Leukocytes in a smear are single, which means. Leukocytes - what is it and when can they be detected. What is smear culture

Women, unlike men, have to visit a doctor who treats the genitourinary system more often. So, during pregnancy, the expectant mother should regularly go to the gynecologist and take some tests. When applying for a job or an educational institution, now they also require the conclusion of a gynecologist. In this article, we will talk about what leukocytes are in a smear. The rate of content of these bodies will also be indicated below. You will find out why a smear is taken for flora and how this procedure goes.

Vaginal swab

This analysis is given at each visit to the doctor. It is worth noting that the study is carried out quite simply and quickly, but nevertheless it can say a lot about the state of the female reproductive system. That is why gynecologists prescribe this analysis in the first place.

How is a smear taken for flora?

A swab is taken at least three times during pregnancy (the rate of leukocytes will be indicated below). If there are any deviations and treatment is required, then a re-analysis is always taken a few weeks after the course of drug therapy.

The analysis is very simple. The woman is offered to sit on the gynecological chair and relax. The doctor inserts a speculum into the vagina and takes material from the cervix, from the walls of the vagina and from the urethra. When deciphering the result, the place where the material was collected from is necessarily taken into account.

The timing of the study and the data obtained

A smear for flora is examined quite quickly. Within one or two working days you will be provided with the results. Remember that it is the doctor who must decipher them. Surely a woman alone will not be able to understand all the data and correctly interpret the conclusion.

Usually, the result always indicates the names of the studied elements and the resulting value. So, the number of leukocytes and the state of the epithelium are necessarily established. The analysis examines the presence or absence of cocci and pathogens of trichomoniasis.

Further studies are more detailed. They are carried out only when necessary.

Leukocytes in a smear: normal

After receiving the result, we can confidently draw a conclusion about the state of the female reproductive system. When decoding, it is necessary to take into account the day of the cycle, the presence of pregnancy and colds. So, what is the rate of leukocytes in a smear in the fairer sex?

Usually the number of white cells in the field of view should not exceed 10. So, if the analysis says that single leukocytes were found, the smear is “normal”. In women who have just finished menstruating, the number of these cells may be slightly higher. In this case, it does not exceed 25 units in the field of view. These data are also considered absolutely normal. However, it is worth notifying the doctor in advance about a recent menstruation.

In expectant mothers, the level of white bodies can also be increased. If you are expecting a baby and passed a smear on the flora, the norm allows leukocytes in an amount of no more than 30 units in the field of view. This applies to all sites from which the material was collected.

In the presence of a viral or bacterial disease, the level of white cells may increase slightly. Moreover, the more acute the infection, the higher the value will be. That is why doctors do not recommend taking a smear on the flora during an illness. If there is no other way out, then you need to warn the doctor about the existing pathology.

The degree of purity of the vagina

After receiving the result, you can preliminarily draw some conclusions. Most often, doctors subdivide the representatives of the weaker sex according to the degree of purity of the vagina. This classification directly depends on the number of leukocytes and other impurities. So, if leukocytes are found in a smear, is this a norm or a pathology?

First degree

In this case, the result of the analysis is the following data. Leukocytes are found in the amount of several units in the field of view. The microflora is represented by beneficial bacteria. There are no cocci, pathological mucus and Trichomonas. In conclusion, it will be indicated: smear analysis (leukocytes) - "normal".

Second degree

There are also single cells of white bodies in the field of view. However, beneficial microflora is presented on a par with cocci and yeast fungi. Usually, in the absence of complaints of itching and unusual discharge, a woman is recognized as absolutely healthy. However, if there are unpleasant symptoms, then minor treatment is required. If such a microflora is found in a future mother, then she is prescribed therapy without certain symptoms.

Third degree

In this case, the result of the analysis may be the following data: the number of leukocytes exceeds the norm (more than 30 cells in the field of view), there are cocci, yeasts and other pathogens. Such a result is always recognized as a deviation from the norm. The woman is being treated.

Degree four

This is the very last step. In this analysis, a large number of leukocytes are present. Useful microflora is depleted, pathogenic bacteria and microorganisms are detected. Upon receipt of such a result, additional diagnostics is necessary, after which the woman is prescribed appropriate treatment.

Leukocytes in a smear: deviations

If you passed a smear for flora and leukocytes were found in it in large numbers, then this is a deviation. In this case, a woman is assigned a number of additional tests. In this case, it is imperative to take into account the presence of a permanent sexual partner and the method of protection. If the fair sex is not "friends" with such a means of protection as condoms, then there is a possibility of an infection that is transmitted through sexual contact.

