A Prospective, Observational Study On Risk Factors, Demographic and Clinico- Microbiological Profile in Pregnant Women with Infected Vaginal Discharge

Background: Vaginal discharge is a common complaint during pregnancy and can be caused by bacterial, fungal, or protozoal infections. Physiological and immunological changes of pregnancy can render women susceptible to vaginal infection that may have negative impacts on maternal and pregnancy outcomes. Thus early identification of risk factors and microbiological evaluation are important. Material and Methods: It was a prospective, observational, hospital based study of 140 pregnant women with infected vaginal discharge in Department of obstetrics and Gynaecology, Ananta Institute of Medical Sciences and Research Centre, Rajsamand, Rajasthan. Demographic and obstetric characteristics, medical and surgical history, clinical manifestations, vaginal discharge characteristics and microbiological profile were evaluated. Four high vaginal swabs were taken from the posterior fornix for Gram stain; potassium hydroxide preparation, saline wet mount and bacterial/fungal culture with antimicrobial susceptibility testing. Vaginal pH, Amsel criteria and Nugent scoring were also evaluated. Data was analysed using SPSS version 25.0 and a p value of <0.05 was considered statistically significant. Results: Most participants were aged 26–30 years (55; 39.29%), from rural areas (100; 71.43%), primigravida (66; 47.14%), and in the third trimester (65; 46.43%). 70 (50.00%) women had lower socioeconomic status. Anaemia (40; 28.57%), diabetes (32; 22.86%), IUCD use (27; 19.29%), and previous urinary tract infection (23; 16.43%) were common. The most common presentation (63; 45.00%) was thick curdy discharge followed by thin excessive discharge (36; 25.71%). Culture was positive in 70 (50.00%) women. E. coli (38, 27.14%) and C. albicans (33, 23.57%) were the most common organisms. The most frequent diagnosis was aerobic vaginitis (80; 57.14%) followed by vaginal candidiasis (47; 33.57%). Conclusion: Pregnant women with infected vaginal discharge exhibited a variety of clinical and microbiological characteristics, which justify systematic clinical and microbiological assessment for proper diagnosis and treatment. Keywords: Pregnancy, Vaginal discharge, Aerobic vaginitis, Candidiasis, Microbiological profile.