Skip to main content
NCBI home page
Infectious Diseases in Obstetrics and Gynecology logoLink to Infectious Diseases in Obstetrics and Gynecology
. 1998;6(3):129–133. doi: 10.1002/(SICI)1098-0997(1998)6:3<129::AID-IDOG6>3.0.CO;2-S

Prevalence of cervicovaginal infections during gestation and accuracy of clinical diagnosis.

J A Simões 1, P C Giraldo 1, A Faúndes 1
PMCID: PMC1784787  PMID: 9785109

Abstract

OBJECTIVES: The aim of this study was to establish the prevalence of cervicovaginal infections in normal third-trimester pregnant women and evaluate the accuracy of clinical diagnosis. METHOD: A total of 328 pregnant women were followed at the Prenatal Outpatient Clinic of the Department of Obstetrics and Gynecology at the School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Brazil, from October 1991 to February 1993. The clinical diagnosis was based on the characteristics of the vaginal discharge, and the etiological diagnosis was based on bacterioscopy of the vaginal secretion and direct immunofluorescence for Chlamydia trachomatis. The data were analyzed statistically, determining the sensitivity, specificity, and positive and negative predictive value of the clinical diagnosis related to the laboratory diagnosis of the different infections. RESULTS: The prevalence of infection was 39.6% (Candida albicans, 19.2%; bacterial vaginosis, 9.5%; intermediate vaginal flora, 6.7%; Chlamydia trachomatis, 2.1%; and vaginal trichomoniasis, 2.1%). The accuracy of clinical diagnosis was low, with sensitivity between 50% and 65% and specificity around 60%, with the exception of trichomoniasis, which showed a sensitivity of 100% and chlamydia, with a sensitivity of 0% and a specificity of 100%. CONCLUSION: The accuracy of the clinical diagnosis of infections was low, specifically with respect to the positive predictive value. The results demonstrate the need for specific testing of cervicovaginal infections at prenatal visits. Reliance on simple vaginal examination results in a low yield for detection of vaginal infections.

Full Text

The Full Text of this article is available as a PDF (404.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amsel R., Totten P. A., Spiegel C. A., Chen K. C., Eschenbach D., Holmes K. K. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med. 1983 Jan;74(1):14–22. doi: 10.1016/0002-9343(83)91112-9. [DOI] [PubMed] [Google Scholar]
  2. Binns B., Williams T., McDowell J., Brunham R. C. Screening for Chlamydia trachomatis infection in a pregnancy counseling clinic. Am J Obstet Gynecol. 1988 Nov;159(5):1144–1149. doi: 10.1016/0002-9378(88)90433-4. [DOI] [PubMed] [Google Scholar]
  3. Blackwell A. L., Thomas P. D., Wareham K., Emery S. J. Health gains from screening for infection of the lower genital tract in women attending for termination of pregnancy. Lancet. 1993 Jul 24;342(8865):206–210. doi: 10.1016/0140-6736(93)92299-9. [DOI] [PubMed] [Google Scholar]
  4. Faro S. Vaginitis and pregnancy. J Reprod Med. 1989 Aug;34(8 Suppl):602–604. [PubMed] [Google Scholar]
  5. Hillier S. L., Krohn M. A., Nugent R. P., Gibbs R. S. Characteristics of three vaginal flora patterns assessed by gram stain among pregnant women. Vaginal Infections and Prematurity Study Group. Am J Obstet Gynecol. 1992 Mar;166(3):938–944. doi: 10.1016/0002-9378(92)91368-k. [DOI] [PubMed] [Google Scholar]
  6. Morton K., Regan L., Spring J., Houang E. A further look at infection at the time of therapeutic abortion. Eur J Obstet Gynecol Reprod Biol. 1990 Dec;37(3):231–236. doi: 10.1016/0028-2243(90)90029-z. [DOI] [PubMed] [Google Scholar]
  7. Persson K., Rönnerstam R., Svanberg L., Holmberg L. Maternal and infantile infection with Chlamydia in a Swedish population. Acta Paediatr Scand. 1981 Jan;70(1):101–105. doi: 10.1111/j.1651-2227.1981.tb07180.x. [DOI] [PubMed] [Google Scholar]
  8. Rettig P. J. Perinatal infections with Chlamydia trachomatis. Clin Perinatol. 1988 Jun;15(2):321–350. [PubMed] [Google Scholar]
  9. Schachter J., Grossman M., Sweet R. L., Holt J., Jordan C., Bishop E. Prospective study of perinatal transmission of Chlamydia trachomatis. JAMA. 1986 Jun 27;255(24):3374–3377. [PubMed] [Google Scholar]
  10. Sobel J. D. Candidal vulvovaginitis. Clin Obstet Gynecol. 1993 Mar;36(1):153–165. doi: 10.1097/00003081-199303000-00021. [DOI] [PubMed] [Google Scholar]
  11. Sobel J. D. Vaginitis. N Engl J Med. 1997 Dec 25;337(26):1896–1903. doi: 10.1056/NEJM199712253372607. [DOI] [PubMed] [Google Scholar]
  12. Summers P. R., Sharp H. T. The management of obscure or difficult cases of vulvovaginitis. Clin Obstet Gynecol. 1993 Mar;36(1):206–214. doi: 10.1097/00003081-199303000-00026. [DOI] [PubMed] [Google Scholar]

Articles from Infectious Diseases in Obstetrics and Gynecology are provided here courtesy of Wiley

RESOURCES