Vaginal microorganisms are the vaginal flora of the body, on which the health of a woman depends. To study it, they take a gynecological smear, in the decoding of which normally lactic acid bacteria should prevail over pathogens in the microflora of the vagina.
Preparatory Activities
Before passing the analysis, you need to prepare:
- do not take antibiotics within 14 days before the study;
- for three days - do not vaginally administer drugs that have contraceptive, antiseptic and antibacterial effects;
- in two days - do not enter into sexual intimacy;
- a day before going to the doctor, do not take a bath;
- do not douche;
- before a visit to the doctor to conduct hygienic procedures of the genitals;
- three hours before the procedure, do not empty the bladder;
- Do not take an analysis during menstruation.
In the case of constant medical treatment, a woman should warn a doctor and tell what drugs she is taking.
Failure to follow these simple rules will distort the results, which, in turn, will affect the diagnosis of pathology. It is advisable for all women to undergo a
bacteriological examination once every six months.
Biological material fence
For research and decoding, a gynecological smear is taken from the urethra, cervical canal and vaginal walls. Examine the microflora and determine the degree of purity.
The procedure for taking material is carried out using a spatula or a special spatula and is carried out in the following cases:
- routine inspection;
- medical examination;
- complaints of women: burning sensation and itching of the genitals, pain near the pubis, discharge.
In order to take a general gynecological smear (its decoding is given below), a gynecological mirror is inserted into the woman’s vagina, with the help of which the cervix and the walls of the vagina are visible. For girls and women who do not have sex (virgins), regardless of age, this tool is not used.
Gynecological smear: transcript. Norms
The female genitourinary system normally contains about 40 different types of microorganisms, most of which are lactobacilli. In a healthy woman, up to 95% of lactic acid bacteria are normally determined. Lactic acid maintains an acidic environment in the vagina and rapidly suppresses pathogens.
Another part of the flora is Klebsiella, Escherichia coli, Corynebacterium, Staphylococcus aureus, Gardnerella, Myrococcus, Peptostreptococcus, Eubacterium and others. A minimum amount of candida fungi is also acceptable.
Reasons for deviations from the norm
In some cases, immunity is reduced (menopause, pregnancy or other hormonal failure, stressful situations), in this case, the doctor may prescribe a gynecological smear on the general flora. Deciphering it will show how the quantitative composition of bacteria has changed. Normal microflora decreases, and, as a result, susceptibility to genital infections increases due to an increase in opportunistic microorganisms: streptococci, Escherichia coli, staphylococci. With a weak immune system, pathogens multiply at a high rate and actively suppress milk microorganisms. As a result, a pathology develops: gardenenosis, candidiasis or vaginal dysbiosis, which provokes:
- inflammation of the appendages and uterus;
- ectopic pregnancy;
- the birth of a premature baby;
- miscarriage;
- infertility.
What is the purpose of the analysis
Examination and interpretation of a gynecological smear allows timely diagnosis of various diseases of the female genital area, as well as assessment of microbial contamination, including the qualitative and quantitative composition of microorganisms, the condition of vaginal epithelial tissues, and the presence of inflammatory processes.
This type of study is called the gold standard for detecting bacterial vaginosis.
Vaginal dysbiosis: the main causes
If a gynecological smear was taken and deciphering it showed the presence of dysbiosis, then the reasons may be the following:
- hormonal imbalance (a small amount of estrogen);
- metabolic disease;
- long-term use of broad-spectrum antibacterial agents;
- errors in observing the rules of personal hygiene of the genitals.
Analysis results
In the laboratory of a medical organization, a gynecological smear is examined. Decoding:
- White blood cells. For the cervical canal, the norm is the presence of up to 30 cells in the field of view , for the urethra - within 5, for the vagina - no more than 10. A small amount of white blood cells protects the genitals, and their growth indicates inflammation: urethritis, colpitis, cervicitis. In the case of the acute phase of the inflammatory process, the number of leukocytes exceeds 100 cells in the field of view.
