Early pregnancy threshold vaginal pH and Gram stain scores predictive of subsequent preterm birth in asymptomatic women

Hauth, John C.; MacPherson, Cora; Carey, J. Christopher; Klebanoff, Mark A.; Hillier, Sharon L.; Ernest, Joseph M.; Leveno, Kenneth J.; Wapner, G. Ronald; Varner, Michael W.; Trout, Wayne; Moawad, Atef H.; Sibai, Baha M.

doi:10.1067/mob.2003.184

Cited by 69 publications

(49 citation statements)

References 17 publications

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“…This pH cut of point is significant and may be relevant for screening purposes in low risk population especially for prediction of early PTL. Regarding that matter, our results are similar compared to other authors pointing vaginal pH as one of the most predictive parameter for prediction of PTL but only using a cut off pH value of 5.0 and more [21][22][23][24] . Based on our results it can be concluded that both, CL measurements and vaginal pH assessment, representing screening tests for cervical insufficiency and BV are highly specific and accurate in the screening for PTL in low risk population.…”

Section: Discussionsupporting

confidence: 77%

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Vaginal pH versus cervical length in the mid‐trimester as screening predictors of preterm labor in a low‐risk population

Matijević

Grgić

Knežević

2010

Intl J Gynecology & Obste

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Methods: Prospective cohort study of 316 low-risk pregnant women. Vaginal pH was measured using test gloves for measuring the vaginal acidity, while CL was measured using transvaginal ultrasound. The cut off value for vaginal pH used was 5.0 (95 th centile for our population) whereas shortened CL was defined as < 26 mm (5 th centile for our population).Results: Elevated vaginal pH was found in 4.4% whereas shortened CL was found in 2.8%. The incidence of PTL (< 37 weeks) was 7.2%, and early PTL (< 34 weeks) was 3.4%. Shortened CL is significantly related to PTL (LR weighted by prevalence 2.7, 95% CI 1.1-6.7) but is not to early PTL (LR weighted by prevalence 0.8, 95% CI 0.4-1.8). Elevated vaginal pH is better predictor of PTL (LR weighted by prevalence 3.7, 95% CI 1.3-10.4) and early PTL (LR weighted by prevalence 1.7, 95% CI 1.1-3.1). Conclusion:Elevated vaginal pH has better accuracy in comparison with shortened CL regarding the prediction of early PTL in low risk pregnant women.

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Section: Discussionsupporting

confidence: 77%

“…The vaginal pH 5.0 (> 95 th centile) for our study population was defined as elevated and used as predictive parameter for BV. The same cut off value has been used in many other studies 11,[21][22][23] .…”

Section: Methodsmentioning

confidence: 99%

Vaginal pH versus cervical length in the mid‐trimester as screening predictors of preterm labor in a low‐risk population

Matijević

Grgić

Knežević

2010

Intl J Gynecology & Obste

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“…The risk of PTB is reported to increase considerably in women with the most antagonistic vaginal flora (i.e. Nugent score of 9 or 10 and/or vaginal pH > 5) (Hauth et al, 2003).…”

Section: Complications Associated With Bacterial Vaginosismentioning

confidence: 99%

Normal flora and bacterial vaginosis in pregnancy: an overview

Redelinghuys

Ehlers

Dreyer

et al. 2015

Critical Reviews in Microbiology

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The female genital tract is an intricate, yet balanced ecosystem that hosts a variety of different residential microflora. The physiological changes that occur during pregnancy may disrupt this balanced ecosystem and predispose women to a potentially pathogenic microbiota. Bacteria that are associated with bacterial vaginosis (BV) are opportunistic pathogens that frequently form part of this microbiota. The overgrowth of and infections with these bacteria are linked to poor obstetric outcomes and increased transmission of other reproductive tract infections (RTIs). These infections increase women's susceptibility of acquiring HIV, the rates of HIV shedding and the development of Acquired Immune

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“…Although all in the same line, these aberrations were all studied form a different perspective. Most studies used Nugent's or Spiegel's score on Gram stains to detect an association between bacterial vaginosis (BV) and intermediate flora with adverse pregnancy outcome (Hay et al, 1994;Elliot et al, 1990;Lee et al, 2009;Thorp et al, 2008;Cauci et al, 2002c;Hauth et al, 2003;Kekki et al, 2001;Kiss et al, Klebanoff et al, 2005;McDonald et al, 1997;Oakeshott et al, 2004;Verstraelen et al, 2007), but similar findings could be obtained with clinical Amsel criteria to diagnose BV (Honest et al, 2004;Rouse et al, 2009), abnormal lactobacillary grades on both Pap smears, gram stains, and wet mount preparations (Hay et al, 1994;Donders et al, 1993b;Mass et al, 1999;Donders et al, 2009) and with other abnormalities of the bacterial flora than full BV Donders et al, E pub ahead of print 2010;Donders et al, 2009). As is generally acknowledged, Nugent score above 7 on Gram stained specimens corresponds well with BV, and is nowadays accepted as golden standard for the diagnosis of BV in most clinical trials.…”

Section: Abnormal Vaginal Flora Subtypes In Pregnancymentioning

confidence: 99%