vaginal discharge dr sathisha nayak dept. of o & g mmmc

VAGINAL DISCHARGE

DR Sathisha Nayak

Dept. of O & G

MMMC

IDENTIFY !!

VAGINAL DISCHRGE

OBJECTIVES :1.WHAT IS LEUCORRHOEA?2.IS IT NORMAL?3. NORMAL VS BNORMAL4.CLASSIFICATION5.COMMON CAUSES6.CLINICAL FEATURES7.EVALUATION8.MANAGEMENT

LEUCORRHOEA

• EXECESSIVE VAGINAL DISCHARGE

NOT DUE TO INFECTION(EXECESSIVE

CERVICAL MUCUS OR VAGINAL

TRANSUDATION)

ECTROPION, CERVICAL TEARS.

IS VAGINAL DISCHARGE NORMAL?

• COULD BE PATHOLOGICAL• YES –SOME SITUATIONS IT CAN BE - PUBERTAL - PREGNANCY - PREMENSTRUAL - OC PILLS-SCANTY,NO SMELL,WHITISH,NO ITCHING NOT BLOOD STAINED.

NORMAL CERVIX

CLASSIFICATION

• PHYSIOLOGICAL

• PATHIOLOGICAL

- INFECTIVE

- NON INFECTIVE- NEOPLASTIC

- ATROPHIC

- ALLERGIC,FB

INFECTIVE CAUSES

• VAGINAL

- CANDIDA VAGINITIS

- TRICHOMONIAL VAGINITIS

- BACTERIAL VAGINOSIS

• CERVICAL

- GONORRHOEA CERVICITIS

- CHLAMYDIA CERVICITIS

CANDIDA VAGINITIS

AGE- 20-40Y COMMON IN – PREGNANCY DIABETIC OBESE WOMENFEATURES - CURDY WHITE,ITENSE ITCHING EXCORATION OF VULVASMEAR- 10%KOH-FUNGAL HYPHE SEENTREATMENT-CLOTRIMAZOLE-100MG BDx7D 200MGBDx3D RECURRENT -FLUCONOZLOE 150 MG WX4W

CANDIDA VAGINITIS

CANDIDA VAGINITIS

TRICHOMONIAL VAGINITIS

• AGENT - TRICHOMONIA VAGINALIS• AGE -20-40YRS,SEX ACTIVITYFEATURES GREENISH,FROTHY,COPIOUS,ITCHING STRAWBERRY SPOTS ON VAGINAVAG. SMEAR-MOTILE ORGANISMSTREATMENT- METRONIDAZOLE - 200XBDX7D OR400XBDX3 -COUPLE TREATED TOGETHER

TRICHOMONIAL VAGINITIS

BACTERIAL VAGINOSIS

AGENT–G.VAGINALIS+ANAEROBIC

AGE -20-40 YRS

FEATURES-WHITISH GREY,COPIOUS

NO ITCHING,FISHY SMELL

VAG.SMEAR-CLUE CELLS

TREATMENT-METRONIDAZOLE500XBD

X7DAYS

BACTERIAL VAGINOSIS

HOW TO ASSES..?

DETAILED HISTORY

COLOUR AMOUNT,SMELL,ITCHING

RELATION TO COITUS /MENSES,pH

CLINICAL EXAMINATION-EX GENITAL

P/S EXAM

INVESTIGATIONS-VAGINAL SMEAR

-CULTURE

CERVICAL INFECTIONS

GONORRHOEA-NEISS. GONORRHOEAE

-85 %ASYMPTOMATIC

- MUCOPURULANT

- SMEAR FROM CX O&URETHRA

- INTRACELL. GM –VE DIPLOCOCCI

-SINGLE DOSE CEFETRIOXONE

CERVICAL INFECTIONS

• CLAMYDIA-CL.TRACHOMATIS

• AGE -20-40

• MUCOPURULANT

• SEXUAL TRANSMITTED

• FLOROSCENT ANTIBODY TEST/CULT.

• DOXYCYCLINE 100XBDX7D

CERVICAL INFECTIONS

BEWARE !

IN ANY VAGINAL DISCHARGE R/O-

-CARCINOMA CERVIX,CA ENDOMET.

(FOUL SMELL OR BLOOD STAINED)

-POLYPS,FB,VAG DOUCH(CHEMICAL)

-STD-PARTNER SCREENING

-DIABETES/HIV IN CANDIDA

DYSPLASIA

IDENTIFY

IDENTIFY

IDENTIFY

IDENTIFY

THANK YOU