A Scoping Review of Bacterial Vaginosis – A Silent but Potential Threat to Pregnancies and Gynecological Surgeries and Procedures


  • Idowu Ade-Ojo Ekiti State University
  • Esther Abolarin
  • Abimbola Okiki
  • Oso Olufunke




Bacterial vaginosis, Gardnerella, pregnancy


Bacterial vaginosis (BV) is a common vaginal disorder in women of the reproductive age group that causes offensive vaginal discharge. BV occurs when Lactobacillus spp., the predominant species in healthy vaginal flora, are replaced by anaerobic bacteria, such as Gardnerella vaginalis. The prevalence is about 15-30% of women of reproductive age group. The reported risk factors include a high number of lifetime sexual partners, engagement in sexual intercourse at a younger age, practicing regular douching, and smoking. When BV occurs in pregnancy, there is an increased risk of preterm delivery and its associated complications. For decades, metronidazole has been the drug of choice for the treatment of BV, however, the rate of recurrence is as high as 50%. Therefore, prevention through lifestyle modifications will help to reduce the prevalence of BV.


. Zimmer, M, et al., Polish Society of Gynecologists and Obstetricians recommendation on the use of antiseptics for treatment of inflammatory vaginitis. Ginekologia Polska, 2020. 91(7): p. 432–7.

. Mascarenhas, M.R.E., et al., Prevalence and risk factors for bacterial vaginosis and other vulvovaginitis in a population of sexually active adolescents from salvador, bahia, brazil. Infectious Diseases in Obstetrics and Gynecology, 2012. P. 1–6.

. Chen, X, et al., The female vaginal microbiome in health and bacterial vaginosis. Front Cell Infect Microbiol, 2021. 11:631972. DOI: 10.3389/fcimb.2021.

. Machado, D, et al., Bacterial vaginosis biofilms: challenges to current therapies and emerging solutions. Front Microbiol, 2016. 6:1528. doi: 10.3389/fmicb.2015.01528.

. Mokoena, M.P., Lactic Acid Bacteria and Their Bacteriocins: Classification, Biosynthesis and Applications against Uropathogens: A Mini-Review. Molecules, 2017. 22: 1255. https://doi.org/10.3390/molecules22081255.

. Horrocks, V, et al., NMR metabolomics of symbioses between bacterial vaginosis-associated bacteria. bioRxiv, 2021. 11.17.468714; doi: https://doi.org/10.1101/2021.11.17.468714.

. Morrill, S, and N. Gilbert, and A Lewis, Gardnerella vaginalis as a cause of bacterial vaginosis: appraisal of the evidence from in vivo models. Front Cell Infect Microbiol, 2020. 10:168. doi: 10.3389/fcimb.2020.00168.

. Varki, A, and P. Gagneux, Multifarious roles of sialic acids in immunity: Roles of sialic acids in immunity. Annals of the New York Academy of Sciences, 2012. 1253(1): p. 16–36.

. Abdullateef, R. et al., Bacterial vaginosis: Prevalence and associated risk factors among non-pregnant women of reproductive age attending a Nigerian tertiary hospital. Malawi Medical Journal, 2018. 29(4): p290 -. doi: 10.4314/mmj.v29i4.2

. Olusola, P. A., A. Akintayo, and T. Aduloju, Prevalence of bacterial vaginosis in pregnancy in a tertiary health institution, southwestern Nigeria. Pan African Medical Journal, 2019. 33:9. doi: 10.11604/pamj.2019.33.9.17926]

. Shimaoka, M, et al., Association between preterm delivery and bacterial vaginosis with or without treatment. Scientific reports, 2019. 9(1): p. 509-607.

. Bitew, A, et al., Prevalence of bacterial vaginosis and associated risk factors among women complaining of genital tract infection. International Journal of Microbiology, 2017: p. 1–8

. Tachawatcharapunya, S., C. Chayachinda, and N. Parkpinyo, The Prevalence of Bacterial Vaginosis in Asymptomatic Pregnant Women during Early Third Trimester and the Pregnancy Complications. Thai Journal of Obstetrics and Gynaecology, p. 2017: 96-103.