So, with an increase in the level of leukocytes, it is recommended to pass a detailed analysis of the flora, conduct a study for the presence of sexual diseases, and also do a bacterial culture. After receiving the results, you can talk about the diagnosis and prescribe treatment. What can cause an increase in the level of leukocytes in a smear?

1. Bacterial infections obtained through sexual contact (mycoplasma, trichomonas, chlamydia, gonorrhea, syphilis and others).
2. An inflammatory process in the vagina against the background of a decrease in immunity (for colds, during pregnancy, and so on).
3. Diseases of the uterus and appendages (endometritis, salpingitis, adnexitis).
4. A decrease in the level of beneficial bacteria against the background of the reproduction of cocci and fungi (thrush, gardnerellosis, and so on).
5. The development of tumors of a benign or malignant nature.

Conclusion

Now you know what white blood cells are in a smear. The norm is always indicated on the form with the result of the analysis. If you deviate from it, you should visit a doctor as soon as possible and carry out appropriate treatment. Otherwise, you can get serious complications. Take your tests on time and be healthy!

smear on flora- an analysis often prescribed by gynecologists. What does it show and what misconceptions exist about it?

This analysis can be called "general". This is the primary diagnosis, which allows the doctor to confirm or deny the presence of an inflammatory process in the vagina, urethra, cervical canal, as well as draw certain conclusions regarding the possible menopause or menopausal changes in the patient.

What is the name of the analysis:

• microscopic (bacterioscopic) examination of a Gram-stained smear is the official name;
• swab from the genitals;
• bacterioscopy;
• microscopy.

Used to diagnose infectious and inflammatory processes. Bacterioscopy allows you to detect bacteria in the genitals of a woman: the simplest microorganisms - gonococci, which provoke gonorrhea, Trichomonas - the causative agent of trichomoniasis. Also, a specialist in a microscope will see some bacteria, fungi (Candida), key cells (a sign of bacterial vaginosis). The type of microorganism is determined by the shape, size, and whether it is stained with a dye or not, that is, it is gram-positive or gram-negative.

In addition, in a smear from each point (taken from the vagina, urethra, cervical canal), the number of leukocytes in the field of view is counted. The more of them, the more pronounced the inflammatory process. The amount of epithelium and mucus is estimated. especially a lot in women of reproductive age during ovulation - in the middle of the menstrual cycle.

Microscopic examination of the discharge of female genital organs is an opportunity to quickly assess whether a woman is gynecologically healthy or not and make one of four diagnoses:

• vaginal candidiasis (thrush);
• bacterial vaginosis (formerly called gardnerellosis);
• gonorrhea;
• trichomoniasis.

If there are no clear signs of one of these diseases, but the smear is bad, an in-depth study of the material is carried out - bacteriological culture is performed.

Reasons for performing cultures in gynecology

1. If the smear has a moderate or high number of leukocytes, but the causative agent of the infection is not known. Since under microscopy there is a lower limit of detection of microorganisms: 10 to 4 - 10 to 5 degrees.
2. If the microbe is identified, to determine its sensitivity to antibiotics.
3. If there are signs of a fungal infection. To accurately establish the type of fungi and prescribe an effective antimycotic drug.

   Some types of fungi, such as Candida albicans (Candida albicans - a diploid fungus), are very dangerous for expectant mothers and can provoke infection and premature rupture of the membranes.

   Other types of Candida fungi can be left untreated if there are no pathological symptoms.

If key cells are found (signs of bacterial vaginosis), but other microbes are present in addition to them. For identification.

What is the difference between culture, flora smear and vaginal cleanliness

in the research method. With a general smear, the material applied to the glass is stained with special dyes and viewed under a microscope. And when a bacteriological (bakposev, cultural, microbiological) study is done, then it is first “sown” on a nutrient medium. And then, after a few days, they look under a microscope - colonies of which microorganisms have grown.

That is, if we are talking about express analysis, you will be given a conclusion only on the number of leukocytes, epithelium and mucus. Sowing is not urgent

Also, with microscopy, you can quickly determine the degree of purity from the vagina. Here the doctor only evaluates the ratio between normal, opportunistic and pathogenic microflora.

The classic assessment of vaginal cleanliness.

Updated table

What doctors don't see on microscopy

1. Pregnancy. To determine it, a smear is not needed and no matter what result it will show. It is necessary to take a blood test for hCG, undergo a gynecological examination with a doctor or do an ultrasound of the uterus. You can determine the chorionic gonadotropin in the urine, but not in the discharge from the genitals!
2. Cancer of the uterus and cervix. To diagnose a malignant degeneration of the endometrium, histological material is needed, and in large quantities. And they take it directly from the uterus.

