孕妇细菌性阴道病的流行情况及临床诊断的预测价值。

Prevalence of bacterial vaginosis in pregnant women and predictive value of clinical diagnosis.

机构信息

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

出版信息

Arch Gynecol Obstet. 2010 Jan;281(1):101-4. doi: 10.1007/s00404-009-1089-x. Epub 2009 Apr 19.

DOI:10.1007/s00404-009-1089-x

PMID:19381663

Abstract

PURPOSE

To study the prevalence of bacterial vaginosis (BV) in pregnant women and to evaluate the accuracy of clinical criteria for the diagnosis of BV.

METHODS

In this observational study 502 asymptomatic pregnant women were screened for bacterial vaginosis in a rural health care facility by Gram stain. Accuracy of clinical diagnosis using individual and two of Amsel's criteria was evaluated.

RESULTS

The frequency of BV was 8.6% by Nugent's method. For Amsel's criteria, sensitivity and specificity was 51.2 and 98%, with 71% PPV and 95.5% NPV. The most sensitive individual criterion was vaginal pH, but with lowest specificity. The criterion with highest specificity was clue cells. The combination of the two criteria, vaginal pH and positive amine test, had best positive and negative predictive values 60.5 and 97.8%, respectively.

CONCLUSION

The diagnosis of BV according to Amsel's criteria may be simplified using a combination of the two criteria, vaginal pH and amine test, in settings where microscopy or Gram staining is not available.

摘要

目的

研究孕妇细菌性阴道病（BV）的患病率，并评估临床标准诊断 BV 的准确性。

方法

在这项观察性研究中，通过革兰氏染色对农村医疗保健机构的 502 名无症状孕妇进行细菌性阴道病筛查。评估了使用个体和 Amsel 标准中的两种进行临床诊断的准确性。

结果

根据 Nugent 法，BV 的频率为 8.6%。对于 Amsel 标准，敏感性和特异性分别为 51.2%和 98%，阳性预测值为 71%，阴性预测值为 95.5%。最敏感的个体标准是阴道 pH 值，但特异性最低。线索细胞是特异性最高的标准。这两个标准（阴道 pH 值和胺试验阳性）的组合具有最佳的阳性和阴性预测值，分别为 60.5%和 97.8%。