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15695

Role of Increasing Vaginal Acidity in Histological Changes and Softening of the Cervix Prior to Dilatation in Perimenopausal Women

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Last updated: 24 Dec 2024

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Abstract

Background: cervical dilatation, along with hysteroscopy or endometrial curettage, is one of the most common procedures in gynecological practice. However, difficulty in entering the internal cervical os may be encountered; Therefore, there is a need for an effective cervical priming agent which can be used in general gynecological practice. Vaginal acidification might increase collagen degradation. It is known that cervical collagen degradation contributes to the ripening process.          Aim of the work: the present study was designed to evaluate the efficacy of acidifying vaginal cream in cervical tissue remodeling and softening. Patients and methods: this study is a double-blinded clinical trial study, conducted in Obstetrics and Gynecology Department of Al-Azhar University hospital (Damietta). It included fifty perimenopausal women, their age ranged from 45-55ys, planned for cervical dilatation before endometrial biopsy due to irregular uterine bleeding. They were divided into two main groups: Group I: women who were treated with acidifying vaginal cream (Eva base cream melted with acetic acid 5%). Group II: women who were treated with neutral (placebo) vaginal cream (Eva base cream only). Efficacy of acidifying vaginal cream on the cervix was assessed on the basis of improved cervical softening and degree of cervical changes on the histological examination. Results: there was no significant difference in both groups during the preoperative assessment of the cervix and premedication. During operation in the study group (I) 1st Hegar's passed was No8  in 52% of cases and No9  in 28% of cases denoting the significant effect of acetic acid on cervical dilation in comparison  with placebo group (II)in which the cervix was closed in 44% of cases and Hegar's No 3 passed in 36% of cases showing statistical significance between the two groups.  As regards the histological examination, it was found that in group (I) collagen dissociation grade II represent   56% and grade III 24% with statistical significance in comparison with  placebo group  (II) in  which collagen was  grade 0, in 76% . Also, the inflammatory changes in group(I) showed moderate changes  in 72% of cases and 20%  showed severe changes with statistical significance in comparison with the  control group(II) in  which 56% of cases showed no inflammatory changes. Conclusion: vaginal acidification with 5% acetic acid as a cervical softening agent appeared to be safe, effective, with no adverse effects.  

DOI

10.21608/ejhm.2014.15695

Keywords

perimenopause, cervical softening, acetic acid

Authors

First Name

Samia Mohammed

Last Name

Eid

MiddleName

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Affiliation

Obstetrics and Gynecology Department Pathology Department; Mansoura Faculty of Medicine

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Orcid

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First Name

Amr

Last Name

El Karef

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Affiliation

Al-Azhar Faculty of Medicine (Damietta);Pathology Department; Mansoura Faculty of Medicine

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Orcid

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Volume

56

Article Issue

1

Related Issue

3395

Issue Date

2014-07-01

Receive Date

2018-10-02

Publish Date

2014-07-01

Page Start

368

Page End

375

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_15695.html

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https://ejhm.journals.ekb.eg/service?article_code=15695

Order

11

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Role of Increasing Vaginal Acidity in Histological Changes and Softening of the Cervix Prior to Dilatation in Perimenopausal Women

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Article

Created At

22 Jan 2023