RELIABILITAS EKSTERNA PEMERIKSAAN SMEAR VAGINA DENGAN KRITERIA SPIEGEL DALAM MENDIAGNOSIS BACTERIAL VAGINOSIS PADA IBU HAMIL

Abstract

Background: Bacterial Vaginosis (BV) is an ecological change of vagina which is characterized by balance alteration of vaginal normal flora. Thus, it manifests the domination of Lactobacillus into anaerobic bacteria. BV prevalence is quite high in reproductively active age women and most of the cases are asymptomatic. Spiegel criteria that is based on direct bacterial counting is a method that highly accurate and objective, and has ability to illustrate alteration of ecological and vaginal micro flora composition. However, this method has not been regularly used in clinical practice. Moreover, the reliability of Spiegel criteria especially external reliability is rarely reported. Purposes: This research aimed to evaluate external reliability of vaginal smear examination using Spiegel criteria in diagnosing BV among pregnant women. Method: This research was a diagnostic test study. Samples were compiled from 83 pregnant women’s Gram stained vaginal smear which were scored by Spiegel criteria. Scoring was done blindly by two examiners in different time. Kappa test was performed to determine reliability between the results of those two examiners. Result: The examination of microbial scoring which included Lactobacillus, Gardnerella, and Mixed flora yielded kappa value 0,343;0,245;0,156 respectively. Otherwise after using the simplification of Spiegel criteria kappa value was increased up to 0, 711. Conclusion: Spiegel criteria method had a good external reliability, therefore it can be used for routine diagnostic of BV in pregnant women. Kata kunci: BV, spiegel criteria, external reliability