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Bakteriell vaginose

Sist revidert:
Sist revidert av:


Definisjon:
Endret vaginal bakterieflora med reduksjon av melkesyrebakterier og økning av anaerobe bakterier. Assosiert med økt risiko for senabort og for tidlig fødsel og gir økt risiko for seksuelt overførte infeksjoner og infeksjoner etter gynekologiske inngrep
Forekomst:
Hos 10-30%
Symptomer:
Økt, illeluktende, tynnflytende og homogen vaginal utflod. Asymptomatisk hos mer enn 50% 
Funn:
Kliniske funn kan være tyntflytende, melkaktig, noen ganger skummende utflod med ubehagelig lukt. Som regel ingen påfallende vulvitt eller vaginitt
Diagnostikk:
Vaginal pH > 4,5. Clue cells kan sees ved mikroskopi. Fiskelukt kan avdekkes ved KOH luktetest
Behandling:
Tilfeldig påvist BV hos asymptomatiske kvinner skal ikke behandles. Antiseptisk lokalbehandling, ev. antibiotika lokalt eller peroralt ved behandlingssvikt. Symptomgivende BV anbefales behandlet før graviditet.
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  2. Kairys N, Garg M. Bacterial Vaginosis. 2022 July 4. In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29083654. Accessed 2023 Jan 17 www.ncbi.nlm.nih.gov  
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  4. Vodstrcil LA, Hocking JS, Law M, et al. Hormonal contraception is associated with a reduced risk of bacterial vaginosis: a systematic review and meta-analysis. PLoS One. 2013;8 :e73055. doi: 10.1371/journal.pone.0073055. eCollection 2013.
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  8. Vieira-Baptista P, Silva AR, Costa M et al. Diagnosis of bacterial vaginosis: Clinical or microscopic? A cross-sectional study. Int J Gynaecol Obstet. 2022 Mar;156(3):552-559. Epub 2021 Jul 12. PMID: 34160078 PubMed  
  9. Lowe NK, Neal JL, Ryan-Wenger NA. Accuracy of the clinical diagnosis of vaginitis compared with a DNA probe laboratory standard. Obstet Gynecol 2009; 113: 89-95. PubMed  
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  11. Brocklehurst P, Gordon A, Heatley E, Milan SJ. Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD000262. DOI: 10.1002/14651858.CD000262.pub4. DOI  
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  14. Myrhaug HT, Brurberg KG, Kirkehei I og Reinar LM. Klindamycin til gravide med asymptomatisk bakteriell vaginose . Rapport fra Kunnskapssenteret nr 11 - 2010.
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  16. Afifirad R, Darb Emamie A, Golmoradi Zadeh R et al. Effects of Pro/Prebiotics Alone over Pro/Prebiotics Combined with Conventional Antibiotic Therapy to Treat Bacterial Vaginosis: A Systematic Review. Int J Clin Pract. 2022 Apr 21;2022:4774783. PMID: 35685517 PubMed  
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  • Silje Folven Barlindhaug, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Ingard Løge, spesialist i allmennmedisin, redaktør Norsk Elektronisk Legehåndbok