"Cytological Findings of Bacterial Vaginosis in Routine Pap Smears" A Two Yrs Institutional Study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 1
Abstract
Introduction = The healthy vaginal microflora is constituted mainly by Gram-positive bacilli .Other nonbeneficial microbial species are also present in small numbers, but are not sufficient to cause disease. Among genital infections, Bacterial Vaginosis (BV) is one of the most common cause of vaginal disorder in women of childbearing age between 15-45 years contributing to more than 60% of all vulvovaginal infections. Aims And Objectives:1.To study the spectrum of cytological findings of Bacterial Vaginosis in routine pap smears.2.To evaluate clinical diagnostic criteria in Bacterial vaginosis.3.To compare the cervical cytology findings with gram staining of pap smears in Bacterial Vaginosis. Material And Methods : The present cross sectional study conducted over two years(November 2015 to October 2017)period comprised of 100 patients who were diagnosed as BV on pap smear in cytopathology department kakatiya medical college, WARANGAL. Discussion : The present study showed maximum number of cases were recorded between 20-30 years age group. Out of 100 cases studied, pap smear showed only Bacterial Vaginosis in 54%,BV was associated with inflammation in 38% and erosion in 8%. 51cases presented with homogenous watery discharge,31 cases with mucoid white discharge and curdy white discharge was seen in 19 cases. According to Amsel's criteria,51 cases showed homogenous discharge, Ph>4.5 was seen in 91cases,whiff test was positive in 80 cases and clue cells were seen in 89 cases. Distribution of BV according to Nugent's score on gram staining showed 85% of cases with abnormal vaginal flora with a score of( 7-10),10% cases showed intermediate flora with a score of (4-6) and 5% cases showed normal flora with a score of ( 0-3). Nugent's score showed a sensitivity of 96.25% , specificity of 60%,positive predictive value of 90.59% and negative predictive value of 80% when compared with Amsel's criteria which showed a sensitivity of 90.59%,specificity of 80%, positive predictive value of 96.25% and negative predictive value of 60% for diagnosing BV. Conclusion: Bacterial vaginosis (BV) is the most common cause of vaginal discharge among women in reproductive age, characterized by an increased vaginal pH and the replacement of vaginal lactobacilli with Gardnerella vaginalis and anaerobic Gram negative rods. Pap smear is the most simple and a quick test which is beneficial in diagnosing cervical infections like Bacterial vaginosis. Control of these infections is possible through regular screening and treatment. Early diagnosis of BV can help prevent further complications, by commencing appropriate treatment. By using Amsel's clinical criteria and Nugent's scoring ,BV can be diagnosed effectively in Pap smears. However, further studies need to be undertaken with inclusion of other ancillary tests for more confirmatory diagnosis
Authors and Affiliations
Dr. G. Vandana, Dr. K. Raja Kumar, Dr. Seema Khan, Dr. Sandhya Anil
Keywords
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