A 25 year old pregnant woman at 12 weeks gestation presented to the clinic with a new complaint of white vaginal discharge.It is associated with a fishy odor.She is medically free with no allergies. What do you think is the problem? How would you manage?
- Fishy odor
- Absence of allergies
- whiff-amine test (Potassium Hydroxide)
- Speculum exam: thin white homogenous discharge that coats the walls of the vagina
- pH > 4.5
- Presence of clue cells on microscopy of wet mound (if available)
Metronidazole 500mg PO twice daily for 7 days
Only if symptoms recur or are persistent
Increased risk of preterm birth
- Amsel R, Totten PA, Spiegel CA, et al. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med 1983; 74:14.
- Brocklehurst P, Gordon A, Heatley E, Milan SJ. Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database Syst Rev 2013; :CD000262.