Comment by Prof. James C. Caillouette, M.D., USA (April
During my 40+ years of obstetrical
practice, and having delivered an estimated 7,000 babies, I
became convinced early on that there is a direct link between
undiagnosed and untreated ascending vaginal infection and
premature birth. This is validated by the outstanding work and
publications of the German physician Prof. Dr. Erich Saling.
In early practice, I developed an office protocol
that included physician, nursing and patient awareness of the
importance of a healthy vagina and healthy sex habits at all
times. Routine vaginal pH screening was done by me at every
Ob/Gyn pelvic examination as part of screening for vaginal
Later in my practice I was informed that Prof.
Saling was a strong proponent of similar testing of obstetrical
patients in Germany. Dr Saling's promotion of the pH screening
glove in Germany has shown that premature birth could be
considerably reduced when such patient screening started very
early in the pregnancy, was performed frequently and led to
proper treatment. Prof. Saling and I were on the same glide path
at a similar time in two different parts of the world. To be able
to collaborate with Prof. Saling in the prevention of premature
birth was my dream.
There is continued resistance in the United States
academic and professional organizations, as well as from March of
Dimes, to this simple patient and healthcare provider use of
vaginal pH to screen for, treat and promote a healthy vagina.
Since Prof. Saling has retired, he is not able anymore to perform
controlled trials regarding this issue. But other institutions
which have the necessary resources should no longer hesitate to
The fact that premature birth has gone from 6% to
12.5% in Caucasians and 18.5% in African Americans during my
medical practice life and yet has not inspired positive action by
the OB-leadership, the Federal government and the March of Dimes
(except calls for more studies), is both shocking and
inexcusable. The national tragedy of this escalation in the
number of damaged children must stop. Routine vaginal pH testing
by every pregnant woman is simple, inexpensive (certainly
relative to the cost of a damaged child), can lead to better
informed sex habits and better vaginal health. How much more
simple and inexpensive does the solution need to be?
James C. Caillouette MD, FACOG.
Short CV of the author of the comment:
James C. Caillouette, M.D. F.A.C.O.G., F.A.C.S.
was born in 1927, studied at the University of Washington School
of Medicine and received his M.D. in 1954 with Honors. He
performed his Internship and his Residency at the Los Angeles
County General Hospital.
From 1959 onwards, he was an attending physician
at the Keck/U.S.C. School of Medicine and in 1978 became a
Clinical Professor (since 2002 Emeritus). Additionally he had
specific teaching responsibilities at the Keck/U.S.C. School of
Medicine, hospital staff appointments at the St. Luke's Hospital,
Pasadena, the Los Angeles County-U.S.C. Medical Center, the Los
Angeles County-U.S.C. Medical Center, as well as at the
Huntington Memorial Hospital, Pasadena, CA where he also had a
private practice of Obstetrics & Gynecology.
He was a member, on the board or president of
numerous local, regional and national medical organizations and
societies such as the American College of Obstetrics and
Gynecologists, California Medical Association, Pacific Coast
Obstetrical and Gynecological Society and the National Foundation
March of Dimes as well as in several community scientific and
charitable organizations and clubs, but also of organizations and
clubs supporting education and the arts.
He has been a shareholder, partner or director of
some 20 companies and has 35 issued patents with 8 patents
pending. A number of the patents embody the evaluation of vaginal
He published many articles on a wide range of
obstetrical issues. Since 1974 he was first editor of the
Epitomes of Medicine CMA Journal. In1954 he analysed factors
related to stillbirth. Since the early 1960s one major area of
his research was septic abortion. Later on he studied vaginal
health and in this context the role of vaginal pH. He recommended
vaginal pH-measurements for assessing the menopausal status and
for distinguishing between bacterial and yeast infection (in this
context he also developed and recommended a vaginal
pH-self-test-device). Other major areas of his research
activities have been: fluid and electrolyte balance, septic
shock, clotting defects in pregnancy, hypo-immune states in
pregnancy, and primary care in OB/GYN
- Scribner, B.H. and Caillouette, J.C.: Improved Method for
the Bedside Determination of Bicarbonate in Serum, J.A.M.A.
155:7, pp 644-648, June 12, 1954
- Caillouette, J.C. and Russell, K.P.: Factors Related to
Stillbirths: An Analysis at the Los Angeles County Hospital.
Obstet. Gynecol. 1958; 11: 164-169
- Caillouette, J.C.: The Management of Septic Abortion. GP
28:6, pp 104-110, December, 1963
- Caillouette, J.C., Sharp, C.F., Zimmerman, G.J., Roy, S.:
Vaginal pH as a marker for bacterial pathogens and menopausal
status. Am J Obstet. Gyncol. 1997; 176: 1270-1277
- Roy, S; Caillouette, J.C.; Roy T., Faden, J.S. and Ramos,
D.E.: Improving Appropriate Use of Medications: The Role of an
Over-the-Counter Vaginal pH Self-test Device. Infect. Dis.
Obstet. Gynecol. 2003;11:209-216