Does vaginal douching affect the risk of vaginal infections in pregnant women?

OBJECTIVE: To evaluate the relationship between vaginal douching and vaginal infections among women in early pregnancy. METHODS: We conducted this study in the Department of Gynecology and Obstetrics, Family Planning Center, Dr. E. Hayri Ustundag Hospital, Izmir, Turkey, between March 2003 and December 2004. We examined the vaginal swabs of 129 women, asking for termination of pregnancy in a family-planning center as both wet-preparations and cultures for vaginal microorganisms, and recorded the informations on women's vaginal douching habit. RESULTS: Among 129 women examined, 80 had at least one type of vaginal microorganisms. Of 67 vaginal douche users, 48 (71.6%) had at least one type of vaginal organisms, whereas of 62 nonusers, only 32 (51.6%) had microorganism, although age, educational status, coital frequency, age at the first intercourse were not statistically different between the vaginal douche-users and non-users. Especially, Group B Streptococcus (GBS), Enterococcus spp. and Candida spp. were found more frequent in vaginal douche-user women. CONCLUSION: We found that vaginal douching tends pregnant women to genital tract the incidence of vaginal infections, especially those caused by Enterococcus spp. and GBS. As such infections may render such women to high risk in terms of perinatal mortality and morbidity, it would be appropriate to discourage vaginal douching in pregnant women.

Increased sensitivity of Trichomonas vaginalis isolation from vaginal secretions by subsequent blind passage of preliminary negative cultures.

Trichomonas vaginalis is a vaginal protozoon causing the most prevalent nonviral sexually transmitted disease. Culture is considered as the most reliable and gold standard among conventional diagnostic methods in the detection of T. vaginalis. In the present study, the diagnostic effect of subsequent blind culturing of vaginal secretion samples in Diamond's complete medium at every 48 h was investigated in 93 women. Vaginal secretion samples were examined by wet mount and inoculated into Diamond's complete medium. All tubes were subcultured to a new culture tube blindly 5 times at 48-h interval and checked microscopically everyday for the presence of T. vaginalis trophozoites. Three of 93 women were found to be positive both by wet mount and standard culture methods. Five more positive results were detected with subsequent blind culturing among 90 negative results. This system appears to be a useful method for the detection of T. vaginalis.

Results and lessons learned from a small medical abortion clinical study in Turkey.

This article presents results from a small, introductory clinical study offering a simplified regimen medical abortion to women in Turkey. A total of 208 women from five sites were recruited from July 2000 through March 2001. All eligible consenting women were given 200 mg oral mifepristone at the clinic followed by 400 microg oral misoprostol 2 days later either at home or at the clinic. The overall success rate of 84.1% is lower than in previous studies of this regimen, and a surprisingly high proportion of women (9.1%) were diagnosed with incomplete abortion. In spite of the higher than expected failure rate, women expressed a high degree of satisfaction. Several challenges were faced during this study, providing valuable insights about ways to introduce medical abortion into new settings with the best chances for success.