. Chawla, R, et al., Comparison of hay’s criteria with Nugent’s scoring system for diagnosis of bacterial vaginosis. BioMedical Research International, 2013. P. 1–5.

. Colonna, C., and M. Steelman, Amsel Criteria. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542319.

. Gardner, H., and C. Dukes, Hemophilus vaginalis vaginitis. Annals of the New York Academy of Sciences 2006. 83(2): p. 280–9.

. Gardner, H., and C. Dukes, Haemophilus vaginalis vaginitis. American Journal of Obstetrics and Gynecology, 1955. 69(5): p. 962–76

. Nugent, R., M. Krohn., and S. Hillier, Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation Journal of Clinical Microbiology, 1991. 29(2): p. 297–301.

. Mohanty, S., et al., Interobserver variation in the interpretation of Nugent scoring method for diagnosis of bacterial vaginosis. Indian Journal of Medical Research, 2010. 131: p. 88–91.

. Mitchell, C., and J. Marrazzo, Bacterial vaginosis and the cervicovaginal immune response. America Journal of Reproductive Immunology, 2014. 71(6): p. 555–63.

. Onderdonk, A.B., M. Delaney, and R. Fichorova, The human microbiome during bacterial vaginosis. Clinical Microbiology Reviews, 2016. 29(2): p. 223–38.

. Mtshali, A., et al., Temporal changes in vaginal microbiota and genital tract cytokines among south African women treated for bacterial vaginosis. Frontiers in Immunology, 2021. 12:730986.

. Paavonen, J., and R. Brunham, Bacterial vaginosis and desquamative inflammatory vaginitis. New England Journal of Medicine, 2018. 379(23): p. 2246–2254.

. Turovskiy, Y., et al., The aetiology of bacterial vaginosis. Journal of Applied Microbiology 2011. 110(5): p. 1105–28.

. Livengood, C.H., Bacterial vaginosis: an overview for 2009. Review in Obstetrics and Gynecology, 2009. 2(1): p. 28–37.

. Bohbot, J.M., et al., Efficacy and safety of vaginally administered lyophilized Lactobacillus crispatus IP 174178 in the prevention of bacterial vaginosis recurrence. Journal of Gynecology Obstetrics and Human Reproduction, 2018. 47(2): p. 81–6

. Peebles, K., et al., High global burden and costs of bacterial vaginosis: a systematic review and meta-analysis. Sexually Transmitted Diseases, 2019. (5): p. 304–11.

. Kenyon, C., R. Colebunders, and T Crucitti, The global epidemiology of bacterial vaginosis: a systematic review. American Journal of Obstetrics and Gynecology, 2013. 209(6): p. 505–23.

. Torrone, E.A., et al., Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: An individual participant data meta-analysis of 18 HIV prevention studies. PLoS Medicine, 2018. 15(2):e1002511.

. Jespers, V., et al., Prevalence and correlates of bacterial vaginosis in different sub-populations of women in sub-Saharan Africa: a cross-sectional study. PLoS ONE, 2014. 9(10):e109670.

. Allsworth, J.E., and J. Peipert, Prevalence of bacterial vaginosis: 2001–2004 National Health and Nutrition Examination Survey Data. Obstetrics & Gynecology, 2007. 109(1):p. 114–120.

. Joseph, R.J., et al., Finding a balance in the vaginal microbiome: how do we treat and prevent the occurrence of bacterial vaginosis? Antibiotics, 2021. 10(6): p. 719.

. Brooks-Smith-Lowe, K., and S. Rodrigo, Prevalence of bacterial vaginosis in grenadian women of reproductive age. West Indian Medical Journal, 2014. 62(7).

. Verstraelen, H,et al., The epidemiology of bacterial vaginosis in relation to sexual behaviour. BMC Infectious Disease. 2010, 10(1): p. 81.

. Smart, S., Social and sexual risk factors for bacterial vaginosis. Sexually Transmitted Infections, 2004. 80(1): p. 58–62.

