الفهرس 
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Abstract
Miscarriage or spontaneous abortion is the spontaneous end of pregnancy at a stage where the embryo or fetus is incapable of surviving, generally defined in humans at prior to 20 weeks of gestation or below a fetal weight of 500g (Speroff , 2005).
Three-fourths of spontaneous abortion occurs before 16th week; of these, three-fourths occur before eighth week. Almost 20% of clinically recognized pregnancies terminate in spontaneous abortion (George L, 2002).
Causes of spontaneous abortion can be summarized to be: chromosomal abnormalities, infection, hormonal problems, incompetent cervix, immunological disorders, uterine abnormalities, nutritional and environmental factors. In many cases of miscarriage no obvious cause was found (Mikio A and Nihira, 2009).
Bacterial vaginosis is a condition characterized by alteration of the vaginal ecology in which the normal flora, dominated by lactobacilli, is replaced by a mixed bacterial flora which includes Gardnerella vaginalis, Mobiluncus spp and Mycoplasma hominis (Spiegel, 1991).
Bacterial vaginosis is the most prevalent form of vaginal infection in women during childbearing age the average incidence of bacterial vaginosis varies and reported to be 30-65% in patients visiting gynaecological and sexually transmitted diseases clinics and 10-25% in patients visiting obstetric clinics (Hansen, 2004).
The main cause of bacterial vaginosis is a decrease in the quantity of lactobacilli removes the source for hydrogen peroxide, which leads to overgrowth by Prevotella, Mobiluncus, and other anaerobes that produce succinic acid that may inhibit chemotaxis of white blood cells facilitating bacterial vaginosis to be developed (Spiegel, 2002).
In clinical practice B.V is diagnosed using the criteria of Amsel:
1. Thin, white, yellow, homogeneous discharge
2. Clue cells on microscopy.
3. PH of vaginal fluid >4.5.
4. Release of a fishy odor on adding alkali—10% potassium hydroxide (KOH) solution. (Amsel , 1983).
Gram stain of vaginal fluid is the most widely used and evaluated microbiologic diagnostic method for bacterial vaginosis. (Nugent, 1991).
Women with bacterial vaginosis are at increased risk for pelvic inflammatory disease (Eschenbach, 1998), postoperative cuff infections after hysterectomy (Soper, 1990) and abnormal cervical cytology (Platz-Christensen, 1994).
The consequences of bacterial vaginosis in pregnancy include preterm labor and premature rupture of membranes, which are worse in developing countries due to limited resources to support proper antenatal care. Bacterial vaginosis is treatable with antibiotics prescribed by a health care provider. Two different antibiotics are recommended as treatment for bacterial vaginosis: metronidazole or clindamycin. Either can be used with non-pregnant or pregnant women, but the recommended dosages differ. (Darwish, 2007).
In the present study we recruited 192 pregnant women at the 7th week of gestation from the women who attended to antenatal care clinic of Ain Shams University Maternity Hospital between June and December 2010. Samples were collected for our study. 12 samples were excluded by the laboratory because these samples were incorrectly prepared (180 samples were collected).
For each case, a full history, general and local examinations done and we took vaginal swab to screen for bacterial vaginosis using Nugent gram stain scoring system among these women and divided them to 3 groups:-
Group I : with normal vaginal flora (55 women = 30.6%).
Group II : Intermediate for bacterial vaginosis (21women= 11.7%).
Group III : positive for bacterial vaginosis (104 women = 57.8%).
The results of our study concluded that there was no statistically significant relation between bacterial vaginosis and first trimester miscarriage when comparing pregnant women with bacterial vaginosis (12.5%) and intermediate flora (23.8%) with normal flora (10.9%) regarding first trimester miscarriage (P= 0.311, 2).
from the result of our study and the results of other similar studies it seems unlikely that screening and treatment of asymptomatic bacterial vaginosis would improve miscarriage rates, particularly in the first trimester.