A smear for the degree of purity: deciphering the results of the study.

The most important role in the diagnosis of inflammatory diseases of the female reproductive system is played by the assessment of vaginal microflora , which is a collection of many microorganisms that are in various relationships with each other.

Normal bacterial flora plays a protective role, preventing infections from entering the body. If infection with pathogenic microorganisms occurs, then this process is reflected in the microflora of the vagina.

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Kovaleva Elena Anatolyevna

Doctor-Laboratory Assistant. 14 years of experience in clinical diagnostic services.

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A gynecological smear for the degree of purity allows you to assess the state of the flora and determine the presence of inflammatory processes .

Types of smears in gynecology

Laboratory tests in gynecology are mandatory and additional: for preventive and diagnostic purposes, a smear is required, and if necessary, more detailed studies are prescribed, such as cytology and bacterial culture.

Bacterioscopy

Taking a smear on the flora is also called a bacterioscopy or a general smear. Deciphering such an analysis makes it possible to determine:

• composition of the microflora of the vagina, cervix and urethra;
• the presence of pathogenic microorganisms (gonococci, trichomonas and fungi);
• localization and intensity of the inflammatory process in the genitals.

Bacterial culture

This is a laboratory analysis of the genital organs, in which biological material is placed in a nutrient medium in order to grow and study pathogenic bacteria. After laboratory testing, a conclusion is made about the type of pathogens and their susceptibility to antibiotics.

Bacterial culture is prescribed after receiving a smear, in cases where coccus bacilli and other pathogenic microorganisms are detected. Bacterial culture is also carried out for frequent inflammation of the urinary tract.

Cytology

Cytology tests in gynecology are a laboratory study of the epithelium of the internal genital organs.

Scrapings for cytology are prescribed in two cases: to study hormonal disorders and for oncological tests.

In case of hormonal disorders in a woman’s body (for example, amenorrhea), smears are taken 5-6 times throughout the entire menstrual cycle. Based on changes in the epithelium, conclusions are drawn about the hormonal function of the ovaries.

If there is a suspicion of oncological processes with severe erosion, a scraping is performed from the cervix.

Interpretation of smear results (table)

Material for studying the microflora of a woman is taken from the posterior vaginal vault, cervical canal and urethra. Then, using a laboratory method, a smear microscopy is performed, where the number of leukocytes, epithelial cells, erythrocytes, cocci, lactobacilli is determined and the presence of diplococci is determined. In accordance with the results of the study, it is customary to distinguish 4 degrees of smear purity :

In some medical institutions, a smear on microflora includes a quantitative determination of its species composition. The presence in the smear of pathogenic microorganisms such as Candida fungi, ureaplasma, clostridia, streptococci, staphylococci, gardnerella, veillonella and others provokes the development of inflammatory diseases.

Expert opinion

Kovaleva Elena Anatolyevna

Doctor-Laboratory Assistant. 14 years of experience in clinical diagnostic services.

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When determining III and IV smears, the patient will need to undergo a number of additional tests to diagnose infectious agents using the bacteriological method, PCR, etc.

Degrees of definition

Vaginal cleanliness is determined using several grade forms. Based on what data is revealed by examination in a general smear, four degrees are distinguished. With the first degree of determination, this fact means that the patient is healthy. In this case, the state of the vaginal microflora is optimal. But, according to medical data, such identification of the form is very rare. When the second degree is detected, a slight deviation in the level of flora occurs. This form is the most common degree in healthy patients. In the third degree, it is discovered that there has been a deviation from the norm of the indicator, opportunistic bacteria are growing.

In the fourth degree, significant deviations from the norm are determined, which means that bacterial vaginosis and other sexually transmitted infections have progressed. When the amount of lactobacilli decreases, this means that there has been a violation of the acid-base balance of the vaginal microflora level. This manifestation occurs in women with an active sex life. The level of the indicator in the vagina is significantly influenced by pathogenic and opportunistic microorganisms. Coccus is a type of bacterium with a spherical shape.

This bacterium is found in the system both as a norm and as a deviation from the indicator when various inflammatory diseases occur. The norm is the detection of single cocci in the analysis. When a decrease in immune defense occurs, the level of coccobacillary forms in the flora begins to increase. Coccus happens:

• gram positive;
• gram negative.

To determine the type of coccus using a laboratory test, staining is carried out using a special technique. During which the so-called gram staining is revealed.

Those types of microorganisms that remain colored after the smear is washed are considered gram-positive. And those that are discolored are considered gram-negative. Gram-positive indicators are streptococcus and staphyloccus cells. Gram-cell cocci are the cells of gonococcus, Proteus, and Escherichia coli. When the number of epithelium and leukocyte levels increase, this means that acute or chronic forms of the inflammatory process are developing in the body.

