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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.
Objective:
The purpose of this study was to determine whether digital examination introduces vaginal organisms into the cervix.
Study Design:
Thirty-five women with reported ruptured membranes at >/=34 weeks' gestation underwent a sterile speculum examination and a standardized semiqualitative, semiquantitative endocervical culture before and immediately after digital cervical examination.
Results:
Cultures taken before digital examination demonstrated a mean of 2.8 +/- 1.7 different types of organisms, whereas cultures taken after digital examination demonstrated a mean of 4.4 +/- 1.5 different types of organisms (P <.0001). Twenty-eight patients (80%) had heavier growth or a greater number of different organisms in the postexamination culture than in the pre-examination culture. The state of the fetal membranes (ruptured as opposed to intact) did not alter these relationships.
Conclusion:
An immediate effect of digital examination is the introduction of vaginal organisms into the cervical canal.