Etiologic characterization of vulvovaginitis among females attending a tertiary care hospital: a one year study

Abstract

Background: Vulvovaginitis is one among the major pathologies encountered in reproductive age group. Etiologies are always multiple and candidiasis, bacterial vaginitis and trichomoniasis account for 90% of etiology. The incidence is dependable upon multiple factors like age group, ethnicity, socioeconomic status, geographical locale. Improperly treated and untreated vulvovaginitis is associated with long term complications like infertility, pelvic inflammatory disease in nulliparous females and preterm labour, miscarriage, ectopic pregnancy, chorioamnionitis among pregnant females and recurrent UTIs, cervicitis, endometritis, increased risk of acquiring STIs among normal females. The present study was undertaken with the objective of understanding the etiologies associated with vulvovaginitis among women attending Obstetrics clinic of a tertiary care hospital. The risk factors associated with the conditions, the features of the vaginal discharge and symptoms associated with each etiology were studied.Methods: A cross sectional study for a period of one year was conducted among 200 female patients attending the Department of gynecology for vaginitis and evaluated for etiology. Patient’s risk factors, clinical history, symptoms were collected by questionnaire and specimens were collected from all the cases and processed as per standard guidelines. Bacterial vaginosis was confirmed based on Neugent’s criteria, Trichomoniasis by wet mount examination and candidiasis by culture. The study was approved by the institutional ethical committee.Results: 137 cases of vulvovaginitis were diagnosed based on etiology. Vulvovaginitis was most common among 27-36 years and in multiparous women. Most common causative agent was Candida (59.12%) followed by bacterial vaginosis (22.63%) and Trichomoniasis (18.25%). Vaginal discharge was the commonest symptom (100%) followed by malodor and vulval irritation. Following unhygienic practices was the commonest risk factor associated with Vulvovaginitis.Conclusions: A regular evaluation is mandatory for all the females attending hospital for vaginitis. Successful management reduces the morbid conditions and it’s essential to treat the conditions during the pregnancy which prevents the complications associated like preterm birth, miscarriage etc. and adverse outcomes.

Clinical presentation, diagnosis and management of bacterial vaginosis: a hospital based cross-sectional study

“…While Kiran CK et al, found that among cases with BV 100% of cases had thin discharge. 19 In this study, foul smelling discharge was associated with 66.3% cases of BV. Kiran CK et al, found malodor was present in 38.71% cases of bacterial vaginosis.…”

“…While Kiran CK et al, found, among females with BV 6.45% had greenish discharge. 19 Meena V et al, found, 60% of cases with BV had grayish white discharge and none had yellow discharge. 21 Study found that in this study cases who had bacterial vaginosis, 1.2% cases had mucoid discharge, 19.8% cases had thick discharge, 79.1% cases had thin discharge.…”

“…Kiran CK et al, found malodor was present in 38.71% cases of bacterial vaginosis. 19 Meena V et al, found fishy odor in 79.2% of cases with BV. 21 Narayankhedkar A et al, found 40% of cases with BV had malodor.…”

“…Kiran CK et al, found pain abdomen was present in 45.16% cases of bacterial vaginosis. 19 Narayankhedkar A et al, found pain abdomen was the complaint of 66.7% cases of bacterial vaginosis. 4 In this study, pruritis was present in 34.9% cases with bacterial vaginosis.…”

“…Kiran CK et al, found 67.74% of cases with bacterial vaginosis had copious amount of discharge. 19 Landers DV et al, found out that among women with abnormal discharge, 62% of the women were diagnosed clinically as having bacterial vaginosis. 20 In this study in 67.4% cases with BV had yellow discharge.…”