James C. Caillouette 

 Dirk Masson

Comment by Prof. James C. Caillouette, M.D., USA (April 2010)

James CaillouetteDuring 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 infections.

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 do so.

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 pH.

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.


Selected publications

  1. 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
  2. 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
  3. Caillouette, J.C.: The Management of Septic Abortion. GP 28:6, pp 104–110, December, 1963
  4. 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
  5. 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
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Comment by Dr. Dirk Masson, Germany (October 2010)

Dirk Masson The comment and a short curriculum vitae of Dr. Masson is on our german page.