   CC and other pathologies (erosion, leukoplakia, atypical cells, etc.) are determined according to the results of a cytological study. This analysis is taken directly from the cervix, from the transformation zone, according to a certain technique with Papanicolaou staining (hence the name of the analysis - PAP test). It is also called oncocytology.

3. Does not show infections (STDs) such as:
   • herpes;
   • chlamydia (chlamydia);
   • mycoplasmas (mycoplasmosis);
   • ureaplasma (ureaplasmosis);

The first four infections are diagnosed by PCR. And it is impossible to determine the presence of the immunodeficiency virus by a smear with high accuracy. You need to take a blood test.

How to prepare for the test and when it is needed

The doctor takes a smear from the patient on the gynecological chair (regardless of whether she is pregnant or not) using a special brush or a sterile Volkmann spoon. It doesn't hurt at all and is very fast.

It is technically possible to achieve a good, even perfect smear, if you sanitize the vagina with chlorhexidine or miramistin, for example. But what's the point?

To get a reliable smear result, 48 hours before it is taken, you cannot:

• douche;
• have sex;
• use any vaginal hygiene products, intimate deodorants, as well as medications, if they have not been prescribed by a doctor;
• do an ultrasound using a vaginal probe;
• undergo a colposcopy.
• before visiting the gynecologist or laboratory, 3 hours, you should not urinate.

Pap smears should be taken outside of menstrual bleeding. Even if there is just a "daub" on the last day of menstruation, it is better to postpone the study, since the result will certainly be bad - a large number of leukocytes will be revealed.

There are no restrictions on drinking alcohol.

Can I take a smear while taking antibiotics or immediately after treatment? It is undesirable to do this within 10 days after the use of topical drugs (vaginal) and one month after taking antibacterial agents inside.

Microscopic examination is prescribed:

• in a planned manner when visiting a gynecologist;
• upon admission to the gynecological hospital;
• before IVF;
• during pregnancy (especially if there is often a bad smear);
• if there are complaints: unusual discharge, itching, pelvic pain, etc.

Deciphering the results: what is considered normal and what is pathology in the microflora

To begin with, we bring to your attention a table that displays the indicators of the so-called first degree of purity. There is no mention of the urethra in it (although the material is also taken from there), since we are talking about gynecological diseases. The inflammatory process in the urethra is treated by a urologist.

Epithelium - the number of epithelial cells is not counted, as it has no diagnostic value. But too little epithelium indicates an atrophic type of smear - it happens in women during menopause.

Leukocytes - are considered in the "field of view":

• no more than 10 - a small amount;
• 10-15 - a moderate amount;
• 30-50 - a large number, a woman notices pathological symptoms, and the doctor, upon examination, diagnoses an inflammatory process in the vagina and (or) on the cervix.

Mucus (strands of mucus)- normally should be present, but a large amount of it happens with inflammation. There should be no mucus in the urethra.

Rod flora or gr lactomorphotypes- the norm, this is the protection of the vagina from microbes.

Trichomonas, gonococci and key cells a healthy woman should not have it in the cervix and vagina. Candida is also normally absent. At least in a significant amount, which is detected in the analysis of the flora.

The validity of the smear is not great. But if a woman enters a hospital, then right there, during the initial examination on the chair, they take a fresh one.

Usually the results are valid for 7-14 days. Therefore, if you need to take it before the operation, do it 3 days before admission to the hospital. The last of the scheduled tests.

What is found in bakposeve

A gynecologist can best decipher the result of a cultural study. But you yourself, if you read the information below, will roughly understand your analysis.

The number of microorganisms can be expressed in "crosses":

• "+" - a small amount;
• "++" - a moderate amount;
• "+++" - a large number;
• "++++" - abundant flora.

But more often the number of representatives of the microflora is expressed in degrees. For example: Klebsiella: 10 to the 4th power. By the way, this is one of the representatives of enterobacteria. Gram-negative bacillus, aerobic microorganism. One of the most dangerous pathogens, although it is only conditionally pathogenic. This is because Klebsiella is resistant (immune) to most antibacterial agents.

Below we describe other common terms that appear in the results of the study, or you may hear from a doctor.

Soor is candidiasis or, in other words, thrush. It is treated with antimycotic (antifungal) drugs.

Blastospores and pseudomycelium of yeast-like fungi- candidiasis or other fungal disease, usually treated similarly to thrush.

