Department of Gynecology and Obstetrics, Botucatu Medical School, UNESP-São Paulo State University, Botucatu, Brazil.
Gynecol Obstet Invest. 2011;71(3):158-62. doi: 10.1159/000316051. Epub 2010 Dec 14.
To evaluate associations between alterations in vaginal flora and clinical symptoms in low-risk pregnant women.
Vaginal specimens from 245 pregnant women were analyzed by microscopy for vaginal flora. Signs and symptoms of vaginal infection were determined by patient interviews and gynecologic examinations.
Abnormal vaginal flora was identified in 45.7% of the subjects. The final clinical diagnoses were bacterial vaginosis (21.6%), vaginal candidosis (10.2%), intermediate vaginal flora (5.2%), aerobic vaginitis (2.9%), mixed flora (2.9%) and other abnormal findings (2.9%). The percentage of women with or without clinical signs or symptoms was not significantly different between these categories. The presence of vaginal odor or vaginal discharge characteristics was not diagnostic of any specific flora alteration; pruritus was highly associated with candidosis (p < 0.0001). Compared to women with normal flora, pruritus was more prevalent in women with candidosis (p < 0.0001), while vaginal odor was associated with bacterial vaginosis (p = 0.0026).
The prevalence of atypical vaginal flora is common in our low-risk pregnant population and is not always associated with pathology. The occurrence of specific signs or symptoms does not always discriminate between women with different types of atypical vaginal flora or between those with abnormal and normal vaginal flora.
评估低危孕妇阴道菌群改变与临床症状之间的关系。
对 245 例孕妇的阴道标本进行显微镜检查，分析阴道菌群。通过患者访谈和妇科检查确定阴道感染的体征和症状。
45.7%的受试者存在异常阴道菌群。最终临床诊断为细菌性阴道病（21.6%）、阴道念珠菌病（10.2%）、中间型阴道菌群（5.2%）、需氧性阴道炎（2.9%）、混合菌群（2.9%）和其他异常发现（2.9%）。这些类别中，有或无临床体征或症状的女性比例没有显著差异。阴道异味或阴道分泌物特征不能诊断任何特定的菌群改变；瘙痒与念珠菌病高度相关（p<0.0001）。与正常菌群的女性相比，患有念珠菌病的女性瘙痒更为普遍（p<0.0001），而阴道异味与细菌性阴道病相关（p=0.0026）。
在我们的低危孕妇人群中，非典型阴道菌群的流行率较高，但并不总是与病理学相关。特定体征或症状的发生并不总是能区分不同类型的非典型阴道菌群，也不能区分异常和正常阴道菌群的女性。
