title: Factors related to elevated vaginal pH in the first trimester of pregnancy.
abstract: OBJECTIVE
  To assess different bacterial and epidemiological factors associations with increased vaginal pH in the pregnant women population during the first trimester.
  
  
  METHODS
  A cross-sectional, observational study.
  
  
  METHODS
  Three outpatient clinics in Riga.
  
  
  METHODS
  From July 2009 until January 2010, 139 unselected consecutive pregnant women at the first prenatal visit.
  
  
  METHODS
  Pregnant women were submitted to an interview, vaginal examination and vaginal specimen collection for pH measurement and native microscopy.
  
  
  METHODS
  Vaginal pH ≥4.5 was considered as elevated. Abnormal bacterial microflora was classified according to Donders.
  
  
  RESULTS
  Elevated vaginal pH was significantly associated with bacterial vaginosis (p < 0.001), aerobic vaginitis (p < 0.001) and mixed aerobic vaginitis and bacterial vaginosis flora (p < 0.001) and presence of sperm cells in the smears (p= 0.024). Most cases with sperm were associated with abnormal vaginal flora. Normal lactobacillary morphotypes were more often found in the pH ≤4.4 group (p < 0.001), while leptosomic and short types were found more frequently with increased pH.
  
  
  CONCLUSIONS
  Elevated vaginal pH is associated with different types of abnormal vaginal flora and the presence of sperm cells.
authors.affiliation: Department of Obstetrics and Gynecology, Riga Stradins University, Latvia. zodzika@inbox.lv
authors.forename: Jana
authors.initials: J
authors.lastname: Zodzika
authors.forename: Dace
authors.initials: D
authors.lastname: Rezeberga
authors.forename: Irina
authors.initials: I
authors.lastname: Jermakova
authors.forename: Olga
authors.initials: O
authors.lastname: Vasina
authors.forename: Natalija
authors.initials: N
authors.lastname: Vedmedovska
authors.forename: Gilbert
authors.initials: G
authors.lastname: Donders
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011261:Pregnancy Trimester, First; D012307:Risk Factors; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D014621:Vagina / Q000737:chemistry* / Q000382:microbiology* / Q000473:pathology; D014626:Vaginal Smears; D014627:Vaginitis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult