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17421 - Clinical Overview and Public Health Implications...

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Bacterial Vaginosis and Pregnancy : Clinical Overview and Public Health Implications Deborah B. Nelson, Ph.D. Assistant Professor Center for Clinical Epidemiology and Biostatistics University of Pennsylvania School of Medicine http://www.med.upenn.edu/crrwh/Nelson.htm
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Learning Objectives Review the Prevalence, Identification, and Treatment of Bacterial Vaginosis (BV) Describe the Epidemiology and Consequences of Bacterial Vaginosis in Pregnancy Discuss Current Research Findings Present the BEAR Project: Hypothesis, Specific Aims and Methodology Nelson DB, Macones GA. Bacterial Vaginosis in Pregnancy: Current Findings and Future Directions. Epidemiologic Reviews 2002 (24: 102-108).
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Bacterial Vaginosis: Clinical Background BV is the most frequent cause of vaginal discharge 3 million cases of BV; 800,000 cases among pregnant women annually (Goldman & Hatch 2000) . Prevalence of BV: 25%-60% among nonpregnant women; 10-35% among pregnant women (Goldman & Hatch 2000) .
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Bacterial Vaginosis: Microbiology The normal vagina is an acidic environment inhabited primarily by hydrogen-producing lactobacilli There is some change in the microbiological flora of the vagina (due to environmental, behavioral, or hormonal factors) BV is characterized by a reduced number of lactobacilli and an overgrowth of gram negative, anaerobic bacteria.
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Bacterial Vaginosis: Microbiology Anaerobic organisms in BV include: Mycoplasma hominis, Bacteroides spp., Mobiluncus spp., Gardnerella vaginalis. Increase in polyamines resulting in the characteristic odor of BV and the increase in epithelial cell exfoliation.
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Bacterial Vaginosis: Clinical Diagnosis 1. Amsel criteria: three of four clincal conditions An elevated vaginal pH (> 4.5).
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