presentasi referat besar - pengobtan bv
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7/21/2019 Presentasi Referat Besar - Pengobtan Bv
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BACTERIAL VAGINOSIS DIAGNOSE
and TREATMENT
Coass :
J A Y A 110 205 0056
Yusuf Muchtar 110 210 0153
Advisor :
dr. Karlina Novianti Kasim
u!"rvisor :
#r. dr. ri $ita%ani& !.KK
7/21/2019 Presentasi Referat Besar - Pengobtan Bv
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#"finition
Bacterial vaginosis (BV is vaginal
in!la""ation ca#sed $% increased
concentration o! anaero$ic $acteria invaginal !lora&
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)is* +actors
) A!rican A"erican
) T+o or "ore se- ,artners in ,revio#s si-
"ont*s:ne+ se- ,artner ) Do#c*ing
) ;or"onal c*anges d#ring ,regnanc% and
"eno,a#se) Lac6 o! ;'O'4,rod#cing lacto$acilli
) Anti$iotic
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,ato("n"sis
) Overgro+t* o! $acteria s,ecies nor"all% ,resent in vagina
+it* anaero$ic $acteria
) BV correlates +it* a decrease or loss o! ,rotective
lacto$acilli
2 Vaginal acid ,; nor"all% "aintained $% lacto$acilli t*ro#g*
"eta$olis" o! gl#cose:gl%cogen
2 ;%drogen ,ero-ide (;'O' is ,rod#ced $% so"e Lactobacilli 7s,&
2 ;'O' *el,s "aintain a lo+ ,;7 +*ic* in*i$its $acteria overgro+t*
2 Loss o! ,rotective lacto$acilli "a% lead to BV
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Clinical ,r"s"ntation and
%m!toms
) 3</ as%",to"atic
) Signs : s%",to"s +*en ,resent 2 3</ re,ort "alodoro#s (!is*% s"elling
vaginal disc*arge7 itc*
2 Re,orted "ore co""onl% a!ter vaginalinterco#rse7 a!ter co",letion o! "enses7
and a!ter se-#al activities
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-"t ,r"!.: act"rial $a(inosis
Cl#e Cells a,,ereance in "icrosco,% e-a"ination
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>
$ #ia(nosis: Ams"l Crit"ria
A"sel CriteriaM#st *ave at leastt*ree o! t*e!ollo+ing !indings
Vaginal ,; ?9&3
0resence o! ?'</ ,er ;0@o! cl#e cells on +et "o#nte-a"ination
0ositive a"ine or +*i!! test
;o"ogeneo#s7 non4visco#s7"il6%4+*ite disc*argead*erent to t*e vaginal +alls
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/th"r #ia(nostic ools
) Vaginal Gra" stain (N#gents criteria 2 0redo"inant Lactobacilli : <4 (negati!
2 Mi-ed @lora 94. (inter"ediate 2 0redo"inant gra" negati! Coccobacilli : =41< (,ositi! BV
) C#lt#re
) Cro"atiogra,*% E-a"ination) Bioc*e"istr% E-a"ination
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$ #iff"r"ntial #ia(nos"
Normal richomoniasis Candidiasisact"rial
$a(inosis
,rimar% s%m!tom Itc*7 disc*argeItc*7 disco"!ort7t*ic6 disc*arge
disc*arge7 itc*
$a(inal dischar(" Clear to+*ite @rot*%7 gra% or %ello+4green "alodoro#s T*ic67 cl#",%7 +*itecottage c*eeseF
;o"ogeno#s7ad*erent7
t*in7+*ite 4 gra%"alodoro#s !o#l
!is*%F
$a(inal ! &> 4 9&' ? 9&3 9&3 ? 9&3
m"ll 4 @is*% odor (H 4 @is*% odor (HHH
Microsco!icfindin(
E,it*elialcell +it*
lactobacillus
Trichomonas "otil7 alot o! 0MN
O; %east and,se#do*i!a
Cl#e cell
r"atm"nt 4 "etronidaJole Anti!#ngi MetronidaJole
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Tric*o"oniasis Bacterial vaginosis
Candidiasis
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Com!lications
) 0reter" $irt* in ,regnanc%
) Trans"ission and acK#isition o! ;IV
) Cervical Intrae,it*elial Neo,lasia
) 0ost,art#" @ever
) 0ost o,erative g%necologic co",lications
) 0ost a$ortal in!ections
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r"atm"nt in Non ,r"(nanc%
C#Cr"comm"nd"d r"(im"ns:) MetronidaJole 3<< "g orall% t+ice a da% !or = da%s7 or
) MetronidaJole gel <&=3/7 one !#ll a,,licator (3 gra"s intravaginall%7once a da% !or 3 da%s7 or
) Clinda"%cin crea" '/7 one !#ll a,,licator (3 gra"s intravaginall% at
$edti"e !or = da%s
Alt"rnativ" r"(im"ns:
) TinidaJole ' g orall% once a da% !or ' da%s7 or
) TinidaJole 1 g orall% once a da% !or 3 da%s7 or
) Clinda"%cin << "g orall% t+ice a da% !or = da%s7 or
) Clinda"%cin ov#les 1<< "g intravaginall% once at $edti"e !or da%s7or
) MetronidaJole =3< "g orall% once a da% !or = da%s
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r"atm"nt in ,r"(nanc%
2 MetronidaJole '3< "g orall% ti"es a da% !or = da%s7
or
2 MetronidaJole 3<< "g orall% t+ice a da% !or = da%s7 or
2 Clinda"%cin << "g orall% t+ice a da% !or = da%s
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/th"r condition
) Allergic +it* MetronidaJole
2 Clinda"%cin crea" intravaginall%
) Rec#rrent In!ection MetronidaJole gel <7=3/
(a!ter t*is7 contin#e to t+ice a da%
intravaginall% !or ' - 5ee6s 2 0artnert "anage"ent
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,roiotic r"atm"nt
2 0rod#ce anti"icro$ial co",o#nd s#c* as ;%drogen
0ero-ide7 Lactic Acid7 or Ba6teriocin7 +*ic* in*i$its
,at*ogen gro+t*&
2 0rod#ce a $ios#r!actan containing a large n#"$er o!
collagen 2 $inding ,roteins t*at co#ld in*i$it ,at*ogen
ad*esion and ind#ce a co",etitive e-cl#sion o! t*e
,at*ogen on e,it*elial cell&
2 Ma% ca#se a "#cosal "od#lation t*at en*ances t*e*ost i""#ne s%ste" res,onse&
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