DiagnosticValueof Amsel’sClinicalCriteriafor Diagnosis of Bacterial Vaginosis

Document Type : Original Article


1 Lecturer, Faculty of Nursing & Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 M.Sc. in Midwifery, Mashhad, Iran

3 Assistant Professor of Microbiology, Mashhad University of Medical Sciences, Mashhad, Iran


Introduction:Vaginitis is the most prevalent gynecological complaint for which women seek medical treatment. Amongst different methods of diagnosis of bacterial vaginosis Amsel`s clinical criteria and Nugent scoring is of the most preferentiality. The aim of this study is to evaluate the diagnostic values of whole Amsel`s clinical criteria, each of Amsel`s criterion solitarily and combination of two criteria, respectively, for diagnosis of bacterial vaginosis.
Methods: This study is carried out on 105 women referring to gynecologic clinic of 17-Shahrivar Hospital (Mashhad, Iran, 2006-2007) who underwent speculum examination and were qualified to enroll in study. The Nugent scoring system was used as the gold standard method for diagnosis of bacterial vaginosis. Sensitivity, specificity, positive predictive value and negative predictive value of whole Amsel`s clinical criteria, each of Amsel`s criterion solitarily and combination of two criteria for the diagnosis of bacterial vaginosis were determined according to the aimed standard.
Results: Among Amsel’s clinical criteria, the most sensitive individual criterion was clue cells (96.9%) and the criterion with the highest specificity was Whiff test (80.8%). PH plus clue cells and clue cells plus vaginal discharge were the most sensitive coupled combinations (84.4%), whereas the combination of clue cells and Whiff test was of the highest specificity (89%).
Conclusion: The clinical criteria for the diagnosis of bacterial vaginosis can be simplified into two clinical criteria with no considerable decline in their sensitivity and specificity.


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