. Turner, A. N., et al., Recent biomarker-confirmed unprotected vaginal sex, but not self-reported unprotected sex, is associated with recurrent bacterial vaginosis. Sexually Transmitted Diseases, 2016. 43(3): p. 172–176.

. Uma, S., et al., Bacterial vaginosis in women of low socioeconomic status living in slum areas in Chennai, India. Sex Health, 2006. 3(4): p. 297.

. Ranjit, E., et al., Prevalence of bacterial vaginosis and its association with risk factors among nonpregnant women: a hospital-based study. International Journal of Microbiology, 2018. 2018: p. 1–9.

. Paige, D., Bacterial vaginosis and preterm birth: a comprehensive review of the literature. Journal of Nurse-Midwifery, 1998. 43(2): p. 83–89.

. Dingens, A. S., et al., Bacterial vaginosis and adverse outcomes among full-term infants: a cohort study. BMC Pregnancy Childbirth, 2016. 16(1): p. 278.

. Shaffi, A., et al., Predictors of bacterial vaginosis among pregnant women attending antenatal clinic at tertiary care hospital in Tanzania: a cross-sectional study. East African Health Research Journal, 2021. 5(1): p. 59–68.

. Klebanoff, M. A. and Brotman, R. M., Treatment of bacterial vaginosis to prevent preterm birth. The Lancet, 2018. 392(10160): p. 2141–2142.

. Subtil, D., et al., Early clindamycin for bacterial vaginosis in pregnancy (Premeva): a multicentre, double-blind, randomized controlled trial. The Lancet, 2018. 392(10160): p. 2171–2179.

. Cauci, S., et al., Prevalence of bacterial vaginosis and vaginal flora changes in peri- and postmenopausal women. Journal of Clinical Microbiology, 2002. 40(6): p. 2147–2152.

. Gliniewicz, K., et al., Comparison of the vaginal microbiomes of premenopausal and postmenopausal women. Frontiers in Microbiology, 2019. 10: p. 193.

. Berg, R. C., et al., Effects of female genital cutting on physical health outcomes: a systematic review and meta-analysis. BMJ Open, 2014. 4(11): p. e006316.

. Bradshaw, C. S., et al., Recurrence of bacterial vaginosis is significantly associated with posttreatment sexual activities and hormonal contraceptive use. Clinical Infectious Diseases, 2013. 56(6): p. 777–786.

. Vodstrcil, L. A., et al., Hormonal contraception is associated with a reduced risk of bacterial vaginosis: a systematic review and meta-analysis. PLoS ONE, 2013. 8(9): p. e73055.

. Marconi, C., et al., Prevalence of and risk factors for bacterial vaginosis among women of reproductive age attending a cervical screening in southeastern Brazil. International Journal of Gynecology & Obstetrics, 2015. 131(2): p. 137–141.

. Kiran, C. K., J. Kandati, and M. Ponugoti, Prevalence of bacterial vaginosis in preterm and term labour: a one-year study. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017. 6(6): p. 2292.

. Li, X. D., et al., Incidence and risk factors of bacterial vaginosis among pregnant women: A prospective study in Maanshan city, Anhui Province, China: Risk factors for bacterial vaginosis. Journal of Obstetrics and Gynaecology Research, 2015. 41(8): p. 1214–1222.

. Chenicheri, M., et al., Prevalence of bacterial vaginosis in cases of preterm labour and its effects on obstetric outcome. Journal of Evidence Based Medicine and Healthcare, 2017. 4(28): p. 1669–1673.

. Asiegbu, O. G., et al., Prevalence of bacterial vaginosis among antenatal patients at federal teaching hospital Abakaliki, southeast Nigeria. Open Journal of Obstetrics and Gynecology, 2018. 08(01): p. 75–83.

. Yi, A. W., S. Sudigdoadi, and H. Susiarno, The bacterial vaginosis among pregnant women in Jatinangor. Althea Medical Journal, 2019. 6(4): p. 186–191.

