What does a smear on the flora in women show: the norm, decoding of the results
The content of the article:
- Indications for research
- Where to take a smear for flora and how much is the analysis done?
- Preparation for research
- How is a smear taken for flora
- Vaginal microflora: the norm
-
Decoding indicators
- Leukocytes
- Lactobacillus
- Squamous epithelium
- Slime
- Bacteria
- Key cells
- Result evaluation
What does a smear on flora in women show? A smear on flora refers to the main methods of identifying inflammatory processes in the genitals, as well as their causes. This analysis allows you to determine the presence or absence of inflammation, the degree of its severity, the nature of the microflora of the vagina, urethra, cervical canal, to identify an infectious agent or indirect signs of its presence.
A smear for flora in women (urogenital smear for flora, bacterioscopy, general smear) is a method of laboratory diagnostics, during which a microscopic examination of biological material from the vagina is carried out. This is one of the most common methods of laboratory diagnostics used in gynecological practice, its advantages are availability and information content.
Indications for research
A smear on flora in women is taken during a routine preventive examination by a gynecologist, pregnancy planning, obstetric registration, as well as if an infectious inflammation of the genitals is suspected and in order to monitor the effectiveness of the treatment.
A smear on flora is one of the most common diagnostic methods in gynecology.
During pregnancy, this study plays an especially important role, since due to changes in hormonal levels (in particular, hyperestrogenism) and the resulting decrease in immunity, the risk of developing inflammatory processes in the external and internal genital organs increases. Inflammation can cause termination of pregnancy, premature birth, and infection of the baby when passing through the birth canal.
During pregnancy, a study of the vaginal microflora, as a rule, is prescribed three times at regular intervals, and more often if an infectious inflammation is detected.
The main symptoms that serve as the reason for the appointment of a smear on the flora:
- painful sensations in the lower abdomen (spontaneous or during intercourse);
- itching and / or discomfort in the external genital area;
- unusual discharge from the genital tract;
- painful urination;
- disorders of the menstrual cycle.
For preventive purposes, it is recommended to take a gynecological smear on the flora at least once a year even in the absence of any symptoms, since many diseases of the reproductive system, including infectious ones, are characterized by a latent course. It is also recommended to take a preventive smear for flora if a woman has had unprotected sexual contact with a dubious partner.
Where to take a smear for flora and how much is the analysis done?
A swab for flora can be taken in the antenatal clinic, in the clinic at the place of residence, in a private specialized clinic, in the sampling room of some laboratories.
Usually, a smear examination takes one working day in time, but it is better to clarify the time for obtaining a result with a doctor, since the timing of the analysis in different laboratories may differ.
Preparation for research
Usually, a smear for flora is taken on the fourth or fifth day of the menstrual cycle, unless otherwise indicated. During menstruation, it is undesirable to take an analysis, since it is inevitable that menstrual blood will enter the material, which is highly likely to distort the result.
If a patient is undergoing a course of anti-infectious therapy, it should first be completed and only then tested. A smear on microflora is taken no earlier than three weeks after the end of treatment with antibacterial and antimycotic drugs (unless other instructions have been received from the attending physician). The use of antibacterial, antimycotic, anti-inflammatory drugs and contraceptives can cause false negative test results.
Within 1-2 days before submitting the material for analysis, it is necessary to exclude sexual contacts, and during this period, you should not use vaginal suppositories, ointments, do not douch. On the eve and on the day of delivery of the material, you must not use intimate hygiene products. This analysis does not require restrictions on physical activity and nutrition.
It is advisable not to urinate for 2-3 hours before taking the material for analysis.
How is a smear taken for flora
Before taking material for research, the patient undergoes a routine gynecological examination using mirrors. The doctor visually assesses the vulva, the walls of the vagina and the vaginal part of the cervix, then, using a sterile spatula, he takes material from three areas - the wall of the vagina, the external opening of the urethra, and the cervix. In some cases, the material for research is taken from one specified point, for example, only from the vagina or cervix. The procedure is painless.
A smear on the flora in women is taken during a gynecological examination in the mirrors
The material taken from different areas is applied with a spatula on a glass slide separately from each other, marked (V - vagina, U - urethra, C - cervix), dried and sent to the laboratory.
For a detailed acquaintance with the technique of taking material, you can watch the corresponding video on how to take a smear on the flora from women.
Vaginal microflora: the norm
During the examination of the smear, the so-called degree of vaginal cleanliness is determined. This is the initial screening that allows you to determine the need for further examination and its scope.
