Microscopical, Cytological, and Colposcopic Findings in Women of Reproductive Age with Abnormal Vaginal Discharge

BACKGROUND: Abnormal vaginal discharge is a frequent gynecological complaint among women of reproductive age and is commonly related to infectious etiologies. In some cases, it may be associated with underlying cervical epithelial abnormalities. OBJECTIVE: To identify the prevalent causative organisms of abnormal vaginal discharge in reproductive-age women and to assess the association between microbiological findings, Pap smear results, and colposcopic findings. PATIENTSANDMETHODS: A cross-sectional observational study was conducted on 125 women of reproductive age presenting with abnormal vaginal discharge at the Cervical Cancer Screening Clinic, Al-Yarmouk Teaching Hospital, Baghdad, between January and December 2024. All participants underwent clinical evaluation, microbiological examination, Pap smear testing, and colposcopic assessment. Histopathological examination was performed for selected cases (n = 26) based on clinical indications. Statistical analysis included chi-square testing, odds ratios with 95% confidence intervals (CI), and effect size estimation. RESULTS: The mean age of participants was 36.68 ± 7.58 years. Candida species were the most frequently identified organisms (22.4%), while Trichomonas vaginalis was detected in one case. No bacterial vaginosis was identified microscopically. Cytological examination showed negative results for intraepithelial lesion or malignancy in most cases, with squamous cell carcinoma detected in one patient. No statistically significant association was observed between microbiological findings and Pap smear results (OR = 1.97, 95% CI: 0.62–6.26). Similarly, no significant association was found between abnormal colposcopic findings and histopathology (OR = 1.14, 95% CI: 0.05–24.73). In contrast, colposcopic findings demonstrated significant associations with both cytological and histopathological outcomes. CONCLUSION: Candida infection was the most common cause of abnormal vaginal discharge in this cohort. While microbiological findings showed limited correlation with cervical cytology, colposcopic evaluation demonstrated meaningful associations with cytological and histopathological findings, supporting its role in the assessment of cervical abnormalities. .