. Chitti, S. A. and G. K. Teja, Study on bacterial vaginosis in pregnant women and associated factors on maternal and fetal outcome. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019. 8(9): p. 3459.

. Tesfay, G., et al., Prevalence and associated risk factors of bacterial vaginosis among pregnant women in Africa: a systematic review. In Review, 2020.

. Joyisa, N., et al., Asymptomatic bacterial vaginosis in pregnancy and missed opportunities for treatment: a cross-sectional observational study. Infectious Diseases in Obstetrics and Gynecology, 2019. 2019: p. 1–7.

. Kamga, Y. M., J. P. Ngunde, and J. F. K. T. Akoachere, Prevalence of bacterial vaginosis and associated risk factors in pregnant women receiving antenatal care at the Kumba Health District (Khd), Cameroon. BMC Pregnancy Childbirth, 2019. 19(1): p. 166.

. Gaspar, C., et al., Bacteriocin production of the probiotic Lactobacillus acidophilus KS400. AMB Express, 2018. 8(1): p. 153.

. Baldewijns, S, et al., The role of fatty acid metabolites in vaginal health and disease: application to candidiasis. Frontiers in Microbiology, 2021. 12: p. 705779.

. Kim, S., et al., Features and applications of bacterial sialidases. Applied Microbiology and Biotechnology, 2011. 91(1): p. 1–15.

. Liu, L., et al., Global, regional, and national causes of under-5 mortality in 2000–2015: an updated systematic analysis with implications for the Sustainable Development Goals. The Lancet, 2016. 388(10063): p. 3027–3035.

. Elovitz, M. A., et al., Cervicovaginal microbiota and local immune response modulate the risk of spontaneous preterm delivery. Nature Communications, 2019. 10(1): p. 1305.

. Fettweis, J. M., et al., The vaginal microbiome and preterm birth. Nature Medicine, 2019. 25(6): p. 1012–1021.

. Workowski, K. A. and G. A. Bolan, Centers for Disease Control and Prevention; Sexually transmitted diseases treatment guidelines, 2015. MMWR Recommendations and Report, 2015. 64(RR-03): p. 1–137.

. U.S. Preventive Services Task Force, Screening for bacterial vaginosis in pregnancy to prevent preterm delivery: u. S. Preventive services task force recommendation statement. Annals of Internal Medicine, 2008. 148(3): p. 214.

. Joergensen, J. S., L. K. Kjær-Weile, and R. F. Lamont, The early use of appropriate prophylactic antibiotics in susceptible women for the prevention of preterm birth of infectious etiology. Expert Opinion on Pharmacotherapy, 2014. 15(15): p. 2173–2191.

. Mehta, S. D., Systematic review of randomized trials of treatment of male sexual partners for improved bacterial vaginosis outcomes in women. Sexually Transmitted Diseases, 2012. 39(10): p. 822–830.

. Fethers, K. A., et al., Sexual risk factors and bacterial vaginosis: a systematic review and meta-analysis. Clinical Infectious Diseases, 2008. 47: p. 1426–1435.

. Bautista, C., et al., Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Military Medical Research, 2016. 3(1): p. 4.

. Mengel, M. B., et al., The effectiveness of single-dose metronidazole therapy for patients and their partners with bacterial vaginosis. Journal of Family Practice, 1989. 28: 163–171.

. Moi, H., Prevalence of bacterial vaginosis and its association with genital infections, inflammation, and contraceptive methods in women attending sexually transmitted disease and primary health clinics. International Journal of STD & AIDS, 1990. 1: p. 86–94.

. Ashley, J., Bacterial Vaginosis: A Review of Treatment, Recurrence, and Disparities. The Journal for Nurse Practitioners, 2019. 15: p. 420-423.




How to Cite

Ade-Ojo, I., Abolarin, E., Okiki, A., & Olufunke, O. (2022). A Scoping Review of Bacterial Vaginosis – A Silent but Potential Threat to Pregnancies and Gynecological Surgeries and Procedures. British Journal of Healthcare and Medical Research, 9(3), 152–164. https://doi.org/10.14738/jbemi.93.12421