Depending on the nature of the microflora and cellular contents, 4 degrees of vaginal purity are distinguished:
- A large number of Dederlein rods, a small amount of squamous epithelium in the preparation. Determined in clinically healthy women.
- A small number of cocci are found, but Dederlein's rods predominate. It is not a sign of pathology, it is observed in many clinically healthy women.
- A small number of Dederlein sticks are detected in the preparation, a variety of coccal flora prevails, the number of leukocytes is more than 10 in the field of view. It is observed in inflammatory processes.
- Dederlein's rods are practically absent in the smear, a large number of cocci and leukocytes are found. A sign of bacterial vaginosis.
Normal values of indicators for women of reproductive age are shown in the table.
| Index | Normal values |
| Leukocytes |
Vagina - 0-10 in the field of view Cervix - 0-30 in the field of view Urethra - 0-5 in the field of view |
| Squamous epithelium | Moderate amount |
| Slime | Moderate amount |
| Dederlein sticks |
Vagina - large amount Cervix - absent Urethra - absent |
| Gonococci | Not found |
| Trichomonas | Not found |
| Chlamydia | Not found |
| Microscopic yeast-like fungi | Not found |
| Key cells | Not found |
Decoding indicators
When deciphering the results of a smear on the flora in women, first of all, the number of leukocytes (depending on where the material was collected), the nature and amount of the detected microflora are assessed.
Leukocytes
Leukocytes are white blood cells that provide the destruction of pathogens, a component of the immune system. If the number of white blood cells in the smear is increased, this may indicate an inflammatory process. When assessing the result, the phase of the menstrual cycle is taken into account, depending on which the number of leukocytes can vary.
Lactobacillus
Dederlein's sticks (lactobacilli, vaginal sticks, lactobacilli, gram-positive sticks) are the general name for motionless acidophilic sticks that do not form spores and are the main component of the normal microflora of the vagina. Normally, in a smear, Dederlein's rods should be contained in the studied biomaterial in large quantities. A decrease in their number, especially in the presence of other representatives of microflora, is a sign of inflammation.
In a smear on flora in healthy women, Dederlein sticks are found in large quantities
Squamous epithelium
Squamous epithelium is the cells that line the inside of the vagina and is present in the urethra and cervix. Normally, the amount of squamous epithelium in a smear may vary slightly depending on the hormonal status and the phase of the menstrual cycle. If a large amount of squamous epithelium is found, an inflammatory process (urethritis, cervicitis, vulvovaginitis) can be suspected. The absence of squamous epithelium in a smear may indicate a violation of the hormonal background (in particular, it may be a sign of a violation of the production of sex hormones).
When decoding the results of the analysis, it should be taken into account that in women during pregnancy, as a rule, there is an increase in the number of leukocytes and squamous epithelium.
Slime
Mucus is produced by the glands of the vagina and the cervical canal. Normally, a moderate amount of mucus is detected in the smear (it may be completely absent in the material from the urethra), an increase in its amount may indicate the presence of an infectious and inflammatory process.
Bacteria
Normally, the causative agents of sexually transmitted diseases should be absent in the test material. Their identification indicates the presence of a particular infection. So, the detection of gonococci indicates gonorrhea, Trichomonas are determined with trichomoniasis, etc.
The detection of microscopic yeast-like fungi can be a sign of vaginal candidiasis (the so-called thrush), however, these microorganisms, like some others (cocci, for example), are also present in healthy women, so their quantitative assessment is important.
However, it must be borne in mind that often pathogenic pathogens that cause STDs (sexually transmitted diseases) are not detected by smear microscopy, despite their presence in the body. Therefore, if there is a suspicion of infection, they resort to additional studies (for example, polymerase chain reaction). Microscopy of the smear also makes it impossible to determine the sensitivity to antibiotics or antifungal drugs of the detected microorganisms. For this, a culture analysis (culture tank) with an antibioticogram is carried out.
Key cells
Normally, key cells are absent in the material, their appearance may indicate bacterial vaginosis, as well as erosive or tumor changes in the mucous membrane.
Result evaluation
Even when receiving smear results that go beyond the limits of the norms, the diagnosis is usually not made - this requires a comprehensive diagnosis, as well as the clinical picture of the disease, therefore only a specialist can correctly assess the result. He, if necessary, prescribes therapy.
It should be taken into account that the detection of coccal and other opportunistic microflora is not a basis for prescribing anti-infectious therapy without their quantitative assessment and taking into account data from other diagnostic studies.
Self-medication in most cases leads to serious disturbances in the balance of the vaginal microflora and, as a result, the development of complications, including the further spread of infection.
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Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
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