Diphtheroids are conditionally pathogenic microorganisms, according to the results of research by scientists, in most women, they make up about 10% of the microflora, as well as streptococci, staphylococci, E. coli, gardnerella. If the flora is disturbed, their number increases.

Mixed flora - a variant of the norm, if there are no symptoms of the disease, completely leukocytes or their strong increase (40-60-100). 15-20 is a variant of the norm, especially during pregnancy.

Enterococci (Enterococcus)- representatives of the intestinal microflora, which sometimes enter the vagina. Gram-positive cocci. About Enterococcus fecalis (Enterococcus faecalis) we. There is also enterococcus coli - Escherichia coli. Usually cause unpleasant symptoms at concentrations above 10 to the 4th degree.

Pseudomonas aeruginosa is a Gram-negative bacterium. Often affects people with low immunity. It has good resistance to antibiotics, which makes the treatment process difficult.

polymorphic bacillus- a common representative of the vaginal biocenosis. If the number of leukocytes is normal and there are no complaints, its presence should not disturb.

Erythrocytes - there may be a small amount in a smear, especially if it was taken during an inflammatory process or when there was a small spotting.

Coccal or coccobacillary flora- usually occurs with an infectious process in the vagina or on the cervix. If a woman has complaints, antibacterial treatment is required - sanitation of the vagina.

Diplococci are a type of bacteria (cocci). Small amounts are not harmful. With the exception of gonococci - the causative agents of gonorrhea. She is always treated.

And in conclusion, we give frequent abbreviations that are written on the forms of test results:

• L - leukocytes;
• Ep - epithelium;
• Pl. ep. - squamous epithelium;
• Gn (gn) - gonococcus, the causative agent of gonorrhea;
• Trich - Trichomonas, the causative agent of trichomoniasis.

As noted above, diagnostic material for a smear on the flora is collected from three points - the cervix, urethra and vagina.

And in each smear obtained, similar indicators are evaluated, but the norms of some of them differ depending on the area of ​​localization. Below is a table explaining what is the norm for the content of leukocytes, normal and pathogenic flora, cellular elements and mucus in a smear in women.

When examined by a gynecologist, patients often have to take a scraping. This is one of the main ways to learn about the patient's sexual health.

According to statistics, modern women today increasingly have problems in the field of reproductive health - poor ecology, early sexual life and irregular intimate hygiene often have a bad effect on analysis indicators.

Leukocytes are necessary to fight pathogenic bacteria, cleanse the body as a whole, and normalize metabolic processes.

In a broad sense, a smear is a scraping that is taken from various places for subsequent bacteriological examination. For example, scraping from the urethra is indicated by the letter U, and from the vaginal canal - V.

The laboratory assistant directly diagnoses, he also determines the number of bacteria. Leukocytes are small white blood cells, their most important function is to protect against the ingress of infectious pathogens.

The normal number of leukocytes (LE) should not exceed 15 cells. If the indicator is higher, the diagnosis of "leukocytosis" is made.

To avoid leukocytosis, the following preventive actions can be carried out:

• carefully choose a sexual partner, do not neglect contraception;
• to carry out the procedure of intimate hygiene;
• undergo scheduled examinations by a gynecologist;
• contact only qualified and trusted doctors. Examination of the vagina and internal genital organs is a very delicate procedure and should be entrusted only to an experienced doctor with a good medical reputation;
• adhere to a healthy lifestyle, consume the required amount of vitamins, include more fresh vegetables and fruits in the diet.

If, when deciphering the analysis, the number of leukocytes in the smear is higher than normal, then an inflammatory process is going on in nearby tissues or organs. Why?

The number of leukocytes in a smear is one of the main parameters of this analysis. Scrapings are performed alternately in the following order and their rate in each "subsection" is different:

1. U (at the entrance to the urethra) - single, no more than 5.
2. V (from the walls of the vagina) - no more than 10.
3. C (from the cervical canal of the cervix) - no more than 15 units in the field of view.

In the same way as elevated leukocytes in the blood, it is pointless to treat high leukocytes in a smear, since this is not a disease, but a laboratory indicator. It is necessary to establish a diagnosis, begin to adequately treat the disease, and then the question of how to lower leukocytes in a smear will become irrelevant.