Let's learn about the degree of cleanliness of the vagina and how to clean it

Vaginal care is very important for a woman, because it is the key to her health. Let's figure out how to care for your intimate area. Contents:

Four degrees of vaginal cleanliness based on test results

To determine the degree of vaginal cleanliness, you need to take a smear. This test is usually carried out during pregnancy. It is very important to monitor your own health, so checks should be done regularly. As a result, the smear will show one of four degrees of vaginal cleanliness.

First degree. If you have the first degree, then you do not need to worry about the health of your vagina, since the necessary cleanliness has been achieved. In the first degree, only Bacillus vaginalis is found in the vagina, and the environment is acidic. This test result indicates that your vagina is in good health.

Second degree. In the second degree, there is no need to panic. This degree is considered normal, but it is better to take action and bring the vaginal cleanliness to the first degree. In the second degree, the environment is acidic, but the vagina contains Doderlein bacilli and comma variabile bacteria in small quantities.

Third degree. If the test result shows the third degree, then you need to consult a doctor. This degree is considered an inflammatory process; you may be bothered by discharge and severe itching. It is worth taking care of your health, because this degree is already dangerous to health.

Fourth degree. With this analysis result, the condition of your vagina is critical. This degree is considered a pathology and requires urgent medical treatment. It is characterized by the complete absence of vaginal bacilli. Stage 4 can be cured, but the best treatment is prevention.

Checking the degree of vaginal cleanliness should be done twice a year. This will help protect against contamination of the vaginal environment. The cost of analysis is usually not high. Treatment of the vagina will cost much more.

Bacterial vaginosis

If you don't take good care of your vagina, you risk getting bacterial vaginosis. This is not a sexually transmitted disease. It is characterized by a pungent odor of vaginal discharge, reminiscent of rotten fish.

Bacterial vaginosis is not sexually transmitted, and you can only catch it if you bring your vagina to the fourth degree of purity.

This disease is very dangerous, as it can lead to inflammatory processes in the uterus and appendages. If bacterial vaginosis is detected in a pregnant woman, things are even more complicated. It can lead to pregnancy complications and even premature birth.

It is best to avoid such terrible diseases by keeping your vagina clean, but if you have bacterial vaginosis, treat it with the following antibiotics:

• Neotrizol
• Terzhinan
• Metronidazole
• Neomycin
• Ornidazole
• Clindomycin
• Vagiklin

With metronidazole and clindomycin ointments, treatment will be easier than with similar drugs. They are most often prescribed by doctors to treat bacterial vaginosis.

How to avoid deteriorating vaginal cleanliness

Causes of vaginal contamination include:

• Douching
• Frequent change of sexual partner
• Contraceptives containing 9-nonoxynol
• Treatment with antibiotics
• Suppositories containing 9-nonoxynol

But the most important thing that should not be forgotten is hygiene. It is failure to observe basic sexual hygiene that most often leads to a deterioration in the degree of vaginal cleanliness.

For washing, use only hot water. Using soap can only cause harm. You can completely get rid of contaminants with water without resorting to soap, which can be detrimental to your vaginal environment.

Women's perfumed sprays will not lead to anything good. They can flush out the good bacteria that clears the vagina of infections.

It is especially important to pay close attention to hygiene during menstruation. During this period, women's health is especially vulnerable, as all infectious diseases worsen. To stay clean these days, you need to change your tampon more often and use pads less. You can install a menstrual cup - this will help maintain hygiene.

For greater cleanliness, it doesn't hurt to wear cotton underwear. It allows air to circulate in the tissue, thereby significantly reducing humidity, which contributes to the proliferation of bacteria harmful to the vagina.

To prevent bacteria from spreading, it is better to wear loose clothing. Skinny jeans are the enemy of feminine hygiene.

While watching the video you will learn about the vagina.

The degree of vaginal cleanliness is a very important indicator of a woman’s health. It is necessary to be regularly examined and, if necessary, treated. But it is better to take care of your vagina so as not to become a victim of serious diseases. Do not be ill!

How to prepare for the study and the procedure for conducting it

In order for the data obtained during a microscopic examination to be correct, it is necessary to properly prepare for the procedure. First of all, the following rules should be observed:

• Refrain from sexual intercourse for two days before visiting the gynecologist.
• Stop using lubricants, vaginal suppositories, and douching a couple of days before the procedure.
• The procedure cannot be performed during menstruation.
• You should not take a bath 2 days before taking a flora test.
• On the day of your visit to the gynecologist, do not use detergents other than regular toilet soap to wash your external genitalia.
• Try to refrain from urinating for three hours before the procedure.

