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

Abstract

Background: Bacterial Vaginosis (BV) in pregnant women is associated with low birth weight infants, premature rupture of membranes, chorioamnionitis, pelvic inflammation disease, and post abortal sepsis. These complications are serious health problems, therefore diagnosis and treatment of BV in pregnant women is very important. Amsel criteria has usually been used to diagnose BV in clinical setting. However, this test is subjective and depends on the experience of examiners. Spiegel criteria is one of Gram staining methods that is simple and feasible to diagnose BV, but it hasn’t been used routinely. Besides, the internal reliability of Spiegel criteria was unclear. Objectives: To evaluate internal reliability of vaginal smear examination using Spiegel criteria to diagnose BV in pregnant women. Methods: This was a diagnostic test study. Vaginal smear samples from 83 pregnant women were stained with Gram stain, then identified two times and randomly by an investigator using Spiegel criteria. Kappa test was used to measure internal reliability between first and second examination, three weeks after the first examination. Results: This study yielded kappa value 0.82 for diagnosis BV; 0.60 for Lactobacillus scoring; 0.55 for Gardnerella scoring; and 0.46 for mixed flora scoring. Conclusion: Lactobacillus scoring had good internal reliability, while Gardnerella and mixed flora scoring had poor internal reliability. However, when these scorings were simplified with Spiegel criteria, internal reliability to diagnose BV became very good. It showed that Spiegel criteria had very good internal reliability to diagnose BV in pregnant women, thus it could be suggested for routine examination. Key words: internal reliability, Spiegel criteria, bacterial vaginosis.