PREVALENCE OF VAGINAL DYSBIOSIS (BACTERIAL VAGINOSIS AND AEROBIC VAGINITIS) IN ANTENATAL WOMEN AND ITS ADVERSE PREGNANCY OUTCOMES (MATERNAL/FETAL) IN A TERTIARY CARE HOSPITAL IN NORTH INDIA

Author(s):Dr. Sarah Madhulika Jala,Dr.Tapasya Dhar

Received: 2024-11-28 Accepted: 2025-01-30 Published: 2025-02-13

Abstract

Vaginal Dysbiosis is termed as a state in which there is an imbalance in the flora which is normally present in the vagina, where mixed flora of aerobic, anaerobic and microaerophilic species [1,2] instead of Lactobacillus. Vaginal dysbiosis, encompassing variations such as BV and AV, represents a significant concern in maternal health due to its potential impact on pregnancy outcomes. In antenatal women, these disturbances in vaginal microbiota can lead to various adverse consequences for both mothers and fetuses. Understanding the prevalence of vaginal dysbiosis and its association with adverse pregnancy outcomes is crucial, particularly in settings such as tertiary care hospitals in North India where maternal and neonatal health outcomes are of paramount concern. Bacterial Vaginosis has known to be associated with adverse pregnancy outcomes like premature rupture of membranes, preterm delivery, chorioamnionitis, spontaneous abortion, low birth weight. Bacterial vaginosis predisposes to the acquisition of STIs such as Neisseria gonorrhoea, Chlamydia trachomatis, HIVand HSV-2. These conditions not only affect maternal health during pregnancy but also influence fetal development and neonatal health outcomes. Given the diverse population demographics and health disparities in North India, investigating the prevalence and consequences of vaginal dysbiosis is essential for tailored clinical management and improved maternal-fetal outcomes. Bacterial Vaginosis has been shown to be asymptomatic in most of the cases but may have symptoms like vaginal discharge, odour, pain, burning sensation, itching on presentation. It is associated with longterm sequelae including pelvic inflammatory disease. Data suggests that around 26-30 percent of antenatal women have BV and around 47 % are asymptomatic. [3]. Bacterial vaginosis is identified by Gram stain and Amsel’s criteria (Gold standard). Epidemiological studies have shown that advanced maternal age, multiple sexual partners, previous spontaneous miscarriages, alteration ofvaginal bacterial communities are among the causative factors for BV. Recurrence is not uncommon though there are regimens to treat available. Likewise, aerobic vaginitis also lead to perinatal complications. A critical part of aerobic vaginitis is a change of vaginal flora from Lactobacillus-dominated bacteria to aerobic bacteria, which causes variation in vaginal microbiome and leads to lesser positive perinatal outcomes. Additionally, aerobic vaginitis seems to be linked to increased levels of cytokines, which are recognized as risk factors for adverse pregnancy outcomes. However, it is still not completely understood and there are studies that have done research on the microbial diversity of aerobic vaginitis in women of antenatal period. This acts as a hint to understand it is quite a possibility to avoid a preposition of delivery before gestation age of 37 weeks by screening women for BV and AV [38] . This ongoing study aims to explore the prevalence of BV and aerobic vaginitis among antenatal women attending a tertiary care hospital in North India. Additionally, it seeks to evaluate the correlation between these vaginal dysbiosis conditions and unfavourable pregnancy outcomes, including neonatal sepsis, and maternal infections. By elucidating these relationships, the research intends to contribute valuable insights into optimizing antenatal care strategies and enhancing maternal and neonatal health outcomes in the region. This sets the stage by outlining the importance of the topic, highlighting the specific conditions under study, and emphasizing the relevance of further research in the context of maternal and fetal health in North India.

Keywords: Aerobic vaginitis, bacterial vaginosis, fetal outcome, maternal outcome, vaginal dysbiosis

DOI: 10.5281/zenodo.14863152

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