title: The papanicolaou smear: inadequate screening test for bacterial vaginosis during pregnancy.
abstract: OBJECTIVE
  Our purpose was to evaluate the ability of the Papanicolaou smear to identify bacterial vaginosis in comparison with the Amsel clinical criteria.
  
  
  METHODS
  We retrospectively identified 159 pregnant women screened for bacterial vaginosis with the Amsel criteria who had a contemporaneous Papanicolaou smear and negative results on screening for Chlamydia trachomatis and Neisseria gonorrhoeae. Bacterial vaginosis was identified in 45 women. We used the McNemar chi(2) test to determine discrepancies between the two screening methods for the detection of bacterial vaginosis.
  
  
  RESULTS
  Compared with the Amsel criteria, the sensitivity and specificity of the Papanicolaou smear for yielding a diagnosis of bacterial vaginosis were 49% (95% confidence interval, 36%-64%) and 93% (95% confidence interval, 86%-97%), respectively, with a positive predictive value of 73% and a negative predictive value of 82%. The detection of bacterial vaginosis by Papanicolaou smear was significantly different from that by Amsel criteria (P =. 01).
  
  
  CONCLUSIONS
  The Papanicolaou smear is not a reliable screening test for bacterial vaginosis during pregnancy.
authors.affiliation: Departments of Obstetrics and Gynecology, Scott and White Memorial Hospital and Clinic, Texas A&M University Health Sciences Center College of Medicine, Temple 76508, USA.
authors.forename: J F
authors.initials: JF
authors.lastname: Greene
authors.forename: T J
authors.initials: TJ
authors.lastname: Kuehl
authors.forename: S R
authors.initials: SR
authors.lastname: Allen
mesh_terms: D005188:False Negative Reactions; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014626:Vaginal Smears; D016585:Vaginosis, Bacterial / Q000175:diagnosis*