vaginalis, and anaerobes, replacing the lactobacillus dominated flora of the normal vagina. The true prevalence is unknown, being reported as 10–20% in sexually active women2 and higher in women attending specialised clinics for sexually transmitted infections (STI) or for termination of pregnancy.3 The bacteria associated with BV can be treated but recurrence is common.4 BV has been associated with serious health problems including adverse pregnancy outcomes such as preterm delivery and low birthweight babies,5,6 as well as an increased risk of pelvic inflammatory disease (PID)7,8 and post-abortal sepsis.9 BV has also been linked to increased rates of HIV acquisition.10 Although early trials of antibiotic therapy of BV in pregnancy gave variable results,11–14 more recent studies have shown a positive effect of treatment.15,16 However, there are no follow up data available on the effect of treating BV and the subsequent risk of developing PID. There are limited data available on the benefits of treating BV in women undergoing first trimester abortions.17,18

RECOMMENDED TESTS

A variety of tests, which reflect the changes in vaginal ecology, have been used …

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