Vaginal douching may prevent preterm delivery in singleton pregnant women with a short cervix and lower genital tract inflammation

To determine the effectiveness of vaginal saline douching in patients with a short cervix and subclinical cervical infection.Pregnant women at 16-26 gestational weeks with a cervical length of 25 mm were randomized into the bed rest therapy without vaginal douching (BR group) and the bed rest therapy with vaginal douching (VD group) .Patients in the BR group had no asymptomatic vaginal infection, whereas those in the VD group developed an asymptomatic vaginal infection.The BR group was allowed a 2-week bed rest, and the VD group was provided bed rest and vaginal douche with 500 ml saline for 32 weeks.The other treatment measures were standardized.The primary and secondary endpoints were premature birth (weeks of delivery) and transition to the "rescue arm" defined as the rate of tocolytic drug use, respectively.We analyzed 30 and 35 cases in the BR and VD groups, respectively, including those transitioning to the "rescue arm."Patient background and delivery outcomes, including mean delivery time, weeks from allocation to delivery, birth weight, and neonatal outcomes, did not significantly differ.The VD group had a longer gestational period than the BR group (up to 32 gestational weeks) .The VD group had a significantly higher 70-day pregnancy extension effect than the BR group (p0.05) .Moreover, the VD group (10 cases 28.6 ) showed a lower but nonsignificant tendency to transition to the "rescue arm" than the BR group (12 cases 40.0 ) .In patients with a short cervix, cervicitis, or vaginitis, vaginal saline douching may prolong the gestational period and reduce preterm births, thereby improving maternal and neonatal outcomes.