However, in the case when the cause of a significant increase in leukocytes in a smear still could not be established, and this level persists for a long time, the gynecologist may suggest the following treatment regimen:

• normalize sleep patterns;
• balance the diet;
• avoid overheating and hypothermia, as well as sudden changes in temperature;
• prescribe vitamin complexes and drugs that increase immunity;
• sometimes, cancel (prohibit) taking hormonal contraceptives;
• choose therapeutic vaginal agents for external use - suppositories or suppositories, capsules, tablets, liquids for douching, washing agents, creams and gels in applicators, special tampons.

The woman's vagina, like other parts of the body, actively interacts with the environment. It is not sterile, because a large number of different bacteria are constantly present in it. Thanks to such microorganisms, a normal microflora is created in the vagina.

Various microscopic organisms live in the vagina, and one of them is Dederlein's stick. Such lactobacilli maintain normal acidity in the body, and this happens due to the release of hydrogen peroxide. Creating a special acidic environment in the vagina helps prevent the reproduction of pathogenic microorganisms that cause the development of many gynecological diseases.

In the event that any pathology develops in the genital organs, a change in the microflora is noted.

It is thanks to such indicators that specialists can diagnose the disease in a timely manner and determine the cause of its occurrence. With the help of a bacteriological smear on the flora from the vagina, it is possible to determine the composition of the microflora, which begins to change depending on the bacteria that have begun their active reproduction.

Briefly about leukocytes

Leukocytes are white blood cells that protect the body from all types of harmful agents (bacteria, viruses, etc.). That is, the main function of leukocytes is the implementation of the protection of the body, both specific, for example, from a certain type of microorganisms, and nonspecific or general.

The concentration of leukocytes increases in areas of inflammation, where they capture and digest foreign agents. In the case of a large accumulation of pathogenic agents, white blood cells increase significantly in size and begin to break down. The process of destruction of leukocytes is accompanied by a local inflammatory reaction: edema and hyperemia of the damaged area, an increase in local temperature.

What is dangerous leukocytosis in a smear

A condition characterized by an excess of white blood cells (leukocytes) in the blood is called leukocytosis. Cells protect a person from the invasion of viruses and do not allow their reproduction. A permanent elevated level of leukocytes is the result of an inflammatory process of various etiologies, which is often accompanied by the following symptoms:

• burning sensation and unpleasant odor from the vagina;
• pain when urinating;
• white curdled discharge from the vagina;
• painful intercourse;
• failure of the menstrual cycle;
• itching of the genitals;
• unsuccessful attempts to get pregnant;
• temperature increase;
• dizziness.

Assignment of a smear for flora

A smear on the flora is called so because during the diagnosis it turns out which flora (environment) prevails at the moment in the uterus - pathogenic or normal. Indicators for the collection of analysis are a scheduled examination by a specialist, specific complaints of the patient: burning, pain in the genitals, pain in the abdomen, poor urination.

Also, the study is carried out when planning conception, after a course of taking antibiotics, directly during pregnancy, after childbirth. In the first two trimesters, scraping for flora is examined at least 3 times, and if there are complications or complaints from the patient, even more often.

Flora smear analysis is one of the most important diagnostic methods in gynecology. The smear is taken from the mucous membrane of the vagina, cervix or urethra. This analysis allows you to assess the state of the microflora of the genitourinary system and identify the presence of pathogenic microorganisms.

A smear analysis for flora in women is performed during a preventive examination by a gynecologist and in the presence of complaints from the genitourinary system. These include: pain in the lower abdomen, itching, burning in the vagina, discharge, indicating a possible inflammatory process. It is also advisable to do this analysis at the end of the course of antibiotic therapy in order to prevent thrush and when planning pregnancy.

What is this analysis for?

Usually, a vaginal swab is part of a routine medical check-up for women. It is performed by a specialist during a gynecological examination. Also, biological material is taken from the urethra and cervix.

This diagnosis allows you to detect possible problems with women's health, such as an inflammatory process or a disease caused by an infection. In medical terminology, such a study has another name - bacterioscopy.

A gynecological smear is taken if the following diseases are suspected:

• or vaginitis;

Specialists can prescribe a smear with the following complaints of the patient:

• Pain during intercourse.
• Foul-smelling copious discharge with a change in color.

A smear is taken when planning pregnancy and after antibiotic therapy. In addition, the smear allows you to monitor the effectiveness of therapy in the treatment of gynecological diseases.

Advantages of the method:

• Painless procedure.
• Simple rules for preparing for a smear.
• Monitoring the effectiveness of the treatment of women's diseases.
• Ability to identify many diseases of the genitourinary system.

With a preventive purpose, women periodically need to carry out this diagnosis. This will help prevent possible unwanted consequences.

