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The microbiologic effect of digital cervical examination
H M Imseis1, W C Trout, S G Gabbe
1Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, USA.
American Journal of Obstetrics and Gynecology
|March 17, 1999
Summary
Digital cervical examination significantly increases the number of vaginal organisms in the cervix. This finding highlights a potential risk associated with the procedure, even with ruptured membranes.
Area of Science:
- Obstetrics and Gynecology
- Infectious Disease Research
- Microbiology
Background:
- Digital cervical examination is a common obstetric procedure.
- Understanding the potential for microbial transfer is crucial for patient safety.
- Previous research has not definitively established the immediate impact of digital exams on cervical flora.
Purpose of the Study:
- To investigate whether digital examination introduces vaginal organisms into the cervix.
- To quantify changes in microbial presence following digital cervical examination.
Main Methods:
- A study involving 35 women with ruptured membranes at >/=34 weeks' gestation.
- Sterile speculum examinations and standardized endocervical cultures were performed before and after digital examination.
- Semiqualitative and semiquantitative culture techniques were employed.
Main Results:
- Cultures post-examination showed a significant increase in the mean number of different organism types (4.4 +/- 1.5) compared to pre-examination cultures (2.8 +/- 1.7).
- 80% of patients exhibited heavier growth or a greater diversity of organisms after the digital exam.
- The status of fetal membranes (ruptured vs. intact) did not influence these microbial transfer patterns.
Conclusions:
- Digital cervical examination has an immediate effect of introducing vaginal organisms into the cervical canal.
- This microbial introduction may have implications for ascending infections in pregnant individuals.
- Further research may explore strategies to mitigate this observed effect.