The microbiologic effect of digital cervical examination.

Abstract

The purpose of this study was to determine whether digital examination introduces vaginal organisms into the cervix. 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. 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. An immediate effect of digital examination is the introduction of vaginal organisms into the cervical canal.