Preparation for delivery

Some doctors say that this analysis does not require special preparation, however, this is not so. For the reliability of the results, the patient is advised not to go to the toilet for 2-3 hours, since urine can wash away all pathogenic bacteria and infections, it will be difficult for the attending physician to determine the causes of your pathological condition.

Douching, vaginal suppositories and antibacterial soap also contribute to unreliable indicators. Women should definitely take this analysis after the end of menstruation, and besides, all patients should refrain from any sexual contact 2 days before taking the biomaterial.

How to give up?

The analysis is most often taken by a doctor when you come to him for a regular appointment at a polyclinic or when you simply go to a paid laboratory where obstetricians and medical staff take biomaterial from you.

A gynecologist, obstetrician or any other medical worker lightly passes a special disposable stick-shaped spatula over three points - the vagina, urethra and cervical canal.

In men, the urologist or other doctor inserts a special disposable probe into the urethra, rotates around the axis several times and takes an analysis. It is believed that the study does not cause pain, however, this does not exclude the negligence of the doctor, as well as individual sensitivity or the presence of a particular disease, which can cause discomfort.

The meaning of the letters on the analysis form

Doctors do not use full names, but abbreviations - the first letters of each of the analysis parameters. To understand the normal microflora of the vagina, knowing the letter designations will be very helpful.

So what are these letters:

1. abbreviations of the zones from which the material is taken are denoted by the letters V (vagina), C (cervical part of the neck) and U (urethra or urination canal);
2. L - leukocytes, the value of which may not coincide in normal and pathological conditions;
3. Ep - epithelium or Pl.ep - squamous epithelium;
4. GN - gonococcus ("culprit" of gonorrhea);
5. Trich - Trichomonas (causative agents of trichomoniasis).

In a smear, it is possible to detect mucus, indicating a normal internal environment (PH), useful Doderlein sticks (or lactobacilli), the value of which is equal to 95% of all beneficial bacteria.

Some laboratories make it a rule to put marks in relation to the content of a particular type of bacteria. For example, somewhere they use the “+” sign for this. It is put down in 4 categories, where one plus is insignificant content, and the maximum value (4 pluses) corresponds to their abundance.

In the absence of any flora in the smear, the abbreviation “abs” is affixed (Latin, this type of flora does not exist).

What do doctors not see with microscopy?

With the help of this analysis, it is impossible to determine such conditions or diseases of the body:

1) Cancer of the uterus and cervix. To diagnose a malignant degeneration of the endometrium, histological material is needed, and in large quantities. And they take it directly from the uterus with separate diagnostic curettage.

2). To determine it, a smear is not needed and no matter what result it will show. It is necessary to take a blood test for hCG, undergo a gynecological examination with a doctor or do an ultrasound of the uterus. You can determine the chorionic gonadotropin in the urine, but not in the discharge from the genitals!

3) CC and other pathologies (, leukoplakia, koilocytosis, HPV lesions, atypical cells, etc.) are put according to the results of a cytological study. This analysis is taken directly from the cervix, from the transformation zone, according to a certain technique with Papanicolaou staining (hence the name of the analysis - PAP test). It is also called oncocytology.

4) Does not show infections (STDs) such as:

• (chlamydia);
• (mycoplasmosis);
• (ureaplasmosis);

The first four infections are diagnosed by PCR. And it is impossible to determine the presence of the immunodeficiency virus by a smear with high accuracy. You need to take a blood test.

Smear norms for flora

After receiving the results of the tests, it is sometimes very difficult to understand the numbers and letters written by the doctor. In fact, everything is not so difficult. In order to understand whether you have gynecological diseases, you need to know the norm indicators when deciphering the smear analysis for flora. There are few of them.

In the analysis of a smear in an adult woman, the normal indicators are as follows:

1. – must be present, but only in small quantities.
2. (L) These cells are allowed as they help fight infection. The number of leukocytes in the vagina and urethra is not more than ten, and in the cervical region - up to thirty.
3. (pl.ep.) - normally, its amount should be within fifteen cells in the field of view. If the figure is higher, then this is evidence of inflammatory diseases. If less - a sign of hormonal disorders.
4. Dederlein sticks - a healthy woman should have a lot of them. A small number of lactobacilli indicates a disturbed vaginal microflora.

The presence of fungi of the genus Candida, small rods, gram (-) cocci, Trichomonas, gonococci and other microorganisms in the results of the analysis indicates the presence of the disease and requires a deeper study and treatment.

