Bacterial vaginosis: a review.

Bacterial vaginosis (BV) is a clinically definable condition that is frequently diagnosed in the primary care setting. Changes in the nomenclature, causative microorganisms, as well as treatment have caused confusion over the last century. BV is currently viewed as a shift in the normal vaginal ecosystem from a predominance of aerobic bacteria to anaerobic bacteria (Soper, 1993), resulting in a malodorous discharge. However, more than one half of clinically diagnosed patients are asymptomatic. Recent evidence indicates that the anaerobes identified as components of BV have been implicated in obstetric complications, postoperative pelvic infections, and pelvic inflammatory disease. Practice issues resulting from this research include the appropriate treatment of asymptomatic women, especially in pregnancy. This article reviews BV from a historical perspective, provides a summary of recent research findings identifying BV as a possible risk factor in various serious medical conditions and their sequelae, and discusses related practice concerns resulting from the implications of these findings.