Diagnostic Accuracy of Nugent Scoring in Comparison to Amsel's Criteria for Diagnosis of Bacterial Vaginosis in Women of Reproductive age Group at a Tertiary Care Hospital

Abstract

Introduction: Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women of reproductive age and is associated with adverse obstetric and gynecologic outcomes.
Aim: To find out the diagnostic accuracy of Nugent's scoring when Amsel’s criteria considered as gold standard from the patients of reproductive age group suspected for bacterial vaginosis.
Material and Methods: A total of 100 random samples were collected from the patients of reproductive age group having complaint of vaginal discharge suspected for vaginosis attending Obstetrics and Gynecology Out Patient Department (OPD). Bacterial vaginosis was diagnosed using Amsel's criteria and Nugent's method and Gardnerella vaginalis was isolated by inoculating on Columbia agar and identified by Hippurate hydrolysis test.
Result: The sensitivity, specificity, positive predictive value, negative predictive value of Nugent's score when compared to Amsel's criteria was found to be 69.23%, 100%, 100%, 95.6% and 96% respectively. The rate of isolation Gardnerella vaginalis was found to be 15.3%.
Conclusion: The Amsel's criterion has high sensitivity and was found to be highly efficient require lower cost, lesser time and have advantage of being done in outpatient department thus enabling precise and fast treatment for patient. Nugent scoring system can be as good as Amsel's criteria in terms of specificity and positive predictive value, however has lower sensitivity and negative predictive value at diagnosing bacterial vaginosis. Diagnosis of bacterial vaginosis by culture was least sensitive method.