Vaginal pH Self-Screening as a KISS Regimen in Prevention of Early Preterm Birth

Self-measurement of vaginal pH is an established screening procedure for prevention of premature birth due to abnormal vaginal flora and bacterial vaginosis. In the Erfurt and Thuringia studies women were instructed to see their physician immediately if their vaginal pH was abnormal (> 4.5) or other risk factors were present, so results could be confirmed and therapy started. Treatment was with Lactobacillus acidophilus or, for bacterial vaginosis, antibiotics. In the initial trial, 0.3 % of the neonates with a gestational age < 32 + 0 weeks were seen in an intervention group versus 3.3 % (p < 0.01) in the control group; in the larger Thuringia study, the figures were 0.94 versus 1.36 % (p < 0.01). The rate of newborns < 1.000 g was significantly reduced to 0.38 %, the lowest incidence ever seen in Germany. After discontinuation of the Thuringia trial in 2000, the pre-term birth rates returned to the levels prior to the programme, however, the innovative pH measurement regime described has been introduced in > 20 countries so far.