The procedure is performed by a gynecologist on a gynecological chair. A special speculum is inserted into the vagina, and material for examination is collected using a spatula or sterile cotton swab. As a rule, a smear is taken from three places - the cervical canal of the cervix, the opening of the urethra and the vaginal mucosa. The procedure does not cause unpleasant or painful sensations and does not require rehabilitation or recovery.

Study Information

The study period has been increased to 8 days.

Lactobacilli are representatives of the obligate bacteriocenosis of a healthy person; they account for about 10% of the normal flora. When studying the species composition of lactobacilli in healthy people of different age categories, it was found that lactobacilli dominate in young children.

In the vagina of 80% of healthy women, the number of lactobacilli Doderlein reaches 105-107/ml; Lbm is usually isolated. casei, Lbm. acidophilus, Lbm. fermentum, Lbm. plantarum, Lbm. Brevis.

Lactobacilli have a significant effect on metabolic processes, provide the human body with vitamins B, C, K, nicotinic and folic acids, biotin, produce amino acids, lactic, acetic and other organic acids, antibiotic and hormone-like substances, hydrogen peroxide, L. fermentum No. 90T-C4 produces endogenous lysozyme.

Lactobacilli have a set of properties that allow them to compete with opportunistic microorganisms and colonize a certain biotope of the body.

Analytical indicators: specificity of determination – 98%.

The sensitivity of the method is at least 80 DNA copies in 5 μl of a processed (DNA extraction) sample.

Material for research: scrapings of epithelial cells from the cervical and urethral canals, from the vaginal vaults, periurethral area, foreskin.

In healthy women of reproductive age, the total number of microorganisms in vaginal discharge is 107-109 CFU/ml and consists of more than 40 different species. The main part of them are Doderlein rods, lactobacilli (Lactobacillus spp.): L. crispatus, L. jensenii, L. acidophilus, L. brevis. The number of lactobacilli reaches 105-107 CFU/ml.

Lactobacilli have a significant effect on metabolic processes, provide the human body with vitamins B, C, K, nicotinic and folic acids, biotin, produce amino acids, lactic, acetic and other organic acids, antibiotic and hormone-like substances, hydrogen peroxide, L. fermentum No. 90T-C4 produces endogenous lysozyme.

When to take a smear for flora

Taking a gynecological smear is a mandatory procedure when visiting a antenatal clinic. Using this procedure, changes in the bacterial environment of the vagina and urethra, which can lead to pathological processes, are monitored.

A gynecological smear is most informative for the following symptoms:

• itching and discomfort;
• discomfort after sexual intercourse;
• pain during and after urination;
• unusual discharge;
• unpleasant odor;
• lower abdominal pain.

A gynecological smear on the flora makes it possible to diagnose the following diseases:

• thrush or vaginal candidiasis;
• bacterial vaginosis, or dysbacteriosis;
• tyrchomoniasis;
• gonorrhea.

Microflora analysis must be carried out once a year, during a medical examination. If a bacterial infection or inflammatory process is detected in the test results, the test is repeated after a course of treatment.

Popular questions

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Explanation of the procedure

Smear bacterioscopy in women decoding : this technique is the most common procedure performed in gynecological structures. This is due to the fact that numerous diseases in the female body occur when the microflora is disturbed or an infectious process develops in the genitourinary system. If there are relevant complaints, then the procedure must be completed. Diagnostic method: the received forms with the analysis result can only be deciphered by a doctor who will tell the patient about the state of health. For diagnostic purposes, a gynecologist takes a smear to determine the flora.

Using this method, individual indicators are deciphered, which determines the informative level, as well as the method of treatment. When studying these analyzes, the reason why the pathogenic flora was formed, as well as abnormal cells, is determined. It also assesses the level of balance of hormonal levels in the female body system. Specialists do not use the writing of full diseases; they use them in abbreviated form. Designated by the first letter of the analysis parameter. To understand the normal microflora in the vagina, you need to know the letter designations.

As a rule, the zones and the collection of materials are reduced, the vagina is designated by the letter - V, the cervical area in the cervix is ​​designated by the letter - C. The urethra is designated by the letter - U, L means a leukocyte cell, the values ​​of which sometimes do not coincide with the norm in a pathological process. EP is translated as epithelial cell, GN is gonococci, which causes gonorrhea. Trich are translated as Trichomonas cells, in which the formation of the trichomoniasis process occurs. There are many reasons why the process of changing the level of flora in the vagina occurs.

