[Investigation of Trichomonas vaginalis through different methodologies during pregnancy]. / Investigación de Trichomonas vaginalis durante el embarazo mediante diferentes metodologías.

The aim of this study was to conduct a survey regarding the prevalence of trichomoniasis in pregnant patients and to evaluate the utility of different diagnostic methods. Two hundred and twenty three vaginal swab specimens from pregnant women were prospectively examined. Trichomonas vaginalis was investigated by various microscopic examinations, solid culture medium and liquid culture medium. The sensitivity and specificity of microscopy were evaluated by considering both culture media as the "gold standards". The prevalence of T. vaginalis obtained by both culture media (liquid plus solid media) was 4.5% (10/223). The prevalence of T. vaginalis obtained by direct smear, May-Grunwald Giemsa staining, sodium acetate-acetic acid-formalin (SAF)/Methylene blue staining-fixing technique, solid medium and liquid medium was 1.3%, 1.8%, 1.8% and 4.5%, respectively. The sensitivity of the direct smear was 30 %, but for the May-Grunwald Giemsa staining and the SAF/Methylene blue staining-fixing technique was 40%. Considering the three microscopic examinations altogether, the sensitivity rose to 50% and the specificity was 100% for all of them. The solid medium detected only 50% of the positive cases; the liquid medium detected 100%. Due to the low sensitivity obtained with microscopy in asymptomatic pregnant patients, we recommend the use of the liquid medium during pregnancy, in order to provide an early treatment.

Investigación de Trichomonas vaginalis durante el embarazo mediante diferentes metodologías / Investigation of Trichomonas vaginalis through different methodologies during pregnancy

Los objetivos del trabajo fueron conocer la prevalencia de tricomonosis en pacientes embarazadas y evaluar la utilidad de diferentes metodologías para su diagnóstico. Se estudiaron prospectivamente 223 mujeres embarazadas. Trichomonas vaginalis se investigó utilizando distintos exámenes microscópicos, cultivo en medio sólido y medio líquido. Se evaluó la sensibilidad y especificidad de la microscopía considerando a los cultivos en ambos medios como método de referencia. La prevalencia del parásito obtenida por cultivo (medio líquido más medio sólido) fue de 4,5% (10/223) siendo la detección por examen en fresco, coloración de May-Grunwald Giemsa, fresco con solución acética formolada (SAF)/azul de metileno y por cultivo en medio sólido y líquido de 1,3%, 1,8%, 1,8% y 4,5% respectivamente. La sensibilidad del examen en fresco fue 30%, para el May-Grunwald Giemsa y el SAF/azul de metileno fue 40%. Utilizando conjuntamente los tres exámenes microscópicos, la sensibilidad se elevó al 50% y la especificidad fue 100% para todos los exámenes microscópicos. El cultivo en medio líquido detectó el 100% de los casos positivos , mientras que el medio sólido sólo el 50%. Por la baja sensibilidad de la microscopía para T. vaginalis, en embarazadas asintomáticas recomendamos la utilización del cultivo en medio líquido durante el embarazo, para instaurar un tratamiento precoz.

The aim of this study was to conduct a survey regarding the prevalence of trichomoniasis in pregnant patients and to evaluate the utility of different diagnostic methods. Two hundred and twenty three vaginal swab specimens from pregnant women were prospectively examined. Trichomonas vaginalis was investigated by various microscopic examinations, solid culture medium and liquid culture medium. The sensitivity and specificity of microscopy were evaluated by considering both culture media as the "gold standards". The prevalence of T. vaginalis obtained by both culture media (liquid plus solid media) was 4.5% (10/223). The prevalence of T. vaginalis obtained by direct smear, May-Grunwald Giemsa staining, sodium acetate-acetic acid-formalin (SAF)/Methylene blue staining-fixing technique, solid medium and liquid medium was 1.3%, 1.8%, 1.8% and 4.5%, respectively. The sensitivity of the direct smear was 30 %, but for the May- Grunwald Giemsa staining and the SAF/Methylene blue staining-fixing technique was 40%. Considering the three microscopic examinations altogether, the sensitivity rose to 50% and the specificity was 100% for all of them. The solid medium detected only 50% of the positive cases; the liquid medium detected 100%. Due to the low sensitivity obtained with microscopy in asymptomatic pregnant patients, we recommend the use of the liquid medium during pregnancy, in order to provide an early treatment.