Table for decoding the smear norm in women (flora)

The interpretation of the results of the smear analysis for flora in women is presented in the table below:

Degrees of purity by smear on flora

Depending on the results of the smear, there are 4 degrees of purity of the vagina. Degrees of purity reflect the state of the microflora of the vagina.

1. First degree of purity: The number of leukocytes is normal. Most of the microflora of the vagina is represented by lactobacilli (Doderlein sticks, lactomorphotypes). The amount of epithelium is moderate. Mucus - moderately. The first degree of purity indicates that everything is normal: the microflora is in order, immunity is good and inflammation does not threaten you.
2. Second degree of purity: The number of leukocytes is normal. The microflora of the vagina is represented by beneficial lactobacilli along with coccal flora or yeast fungi. The amount of epithelium is moderate. The amount of mucus is moderate. The second degree of purity of the vagina is also normal. However, the composition of the microflora is no longer ideal, which means that local immunity is reduced and there is a higher risk of inflammation in the future.
3. Third degree of purity: The number of leukocytes is above normal. The main part of the microflora is represented by pathogenic bacteria (cocci, yeast fungi), the number of lactobacilli is minimal. There is a lot of epithelium and mucus. The third degree of purity is already inflammation that needs to be treated.
4. Fourth degree of purity: The number of leukocytes is very large (the entire field of view, completely). A large number of pathogenic bacteria, the absence of lactobacilli. There is a lot of epithelium and mucus. The fourth degree of purity indicates severe inflammation that requires immediate treatment.

The first and second degrees of purity are normal and do not require treatment. At these degrees, gynecological manipulations are allowed (cervical biopsy, curettage of the uterus, restoration of the hymen, hysterosalpingography, various operations, etc.)

The third and fourth degrees of purity are inflammation. At these degrees, any gynecological manipulations are contraindicated. You need to treat the inflammation first, and then retake the smear.

What is coccal flora in a smear?

Cocci are bacteria that have a spherical shape. They can occur both in normal conditions and in various inflammatory diseases. Normally, single cocci are found in the smear. If the immune defense is reduced, the amount of coccobacillary flora in the smear increases. Cocci are positive (gr+) and negative (gr-). What is the difference between gr+ and gr- cocci?

For a detailed description of bacteria, microbiologists, in addition to indicating the shape, size and other characteristics, stain the preparation using a special method called "Gram stain". Microorganisms that remain stained after washing the smear are considered "gram-positive" or gr+, and those that become discolored when washed are "gram-negative" or gr-. Gram-positive bacteria include, for example, streptococci, staphylococci, enterococci, and lactobacilli. Gram-negative cocci include gonococci, Escherichia coli, and Proteus.

What are Doderlein sticks?

Doderlein sticks or, as they are also called, lactobacilli and lactobacilli are microorganisms that protect the vagina from pathogenic infections by producing lactic acid, which helps maintain an acidic environment and destroy pathogenic flora.

A decrease in the number of lactobacilli indicates a disturbed acid-base balance of the microflora in the vagina and its shift to the alkaline side, which often occurs in women who are sexually active. The pH of the vagina is significantly affected by both pathogenic microorganisms and opportunistic pathogens (which are sometimes found in the vagina normally).

Smear on flora during pregnancy

The microflora of each woman is strictly individual, and normally consists of 95% of lactobacilli that produce lactic acid and maintain a constant pH of the internal environment. But in the vagina there is also a conditionally pathogenic flora. It got its name because it becomes pathogenic only under certain conditions.

This means that while an acidic environment is present in the vagina, the opportunistic flora does not cause any inconvenience and does not actively multiply. These include yeast-like fungi, which under certain conditions can cause vaginal candidiasis, as well as gardnerella, staphylococci, streptococci, which under other conditions can cause bacterial vaginosis (inflammatory process) in a woman.

A woman's flora can change for a variety of reasons - with a decrease in immunity, taking antibiotics, with common infectious diseases and diabetes. One such factor that can change the microflora is a change in hormonal levels. So, in a pregnant woman, until the end of pregnancy, estrogens are practically not produced, but the hormone progesterone is produced in large quantities. This hormonal background allows Doderlein's sticks to increase 10 times, so the body tries to protect the fetus from possible infection during pregnancy. Therefore, it is very important to undergo an examination before the planned pregnancy and determine the degree of purity of the vagina. If this is not done, then during pregnancy the opportunistic flora can be activated and cause various diseases of the vagina.

