In a small amount, red blood cells in a smear on the flora indicate a normal state of the female body. Exceeding the normal values of the contained red blood cells in the vaginal discharge is considered a sign of some hormonal disorders in the female body and inflammatory processes, which can outwardly be expressed in the form of unpleasant, and in some cases dangerous diseases. In this article, you will be able to familiarize yourself with why red blood cells are determined in a smear on the flora, what are the normal indicators, as well as deviations from acceptable values will indicate.
Why do doctors take a swab?
Smears on the flora are a diagnostic method - the study under a microscope of biomaterial collected from the surfaces of the vaginal mucosa of a woman. However, it is worth paying attention to the fact that the analysis of red blood cells in a smear on the flora is done by everyone: both women and men. Representatives of the stronger sex make a smear to identify any urological disease. Materials for research in men are taken directly from the urethra. In women, a smear can be taken from the urethra, as well as the vagina.
The study of microflora, as well as the cytological composition of the collected biomaterial obtained by scraping or imprint of the mucosa, allows us to diagnose various infectious, including sexually transmitted and hormonal diseases. The same tests help detect cancer, background and precancerous conditions. A smear is taken both for therapeutic purposes and for prophylactic. During the course of treatment of any diseases of the genitourinary system, a smear is usually taken before and after treatment.
Taking a smear is a completely painless procedure that helps to correctly assess the state of the reproductive system in the body of a woman. Biomaterials are applied to a glass slide, after which a thin smear is made, which is a micropreparation suitable for subsequent examination under a microscope.
Materials for research are selected using a glass pipette or a sharp spoon, and then applied to the edge of a special glass slide and smeared with the edge of the coverslip. Smears are slightly dried in air or in the flame of the burner, after being painted.
There are only two methods for staining vaginal smears. Monochrome is used in cytological analysis, as for polychromatic, it is used for cytological and hormonal studies. After all the manipulations performed, the micropreparation will be ready for examination under a microscope.
A violation of the smear preparation technique can lead to an unreliable result, but this situation is extremely rare in practice, since vaginal smears are a standard study, which does not require any special advanced training from a healthcare provider.
Preparation for biomaterial sampling
Women should come prepared for the smear fence. In order for the analysis to be the most reliable, it is necessary to refrain from sexual contact for two days, not to douche, not to carry out therapy with vaginal suppositories, creams and ointments. It is also recommended to urinate no earlier than three hours before going to the gynecological office. It is advisable to take this analysis on the 5th day of the cycle, when the woman runs out of her period.
To determine red blood cells in a smear on the flora, a man must also prepare before passing the material: do not have sex a couple of days before visiting the doctor, do not smoke or drink alcohol a few hours before the test.
The rate of red blood cells
How many of these bodies must be present in the biomaterial? Normally, red blood cells in a smear on the flora should be absent. However, a small number of them are fearless for the body and health.
What is the number of red blood cells in a smear on the flora in women is considered the norm, we found out. Normal is also considered to be available in the field of view of the laboratory doctor, who looks into the eyepiece of the microscope, several bodies. An increased number of red blood cells in women in a smear on the flora indicates the occurrence of an inflammatory process on the cervix. This feature is not direct in this case, but indirect.
A woman’s cervical smear should be taken with a special brush with silicone bristles. With a strong inflammatory process, the neck of the tissue becomes so vulnerable that the elastic bristles of the brush scratch it to the blood, and a huge number of red blood cells penetrate the smear.
What are red blood cells?
Normally, red blood cells in a smear on the flora should be absent, or there should be no more than 3 in the field of view. But what is it? A red blood cell is a non-epithelial element of a vaginal smear. The norm for red blood cells in a smear on the flora is not located in the mucus, but directly in the blood, where these bodies transfer oxygen from the lungs to the body tissue, and also transport carbon dioxide in the opposite direction. Red blood cells are the most numerous cells in the human body. Statistics show that every 4th cell in our body is a red blood cell.
In the bone marrow, more than two million red blood cells are formed every second, which are in the blood and perform their important functions. Red blood cells in human blood are extremely small cells, in shape which are similar to discs, slightly concave on both sides.
This shape and size allows these red blood cells to move freely around the smallest capillary and at the same time have a fairly large surface area, thereby providing gas exchange.
Cell smear
Red blood cells can get on the mucous membrane of the cervix or vagina only together with blood. These bodies do not leave the bloodstream on their own. Most often, an increase in the number of these cells occurs when a biomaterial is taken to determine red blood cells in a smear on the flora. A large number is explained by the fact that the analysis is taken with a shaggy brush, which by chance can slightly scratch the cervix.
Thus, a certain amount of blood will get into the material. In these cases, a large number of red blood cells in a smear on the flora is not a pathology, but an absolute norm.
Blood can also enter directly into the vagina, not only because of injury. Red blood cells in a smear on the flora can be increased for natural reasons, for example, during menstruation. These bodies found in the smear at this time - a natural phenomenon, even if they are there in large numbers. Single red blood cells in a smear can appear on certain days of a woman’s menstrual cycle:
- during ovulation (usually the 13-15th day of the menstrual cycle);
- on the 28th day (just before the start of menstruation).
