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Infectious Diseases in Obstetrics and Gynecology
Volume 12, Issue 2, Pages 63-68

Experience With Routine Vaginal pH Testing in a Family Practice Setting

1Department of Family Medicine, University of Nebraska Medical Center, Omaha, Neb, USA
2Department of Epidemiology, University of Washington, Seattle, WA, USA
3National Institute of Mental Health, 10 Center Drive, Rm 3N 238, Bethesda 20892-1276, MD, USA

Received 15 October 2003; Accepted 21 January 2004

Copyright © 2004 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: Despite recommendations by Centers for Disease Control and the American College of Obstetricians and Gynecologists, pH testing is infrequently performed during the evaluation of vaginitis. Consequently, little information exists on its use in a primary care setting.

Objective: The aim of this study was to describe our experience with routine pH testing, particularly the relationship between symptoms, pH and wet-mount microscopy.

Method: A retrospective chart review was performed on 203 consecutive cases evaluated for vaginitis by wet-mount microscopy.

Results: Of the 203 cases, 21 had normal pH and no symptoms and 182 had symptoms, elevated pH or both; 85% of cases had abnormal wet-mount findings, including 75% with clue cells, 14% withTrichomonas vaginalis, 13% with yeast and 14% with mixed infections. Asymptomatic infection was present in 42% of cases with clue cells alone, 44% of cases with Trichomonas vaginalis alone, 38% of all trichomoniasis cases and 33% of cases with mixed infections. Elevated pH was associated with clue cells (p < 0.001), trichomoniasis (p = 0.01) and mixed infections (p = 0.003). Normal pH was associated with negative wet mount (p < 0.001) and to a lesser degree with uncomplicated vulvovaginal candidiasis (p = 0.06).

Conclusion: Routine pH testing increased detection of trichomoniasis and bacterial vaginosis by prompting microscopy in a significant proportion of asymptomatic cases.