Candidiasis, bacterial vaginosis, bacterial vaginosis, gonorrhea, trichomoniasis - this is a far from complete list of diseases that weaken and loosen the walls of the vagina. This is dangerous because ruptures can occur during childbirth, which might not have happened if the vagina were clean and healthy. Diseases such as mycoplasmosis, chlamydia and ureaplasmosis are not detected by smear analysis, and these pathogenic microorganisms can only be detected by a PCR (polymerase chain reaction) blood test using special markers.

A smear analysis from a pregnant woman is taken at the time of registration, and then for control at 30 and 38 weeks. Usually, to assess the state of the microflora of the vagina, doctors talk about the so-called degrees of purity of the vagina, which a woman must know and ensure that the necessary degree is maintained during pregnancy.

Any woman more than once had to take a smear when visiting a gynecologist. What does the number of leukocytes mean when deciphering this analysis and what does the deviation from the norm indicate?

swab of a healthy woman

Leukocytes in a smear, the norm in women lies within strict limits. But if they are significantly increased or, conversely, less than expected, then this indicates the presence of a disease and the doctor prescribes an additional examination. What does this indicator mean for women's health?

Leukocytes- This is a collection of varieties of blood cells, the function of which is to resist any infection. If their number on the mucous membrane of the vagina, cervix and urethra does not exceed certain limits (leukocytes in a smear, the norm in women is clearly marked), then this indicates that there are no inflammatory processes in the body.

Therefore, with the help of a gynecological (urogenital) smear, it is possible to establish the presence of diseases of the urogenital area in women of any age. In particular, such an assessment of the level of leukocytes (increased or decreased) is necessary in order to ascertain the infectious-inflammatory process and assess its intensity.

The reason for the appointment of such an analysis may be:

• pathological discharge;
• violation of the stability of the menstrual cycle;
• pain in the lower abdomen;
• itching, burning and pain when urinating;
• discomfort with intimacy.

In addition, a smear is taken in the first trimester pregnancy and after prolonged use of antibiotics or hormonal agents, as well as, prophylactically, once every three months.

A woman needs to properly prepare for this procedure, otherwise the result of this analysis will not be reliable.

In order for the smear readings to be accurate, it is necessary:

• refuse intimate relationships no later than three days before the analysis;
• do not take drugs during the week preceding the analysis;
• within two days before taking a smear, exclude the use of soap and gels for intimate hygiene, limit the use of warm boiled water.

A laboratory assistant examines a smear under a microscope and calculates the content of white blood cells in the laboratory material.

The table shows the indications for this parameter, corresponding to the norm of the content of these cells.

What does the excess of the norm of the content of leukocytes in a smear testify to?

If a smear study revealed an increased concentration of leukocytes in a woman than in the table above, then this indicates the likelihood of developing inflammatory processes in the organs associated with reproductive function, namely:

• colpitis;
• andexite;
• endometritis;
• urethritis.

as well as the development of other types of inflammation.

In addition, an increased content of white blood cells may indicate that a woman has:

• venereal diseases;
• tumors.

The number of leukocytes can be increased as a result of taking various medications (for example, antibiotics or hormones), as a result of stress, overwork. Therefore, with an increase in the concentration of leukocytes, the specialist will definitely pay attention to what indicators characterize the microflora present in the biomaterial.

During pregnancy, the white blood cell counts in the smear also differ slightly from the usual norm and range from 15 to 20. A sharp increase in the white blood cell count can indicate both a latent pathology and the presence of inflammation in the body, which requires immediate treatment.

For example, thrush develops against the background of the presence of a fungal infection, and in case of bacterial vaginosis and gonorrhea, infection with Staphylococcus aureus is detected. But the presence of lactobacilli, which are responsible for the acidity of the environment, may be below normal in this case.

Therefore, an increased content of leukocytes in a smear is the reason for the appointment of other tests and a more detailed examination.

In what case can the number of leukocytes be below normal?

However, in some cases, the analysis of the urogenital smear reveals a decrease in the number of leukocytes in women.. Such indicators are found in older women during menopause, usually in the absence of intimate relationships. A decrease in the number of leukocytes is an alarming symptom, since this fact indicates the suppression of the protective functions of the body. In this case, a woman needs to be regularly examined by a doctor in order to prevent the development of a dangerous disease.

Thus, any woman, regardless of age, the presence or absence of intimate relationships, during the reproductive period or during menopause, should not neglect regular visits to the gynecologist.

A simple, painless procedure for taking a smear, performed using sterile disposable instruments and taking several minutes, will be able to detect the development of dangerous diseases in time, many of which may be asymptomatic in the initial stages. Timely diagnosis and appropriate treatment will help a woman of any age in this case to avoid dangerous complications.