Bacterial vaginosis. What is this?
The importance of bacterial vaginosis lies in being the main agent of vaginosis, and this disease, despite being sometimes relatively benign, is associated with important diseases of the upper genital tract, preterm labor, low birth weight, carioamnionitis, premature rupture of the membrane ‘pelvic inflammatory disease and abnormal uterine bleeding.
Gardnerella vaginalis vaginosis has different diagnostic criteria. Currently there are four defined, of which at least three must be met to establish the diagnosis:
- Homogeneous vaginal discharge, grayish white, broadly, generally watery, accumulated in the sac bottom and adhered to the vaginal wall.
- Vaginal pH greater than 4.5.
- Presence of key cells (key cells) in vaginal discharge. These cells described for the first time by Gardner and Dukes, vaginal epithelial cells, poorly defined edges and with a grainy appearance, attached to their surface a large number of bacilli of bacterial vaginosis
- Smell of the flow to “fish”, either spontaneously, postcoital or when adding 10% potassium hydroxide.
Vaginosis caused by bacterial vaginosis is treated with metronidazole, considered the most effective drug since it does not alter normal flora or lactobacilli, their regeneration during therapy, the recovery of balance and the control of the pH of the vagina. The biggest drawback to treatment is the high recurrence rate and chronicity of the infection. Pfeiffer et al achieved 98% immediate cure and 84.2% long-term cure, Blackwell et al 95% and 57.9%. Metronidazole is administered topically or orally. Single-dose imidazole derivatives are also effective. Other drugs are currently being tested, being the clinic of the most studied, with cure frequencies of 93.5% and 89.7% in the short and long term respectively. “Other authors have also reported satisfactory results.
Vaginosis is considered a sexually transmitted disease and therefore a couple problem.