This occurs due to the deterioration of the immune system when antibiotic therapy is used, as infection progresses, and also in diabetes mellitus. The predisposing effect is the formation of hormonal imbalance . As is known, in pregnant women, before childbirth, the production of estrogen substances stops, but the progressive formation of another hormone, progesterone, begins. Smear bacterioscopy is a very important procedure, and you need to take it seriously. If a deviation from the norm is detected, treatment is necessary.

Research results

Factors influencing research results

The preparation rules were violated (smears were taken during menstruation and are represented by a large number of endometrial cells and blood; the preparations contain sperm; the smear is contaminated with spermicidal and creams, lubricant from condoms, ultrasound gel) Before collecting the material, a bimanual examination was carried out. Taking antibacterial therapy, probiotics and eubiotics

Interpretation of the result

Relative value – % content of the total bacterial mass. Absolute value – copies/ml. A decrease in the proportion of lactobacilli (less than 20% of all isolated microorganisms) or their complete absence - pronounced vaginal dysbiosis (disturbance of the normal vaginal microflora). Detection of a low content of lactobacilli in itself is not a basis for concluding the presence of any disease associated with a violation of the microflora composition, but indicates its high probability and requires confirmation based on the results of analysis of clinical data and/or identification of opportunistic bacteria in concentrations of diagnostic significance.

What is the norm for a smear on the vaginal microflora?

In smear microscopy for flora, the following is considered normal:

• flat cells of the vaginal epithelium - up to 10 in the field of view;
• single leukocytes - up to 10 in the field of view;
• cells of the intermediate layer are single;
• “false key” cells – rare;
• the total number of microorganisms is “moderate”, sometimes “large”;
• mucus - in small quantities;
• Lactobacilli predominate among bacteria; other types of microorganisms are rare and rare.

The smear should not contain:

• There are large numbers of destroyed epithelial cells . This indicates cell lysis, which occurs with abnormal growth of lactobacilli.
• Key cells . These are epithelial cells covered with various bacteria.
• Parabasal cells . Cells of the lower layers of the mucosa. Their appearance indicates significant inflammation or atrophy of the mucosa.
• "Massive" number of bacteria , except lactobacilli.
• Yeast cells with pseudomycelium and blastopores (bud cells). Their presence indicates thrush.
• Strict anaerobes - most of them are pathogens.
• Gonococci are the causative agents of gonorrhea.
• Trichomonas are the causative agents of trichomoniasis.
• Atypical cells that are a sign of precancerous or oncological changes .

Some microorganisms (chlamydia, various viruses) are not detected when examined under a microscope due to their small size. To identify them, a blood test for ROC is necessary.

Cytolytic vaginosis, or when lactobacilli become enemies

The mechanism of occurrence of cytolytic vaginosis and what factors provoke increased growth of lactobacilli are still unknown. Cytolytic vaginosis is a diagnosis of exclusion, that is, when other known infectious diseases are excluded. Read on for more details.

The diagnosis of cytolytic vaginosis is extremely rare because most obstetricians and gynecologists have never heard of such a diagnosis. In many textbooks on gynecology, especially older editions, it is also not mentioned. It is often confused with other inflammatory conditions of the vagina caused by candida, trichomonas, gardnerella, and aerobic bacteria. This diagnosis is also missed because the number of lactobacilli is not only normal, but there are many of them. Aren't lactobacilli healthy bacteria? Is it wrong to think that the more lactobacilli, the better?

What do leukocytes indicate in a smear on vaginal flora?

Leukocytes are white blood cells that are designed to fight infection. They can exit through the wall of blood vessels and move independently. Leukocytes have the ability to phagocytose - they engulf bacteria and digest them. Once the bacterium is digested, the white blood cell is destroyed. This releases substances that cause inflammation, manifested by swelling and redness of the mucous membrane. Normally, the number of leukocytes in the vagina should not exceed 10. A large number of leukocytes indicates inflammation. The higher the number of leukocytes, the more pronounced the inflammatory process.

SOURCES: https://tvoyginekolog.online/diagnostika/bakterioskopiya-mazka-rasshifrovka-u-zhenshhin.html https://1diagnos.ru/laboratornye-issledovaniya/bakteriologicheskie/bakterioskopiya-mazka-u-zhenschin.html https:// zabolevanija.net/mazok-na-floru-u-zhenshhin/

How to reduce acidity in the vagina for conception?

Increased vaginal acidity

The increased pH level of the vagina does not create the most favorable environment for sperm. This unique protective mechanism ensures that only the fastest, healthiest and strongest sperm can reach the egg for fertilization. In some cases, this interferes with conception.