Bacterial vaginosis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Most women found to have bacterial vaginosis (BV) reported no symptoms. In symptomatic patients, bacterial vaginosis may present with vaginal odor and white/gray vaginal discharge.[1] If left untreated, bacterial vaginosis may lead to more serious sequelae, such as salpingitis, endometritis, bacteremia, and pelvic inflammatory disease (PID). In most cases, BV causes no complications. However, some complication of bacterial vaginosis may include endometritis, cervicitis, pelvic inflammatory disease (PID), bacteremia, and increase a woman's susceptibility to other STDs.[2][3][4] Additionally, one third of pregnant women found to have a bacterial vaginosis. If left untreated, in pregnant women bacterial vaginosis may result in a serious complication of pregnancy, including premature rupture of membranes, premature labor, chorioamnionitis, postpartum endometritis, and septic abortion.[5][6]
Natural History
Most women found to have bacterial vaginosis (BV) reported no symptoms. Women who have not had vaginal, oral, or anal sex can still be affected by bacterial vaginosis. In symptomatic patients, bacterial vaginosis may present as a ‘fishy’ vaginal odor and a gray/white vaginal discharge.[1] If left untreated, bacterial vaginosis may lead to more serious sequelae, such as salpingitis, endometritis, bacteremia, and pelvic inflammatory disease (PID). If left untreated, pelvic inflammatory disease (PID) may lead to infertility or damage the fallopian tubes enough to increase the future risk of ectopic pregnancy.[2][3]
Bacterial Vaginosis during Pregnancy
Approximately one third of pregnant women found to have a bacterial vaginosis. Pregnant women with BV more often have babies who are born premature or with low birth weight (low birth weight is less than 5.5 pounds). If left untreated, in pregnant women bacterial vaginosis may result in a serious complication of pregnancy, including premature rupture of membranes, premature labor, chorioamnionitis, postpartum endometritis, and septic abortion.[5][6]
Complications
In most cases, BV causes no complications. However, some complication of bacterial vaginosis may include:[2][3]
- Endometritis
- Cervicitis
- Pelvic inflammatory disease (PID)
- Bacteremia
- Increase a woman's susceptibility to other STDs, such as:[4][7]
Complications following Gynecologic Procedures
Some serious complications from bacterial vaginosis following surgical procedures (such as hysterectomy and Iinduced abortion) include:[4][8][9]
- Vaginal cuff cellulitis
- Pelvic abscess
Complications in Pregnancy
Some serious complications from bacterial vaginosis in pregnancy include:[5][6][10]
- Chorioamnionitis
- first trimester miscarriage
- Premature rupture of membrane
- Preterm birth
- Occurrence of postpartum infections
- Endometritis
- Bacteremia
- Wound infection
Prognosis
With treatment, bacterial vaginosis is associated with a good prognosis. However, bacterial vaginosis may associated with adverse outcomes in pregnancy.[3]
References
- ↑ 1.0 1.1 Centers for Disease Control and Prevention. Bacterial Vaginosis (BV) Statisticshttp://www.cdc.gov/std/bv/stats.htm Accessed on October 18, 2016
- ↑ 2.0 2.1 2.2 Laxmi U, Agrawal S, Raghunandan C, et al. Association of bacterial vaginosis with adverse fetomaternal outcome in women with spontaneous preterm labor: a prospective cohort study. J Matern Fetal Neonatal Med 2012;25:64–7.
- ↑ 3.0 3.1 3.2 3.3 Koumans EH, Kendrick JS, CDC Bacterial Vaginosis Working Group (2001). "Preventing adverse sequelae of bacterial vaginosis: a public health program and research agenda". Sex Transm Dis. 28 (5): 292–7. PMID 11354269.
- ↑ 4.0 4.1 4.2 Persson E, Bergström M, Larsson PG, Moberg P, Platz-Christensen JJ, Schedvins K; et al. (1996). "Infections after hysterectomy. A prospective nation-wide Swedish study. The Study Group on Infectious Diseases in Obstetrics and Gynecology within the Swedish Society of Obstetrics and Gynecology". Acta Obstet Gynecol Scand. 75 (8): 757–61. PMID 8906013.
- ↑ 5.0 5.1 5.2 Chaim, W., M. Mazor, and J. R. Leiberman. "The relationship between bacterial vaginosis and preterm birth. A review." Archives of gynecology and obstetrics 259.2 (1997): 51-58.
- ↑ 6.0 6.1 6.2 Faro S, Martens M, Maccato M, Hammill H, Pearlman M (1993). "Vaginal flora and pelvic inflammatory disease". Am J Obstet Gynecol. 169 (2 Pt 2): 470–4. PMID 8357048.
- ↑ Martin HL, Richardson BA, Nyange PM, Lavreys L, Hillier SL, Chohan B; et al. (1999). "Vaginal lactobacilli, microbial flora, and risk of human immunodeficiency virus type 1 and sexually transmitted disease acquisition". J Infect Dis. 180 (6): 1863–8. doi:10.1086/315127. PMID 10558942.
- ↑ Hamark B, Forssman L (1991). "Postabortal endometritis in chlamydia-negative women--association with preoperative clinical signs of infection". Gynecol Obstet Invest. 31 (2): 102–5. PMID 2037257.
- ↑ Moslemi-Kebria M| title=Predictors of surgical site infection in women undergoing hysterectomy for benign gynecologic disease: a multicenter analysis using the national surgical quality improvement program data. | journal=J Minim Invasive Gynecol | year= 2014 | volume= 21 | issue= 5 | pages= 901-9 | pmid=24768957 | doi=10.1016/j.jmig.2014.04.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24768957 }}
- ↑ Ralph SG, Rutherford AJ, Wilson JD (1999). "Influence of bacterial vaginosis on conception and miscarriage in the first trimester: cohort study". BMJ. 319 (7204): 220–3. PMC 28171. PMID 10417083.