Obstetrics & gynaecology
AKT · Obstetrics & gynaecology/Menopause & vulvallow yield
Bacterial vaginosis (gynae)
Anaerobic overgrowth (see Sexual Health page)
Overview
Covered in depth on the Sexual Health page. Listed here as a content-map gynaecology item: thin grey fishy non-itchy discharge with raised pH and clue cells; treated with metronidazole.
Recognise
- Thin grey homogeneous fishy-smelling discharge
- Non-itchy/non-inflammatory
- Raised vaginal pH >4.5, clue cells
Red flags
- Pregnancy (preterm birth association)
Differentials & how to tell them apart
Trichomoniasisfrothy green, itch, strawberry cervix, motile organisms
Candidiasisthick white, itchy, normal pH
Investigations
Raised pH, clue cells, positive whiff test (Amsel/Hay-Ison). See Sexual Health page.
Management
Metronidazole 400 mg BD orally for 5–7 days
- 1Symptomatic: oral metronidazole 400 mg BD 5–7 days (or vaginal gel/clindamycin). Full detail on the Sexual Health page.
Metronidazole — 400 mg BD 5–7 days oral, or vaginal gel
Key points
Cross-referenced — see the Sexual Health page (sexual_health.html) for the full card.
Monitor & prognosis
Symptom resolution.
Benign; recurrent.
Source: NICE CKS BV (see Sexual Health page)