Bacterial vaginosis is characterized by a profound shift in the vaginal microbial flora from gram positive bacilli of genus lacto bacillus to an increased in the load of facultative anaerobes, including Gardenerella vaginalis, Atopobium vaginae and other fastidious bacteria such as Megasphaera, Sneathia and Clostridiales species. The importance of bacterial vaginosis is rather a social, emotional and sexual burden on women than as a medical condition. It affects 10 to 30% of women in developed countries and even more in developing countries with poor hygiene and standard of living. The condition being recurrent usually presents with malodour (rotten fish vaginal odour) and abnormal white discharge per vagina. This alteration in the vaginal bio flora increases the risk of acquiring a broad range of sexually transmitted infection such as gonorrhea, Chlamydia, HSV type 2 and HIV by approximately two folds and also increases the risk of HIV infected women transmitting HIV infection to male partner. Its obstetric sequelae include spontaneous abortion, preterm labor, chorioamnionitis and puerperial sepsis. Treatment requires multiagent approach that combines anti-microbial, Bio film – disrupting agents, life style modification and probiotics to improve vaginal flora and to prevent recurrence. This review focused on risk factor etiology, clinical factor and management.
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