Bacterial vaginosis natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Natural History

Most women found to have bacterial vaginosis (BV) reported no symptoms. Women who have not had vaginal, oral, or anal sex can still be affected by Bacterial vaginosis. In symptomatic patients, bacterial vaginosis may present with thin white/gray malodor vaginal discharge. If left untreated, it may lead to more serious sequelae, such as salpingitis, endometritis, pelvic inflammatory disease (PID), and bacteremia.

Around one third of pregnant women found to have a bacterial vaginosis. if left untreated, in pregnant women bacterial vaginosis may result in complication of pregnancy, including premature rupture of membranes, premature labor, chorioamnionitis, postpartum endometritis, and septic abortion.

Complications

In most cases, BV causes no complications. But there are some serious risks from bacterial vaginosis including:

• Increased risk for infection following surgical procedures such as:
  • Hysterectomy
  • Abortion
• Increased risk for some complications of pregnancy such as:
  • Chorioamnionitis
  • Midtrimester miscarriage
  • Preterm birth
• Increase a woman's susceptibility to other STDs, such as:
  • HIV
  • Herpes
  • Chlamydia
  • Gonorrhea
• Increases the risk for HIV transmission to male sex partners

Bacterial Vaginosis during Pregnancy

Pregnant women with BV more often have babies who are born premature or with low birth weight (low birth weight is less than 5.5 pounds).

The bacteria that cause BV can sometimes infect the uterus (womb) and fallopian tubes (tubes that carry eggs from the ovaries to the uterus). This type of infection is called pelvic inflammatory disease (PID). PID can cause infertility or damage the fallopian tubes enough to increase the future risk of ectopic pregnancy and infertility. Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube which can rupture.