As mentioned earlier, red blood cells in a smear on the flora are not normal, but a large number of them in the material taken directly from the cervical canal indicates the development of cervical erosion or the inflammatory process in this area of the vagina. The cause of the appearance of red blood cells may be intrauterine contraceptives and hormonal disorders, accompanied by blood circulation.
Red blood cells in biomaterial for cytology
In some cases, red blood cells in a smear in women can be found in the biomaterial for cytology. This happens due to the fact that the specialist took the material for the smear roughly and accidentally destroyed the vessels that pass in the delicate tissue of the cervix.
In this case, after taking the smear for several hours, a woman may experience weak discharge with a small admixture of blood. Of course, under these circumstances there will be a large number of red blood cells in the smear.
In this situation, the presence of blood cells will not be a pathology. The doctor who took the material for the study, mark in the form accompanying the micropreparation, the real cause of the red elements present - red blood cells in the smear, which should normally be absent. The reasons for the appearance of these Taurus can be different, ranging from the area of biomaterial intake and ending with circumstances that are independent of the patient’s health status.
Urethral smear bodies
The red blood cells that were found in a smear from the urethra may turn out to be symptoms of a tumor, stones located in the urinary tract. In urine, blood will never be the norm. This condition indicates acute inflammation, including inflammation of a bacterial nature. The most common justification for the appearance of bodies in a smear from the urethra is traumatic urethritis. The cause of this pathology is often a certain medical procedure associated with the mechanical entry of blood into the urethra.
In men
A smear from the urethra in men on the flora is carried out by a special probe, which is inserted into the canal to a depth of about several centimeters. This procedure is rather painful, unpleasant and may be accompanied by the formation of a mechanical injury on the urethral wall.
Among women
A smear for women from the urethra is usually taken in combination with biomaterial from the cervix, as well as from the vagina. This analysis is needed to diagnose infectious diseases of the genitourinary tract, discomfort in the urethra, and rapid urination. In addition, smears from the urethra in the fair sex can be prescribed as an additional examination for crops. To take such a smear, the doctor introduces a special applicator into the urethra 2 - 4 centimeters, and then carefully rotates it to collect more epithelium.
Infectious urethritis is caused by various pathogenic microorganisms. The main of its signs will be the appearance of secretions with blood from the urethra. The volume of these secretions increases significantly in the morning.
All of these diseases will necessarily be accompanied by the formation of red blood cells in a smear.
About a smear on the flora
The normal microflora of the female vagina is quite diverse, it contains a large number of different bacteria. In the representatives of a weak half of humanity of reproductive age, the main microorganisms are lactobacilli, but in addition to them, ureaplasmas (in 80% of patients), gardnerella (in 45% of patients), candida (in 30% of patients) and mycoplasmas (in 15% of patients) are also found opportunistic microorganisms, with a decrease in the immune system that can rapidly multiply, as well as lead to the onset of an inflammatory process. They require the appointment of adequate treatment. In the absence of any clinical manifestation, for example, pathological discharge with an unpleasant odor or itching in the perineum, the definition of these microorganisms as a pathology should not be interpreted.
Chlamydia, as well as viruses, can be found in patients who do not show any complaints, but these agents are not considered part of the natural microflora, and their presence indicates a latent infection.
The microflora in the vagina is dynamic, it can change on different days of the cycle. There are times when lactobacillus flora dominates those days in which gardnerella predominates. Significantly, the imbalance in the microflora of the balance of microorganisms, which is accompanied by clinical symptoms, is the basis of such conditions, for example, bacterial vaginosis and candidiasis. Such conditions can often recur, including even the slightest changes in the patient’s health status or while taking antibiotics. Especially women who have a family predisposition suffer from this.
A smear on the flora (also called a "general smear") is the first and important step in assessing the infectious and inflammatory process localized in the urogenital area. Such a smear allows you to quickly identify one of the following conditions:
- Norm.
- Violations of the vaginal microflora, where bacterial vaginosis should be attributed.
- An infection caused by candida fungi, such as thrush.
- Sexually transmitted infections, in particular, gonorrhea and trichomoniasis.
- Nonspecific, or bacterial, vulvovaginitis. In this case, white blood cells are present in large quantities in the smear. If a huge number of white blood cells is detected and the clinic has an inflammatory process, it is possible to prescribe antibiotics of a wide spectrum of effects, which destroy up to 90% of bacteria. In the absence of a therapeutic effect, it is necessary to carry out bacteriological culture, since it is impossible to determine microscopically the specific type of microorganism that caused inflammation. Bakseeding is usually accompanied by the identification of sensitivity to antibiotics, so that you can choose the optimal drug, as well as achieve the desired effect of therapy.
A smear on the flora is not able to determine:
- Intracellular and latent infections (chlamydia, mycoplasma, herpes, HPV, ureaplasma, HIV). To determine them, the DNA of the agent is necessarily determined by PCR.
- Pregnancy in a woman.
- Pretumor and tumor pathology. A smear is made on cytology, the essence of which is to determine the qualitative change in the epithelium using special stains.
Conclusion
Now you know that the content in the smear of red blood cells is not the norm, but some kind of deviation or symptom of a disease. The cause of the appearance of red cells on the surface of the vaginal mucosa can be physiological and pathological. In the latter case, the patient must undergo a course of anti-inflammatory therapy.