The Impact of Regular Vaginal pH Screening on the Diagnosis of Bacterial Vaginosis in Pregnancy

Our difficulty in recruiting women resulted from our failure to invite all eligible women to participate and from the refusals to participate because we required frequent vaginal examinations. The observation that so many women disliked the idea of regular prenatal vaginal examinations suggests that we should investigate ways of making the vaginal pH test more acceptable, perhaps through self-testing. It is also possible that other populations (eg, women with previous preterm births or women of higher socioeconomic status) would be more open to regular pH testing.

Additional limitations of our study include potential selection bias, which may reduce the generalizability of our findings, and the fact that patients and providers were not blinded to the intervention. It would be helpful to minimize these potential sources of bias in a large-scale blinded randomized trial. Future studies should also differentiate the causes of positive results in follow-up tests and should examine the benefit of treating asymptomatic infections and doing follow-up tests for cure.

Conclusions

Our frequent screening procedures significantly increased the recognition of bacterial vaginosis and the treatment of infected women. Since vaginal symptoms and elevated pH levels appear to be useful in screening for bacterial vaginosis and trichomoniasis, frequent pH testing should be evaluated in larger studies.

Acknowledgments

This study was supported by a grant from the UCare Foundation.