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Infectious Diseases in Obstetrics and Gynecology
Volume 13 (2005), Issue 1, Pages 31-35
http://dx.doi.org/10.1155/2005/935684

Diagnosis of Bacterial Vaginosis From Self-Obtained Vaginal Swabs

1Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
2Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
3Carolina Population Center, School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA

Copyright © 2005 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: To determine the concordance between vaginal fluid Gram stains and pH obtained at speculum exam with similar stains and pH prepared from self-obtained vaginal swabs.

Methods: Using vaginal fluid Gram stain, 129 pregnant women were screened for bacterial vaginosis at 24 to 29 weeks' gestation. Two smears were collected from each woman during the same prenatal visit: the first was prepared from a selfobtained vaginal swab and the second from a physician-obtained speculum examination. Vaginal pH was recorded for each swab. Kappa coefficient was used to quantify agreement between the two sets of results.

Results: When compared with the physician-obtained smear, the ability of the self-obtained Gram stain to diagnose bacterial vaginosis had a sensitivity of 77%, specificity of 97%, positive predictive value of 71% and negative predictive value of 97%. There was substantial agreement (weighted kappa= 0.82) between the two techniques in the ability to determine the grade of vaginal flora.

Conclusion: When compared with physician-obtained vaginal smears, self-obtained smears have substantial agreement in the diagnosis of bacterial vaginosis.