First part of the material Diagnosis During a gynecological examination, the doctor pays attention to the appearance of the mucous membrane. A manual examination of the ovaries and uterus is performed to determine whether inflammation is present. A secretion is taken for microbiological examination, including chlamydia and gonorrhea. Under a microscope, a specialist can distinguish whether vaginosis is bacterial, fungal (candida) and trichomonal. In bacterial vaginosis, the specific cells “clue cells” are detected. These are epithelial cells with anaerobic microorganisms adhering to the surface. In their presence, a reduced amount of lactobacilli is usually observed. With a low concentration of lactobacilli in the natural microflora of the vagina, the acidity of the environment decreases, which makes possible the growth of conditionally pathogenic microorganisms. Acidity of vaginal discharge above 4.5 pH, however, is also an indicator of bacterial vaginosis. If bacterial vaginosis is suspected, a vaginal discharge test is performed with potassium hydroxide (KOH) solution. A reaction is reported in bacterial vaginosis. Treatment Antibiotics are prescribed for bacterial vaginosis. Several types of medication are usually used. Metronidazole (Flagyl) oral tablets or by applying its vaginal version (Metrogel), the other topical agent is clindamycin cream. Tablets have an unpleasant side effect, but the drug is effective. With the gel forms, there are no complaints, although it is possible to cause fungal vaginitis as a side effect of the application of the therapy. Tinidazole is also an antibiotic that is effective in treating bacterial vaginosis and has fewer side effects than metronidazole. Even after successful treatment, bacterial vaginosis is likely to recur. In half of the cases, patients complain of symptoms again up to 12 months after treatment. The cause remains unclear. Antibiotic therapy should be repeated. Complications Bacterial vaginosis may go away completely after the applied therapy. During pregnancy, bacterial vaginosis can lead to premature birth, infection of the amniotic fluid and the uterus. However, numerous scientific studies have reported that the use of bacterial vaginosis therapy during pregnancy does not reduce the incidence of preterm birth. For these reasons, the treatment of bacterial vaginosis during pregnancy is controversial. It is necessary for doctors to carefully assess the benefits and risks of applying or not applying treatment in each individual case. Screening for and treatment of bacterial vaginosis is sometimes recommended for women who have had a preterm birth. The most important thing: Bacterial vaginosis is an abnormal vaginal condition in which there is a specific vaginal discharge and the growth of bacteria that are normally found in the vagina and its natural microflora. Bacterial vaginosis is not a dangerous condition, but it causes discomfort. The symptoms of bacterial vaginosis are :gray-white scanty discharge with a specific smell of fish, although in 50-75% of cases women have no complaints. When making the diagnosis, it is important to exclude other serious infections, such as chlamydia and gonorrhea. Treatment includes oral and vaginal forms of antibiotics Re-development of bacterial vaginosis is possible even after successful therapy. During pregnancy, a careful assessment of the condition and the need for treatment is required.