Effect of Bacterial Vaginosis in the Second Trimester of Pregnancy on the Outcome of Pregnancy

Objective: To study the prevalence of bacterial vaginosis in second trimester pregnancy and its effect on pregnancy outcome  Methods: A study was conducted over a period of 2 years from October, 2018 to October, 2020 wherein 240 patients in their second trimester cases were examined. In addition, data of deliveries collected during the past few years has been compared vis-a-vis 240 cases and analyzed.  Results: The prevalence of bacterial vaginosis was 36% in our study. There was no significant association of demographic factors like literacy, age and parity. Anemia was assessed as a high risk factor for bacterial vaginosis, but no significant association could be derived. The number of patients presenting with symptomatic bacterial vaginosis was more than the asymptomatic positive patients. The most common presenting complaint was of vaginal discharge and on examination, homogenous mucoid discharge was found in majority of the patients. Presence of homogenous mucoid discharge, alkaline pH and presence of clue cells was the most common diagnostic triad fulfilled by patients with bacterial vaginosis. Recurrence was seen in 2 patients inspite of completing the entire course of treatment. PROM and preterm vaginal delivery were the common complications noted. Bacterial vaginosis did not have a significant effect on the neonatal outcome.  Conclusion: Bacterial vaginosis, the polymicrobial inflammation of the vagina, has a high prevalence rate of upto 36%. All pregnant women in their second trimester coming for antenatal checkup should undergo per speculum examination and the three most common parameters of the Amsel’s criteria, that is, homogenous mucoid discharge, raised vaginal pH and presence of clue cells in vaginal smear can be used to diagnose bacterial vaginosis. Pregnant women in their second trimester presenting without any symptoms should also undergo per speculum examination for the diagnosis of asymptomatic bacterial vaginosis and its treatment. The presence of bacterial vaginosis in the second trimester of pregnancy does not affect the maternal and neonatal outcome significantly because after its diagnosis and treatment, the recurrence rate was very low but detection of bacterial vaginosis before the onset of labour for its effect on maternal and neonatal outcome needs further research. Anemia is not a risk factor for bacterial vaginosis, but further studies are required for identification of other potential high risk factors.