title: Validation of vaginal discharge syndrome among pregnant women attending obstetrics clinic, in the tertiary hospital of Western India.
abstract: BACKGROUND
  Sexually transmitted infections (STIs) are major public health problem. The laboratory tests for diagnosing STI are often unavailable or too expensive. Therefore, World Health Organization has recommended a syndromic approach for diagnosis and management of STI/reproductive tract infections (RTIs). Very few studies so far had evaluated effectiveness of the syndromic approach in diagnosing STI/RTIs in pregnancy.
  
  
  OBJECTIVE
  Validation of syndromic management for vaginal discharge syndrome in pregnancy.
  
  
  METHODS
  A cross-sectional study was carried out which included 233 pregnant females attending obstetric clinic. They were subjected to clinical examination, vaginal swab collection, and serological tests.
  
  
  RESULTS
  A total of 183 (78.54%) pregnant females had vaginal discharge on clinical examination and Candida albicans was the most common clinical diagnosis among them. Of 183 cases diagnosed clinically as vaginal discharge syndrome, 38 (20.7%) were tested positive in laboratory investigations. Out of 50 clinically negative cases, 9 (18%) were detected positive for one of the STIs on laboratory testing.
  
  
  CONCLUSIONS
  Syndromic approach for management of vaginal discharge syndrome resulted in over-treatment of 78% (false positive) and under-diagnosis of 19.1% (false negative) pregnant females. Hence, integration of antenatal screening services in the form of laboratory tests for vaginal discharge is recommended.
authors.affiliation: Department of Obstetrics and Gynaecology, Government Medical College, Baroda, India.
authors.forename: Maitri
authors.initials: M
authors.lastname: Shah
authors.affiliation: Department of Obstetrics and Gynaecology, Government Medical College, Baroda, India.
authors.forename: Shetal
authors.initials: S
authors.lastname: Deshmukh
authors.affiliation: Department of Community Medicine, Government Medical College, Baroda, India.
authors.forename: Sangita V
authors.initials: SV
authors.lastname: Patel
authors.affiliation: Department of Community Medicine, GMERS Medical College, Gotri, Gujarat, India.
authors.forename: Kedar
authors.initials: K
authors.lastname: Mehta
authors.affiliation: Department of Skin and VD, Government Medical College, Baroda, India.
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Marfatia
keywords: India; pregnant women; screening; syndromic approach; vaginal discharge syndrome; validation