LACTOBACILLI IN PAPANICOLAOU SMEARS, GENITAL INFECTIONS, AND PREGNANCY

Papanicolaou (Pap) smears taken at the first antenatal visit of black African women were examined for lactobacillary expression and its corr elation with the prevalence of genital infections and with the outcome of pregnancy. Lactobacillary morphotypes were absent(grade III) in 52 % of 256 women. Trichomonas, Chlamydia, gonococci, or syphilis was ide ntified in 54% of grade III women, and in 17% of grade I+II women (p < 0.0001). There were partially independent positive associations of Tri chomonas, Chlamydia, and gonococci and a negative association of Candi da morphotypes with grade III. Absence of lactobacilli, whether or not in the context of bacterial vaginosis, is an indicator for the presen ce of other genital infections. Birthweight was 2000 gm or less in 5% of 82 children of grade I+II mothers, and in 16% of 83 children of gra de III mothers (p = 0.02). Thus, there are populations in whom the gra ding of lactobacilli in routine Pap smears helps to direct further inv estigations and to predict the outcome of pregnancy.