الفهرس 
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Abstract
Bacterial vaginosis is considered one of the most common alterations of the vaginal ecosystem in women of the reproductive age. It is a polymicrobial condition characterized by depletion of vaginal lactobacilli accompanied by overgrowth of mixed vaginal flora.
B.V. is considered one of the main causes of increased vaginal discharge occurring in women attending obstetrical and gynecological clinics.
Patients always present with malodorous vaginal discharge although 50% asymptomatic.
Bacterial vaginosis is clinical entity characterized by the presence of at least 3 of 4 clinical criteria of.
1. Homogenous malodorous vaginal discharge.
2. Vaginal PH > 4.5.
3. Fishy odor on addition of KOH 10% to vaginal discharge.
4. Presence of clue cells on wet mount.
Bacterial vaginosis is not considered a serious disease entity by itself, but it appears to be a risk factor for the occurrence of many complications including upper genital tract infections, postoperative infection and cervical intraepithelial neoplasia.
The aim of the present study was to assess the prevalence of bacterial vaginosis in the reproductive aged women.
It included 500 women divided into 2 groups:
GroupA: Asymptomatic women coming for antenatal care (250 women).
Group B: Asymptomatic women seeking contraception (250 women).
For each woman, a full history, general and local examination was done and clinical diagnosis was obtained by the presence of 3 out of 4 clinical criteria. Also laboratory confirmation by Gram-stained vaginal smear.
The results of Gram-stain diagnosis were classified either to normal women with score (0-3), intermediate women with score (4-6) and B.V. women with score (7-10).
The sensitivity and specificity of the different clinical criteria used in the diagnosis of bacterial vaginosis, in this study were found to be as follows:
• 94.06% and 83.2% for homogenous malodorous vaginal discharge in group A.
• 88.8% and 87.5% for homogenous malodorous vaginal discharge in group B.
• 100% and 22% for elevated vaginal pH > 4.5 in group A.
• 100% and 30.6% for elevated vaginal pH > 4.5 in group B.
• 100% and 94.6% for positive KOH test in group A.
• 100% and 96.8% for positive KOH test in group B.
• 97% and 100% for the presence of clue cells in group A.
• 100% and 100% for the presence of clue cells in group B.
from this study, it was found that the amine test and clue cells in wet mount are the most sensitive and specific criteria among 4 Amsel criteria. Also, the microscopic examination of Gram-stained vaginal smears should be considered the gold standard for the diagnosis of bacterial vaginosis because the clinical signs are subjective and affected by many factors not related to infection. However, still the 4 clinical criteria are excellent tools for guiding the diagnosis of B.V.
It is concluded that bacterial vaginosis is considered as one of the most common vaginal infection in the reproductive age.
The most important organisms in B.V are Gardnerella vaginalis and ureaplasma urealyticum.