Adjuncts to case assessment of vaginal discharge syndrome in pregnant women

ObjectiveTo investigate the aetiology of abnormal vaginal discharge, using a non-culture based method, among pregnant women presenting at the University of Calabar Teaching Hospital, Calabar, Nigeria.MethodsTwo hundred consecutive antenatal patients, aged 18 to 38 years, with complaints of abnormal vaginal discharge between 1st April and 31st July 2004 were investigated clinically for the characteristics of the vaginal discharge. High vaginal swabs taken from the vaginal fornices were examined using a non-culture based method to determine the possible aetiology of the discharge. The possibility of integrating non-culture based laboratory methods in the syndromic case management of abnormal vaginal discharge in an antenatal clinic setting is discussed.ResultsThe commonest form of abnormal discharge was curdy white in 66% of cases. Ten (5%) women had malodourous vaginal discharged, 92% had vulval itching; and superficial dyspareunia was seen in 29% of cases. Microscopic studies of vaginal discharge revealed the following findings: lactobacilli (96%), polymorphs (96%), 'clue' cells (4%); positive Whiff test (5%), and pH > 4.5 (7%). The clinical and laboratory assessment of each patient lasted between 35 and 45 minutes. The procedures used were acceptable to 78% of women.ConclusionThe use of non-culture based laboratory methods in the initial assessment of abnormal vaginal discharge can be a useful adjunct in the syndromic case management of abnormal vaginal discharge in pregnant women.