- Slime. This indicator is normal, if absent in the urethra (urethra), a small amount of mucus is acceptable in the vagina. During menstruation, its presence in the cervix is allowed. If mucus is detected in the urethra, inflammation is suspected. .
- Epithelial cells, which normally should be no more than 15. In the vagina there is a squamous epithelium, in the cervical canal there are cylindrical epithelial cells. If you took a gynecological smear and deciphering it showed the presence of an excess epithelium, then this indicates an acute or chronic inflammatory process in the genitals.
- Microorganisms. Normally present in the vagina: coccal flora in women during menopause and in girls who have not reached puberty; lactobacilli - in women of reproductive age. In the cervix, bacteria should be significantly less than in the vagina. Microflora in the urethra should be absent. If there is a pathogenic or conditionally pathogenic flora, then vaginal dysbiosis or inflammation is diagnosed.
- Trichomonas, gonococcus, key cells, the detection of which implies the following diseases: trichomoniasis, gonorrhea, gardnerellosis. Normally, they should not be.
- Candida fungus. Identify mycelium and spores. The latter suggest the carriage of this type of fungus and may be present in an almost healthy woman. The appearance of mycelium means that a woman in the active phase has an infectious process caused by candidiasis, or thrush.
The degree of purity of the gynecological smear: transcript
The purity of the gynecological smear, and there are only four, determine the presence of an inflammatory process in the female body:
- First one. This degree of purity is found in two categories: in practically healthy women (there are no chronic and acute inflammatory diseases of the genital organs) and in girls who do not have sex. Indicators: a sufficient amount of lactobacilli, acidic pH of the vagina, leukocytes 0-5.
- The second one. With this degree of purity, therapy is not prescribed. Preventive measures are recommended to increase the immune status in order to prevent the development of inflammatory processes. Indicators: mixed vaginal microflora is sown (both normal and pathogenic microbes are present), acidic pH of the vagina, five to ten leukocytes, moderate amount of mucus and flat epithelial tissues.
- Third - this means that in the genitals of a woman there is an inflammatory process and immediate treatment is required. Indicators: lactobacilli are practically absent, virulent microflora and epithelial cells are increased in number, slightly acidic or alkaline pH of the vagina.
- The fourth degree is a high level of danger. According to the results of laboratory tests, the doctor prescribes an additional examination in order to exclude dangerous, including oncological diseases of the female genital organs. Indicators: lactobacilli are not sown, alkaline pH of the vagina, microflora is completely pathogenic, a huge number of leukocytes.
A gynecological smear and decoding it to the microflora allows you to diagnose the disease in the early stages, prescribe treatment in a timely manner and prevent the development of the chronic process.
Smear on the flora during pregnancy
This analysis for pregnant women is taken when registering in a antenatal clinic, as well as in the period of 30 and 38 weeks in order to control the degree of purity of the vagina throughout pregnancy.
Women planning children are recommended to take care of themselves and the health of the unborn baby beforehand, and pass a gynecological smear on the flora before the alleged pregnancy. Decryption: normally 95% of all bacteria are lactobacilli, 5% is a conditionally pathogenic flora that does not multiply in an acidic environment. Under certain conditions, when the pH is shifted towards the alkaline environment, pathogenic bacteria begin to spread actively. One of the reasons for changing microflora is pregnancy.
Throughout the entire period of bearing a baby, a woman has a different hormonal background. Increased production of the hormone progesterone occurs, and estrogen - a minimal amount. Thanks to this restructuring of the body, the number of Doderlein sticks (lactobacilli) increases by about ten times in order to protect the fetus from infection during pregnancy.
Thus, before planning pregnancy, it is very important to undergo the necessary laboratory tests and obtain a transcript of the analysis of the gynecological smear, including the degree of purity of the vagina. Otherwise, the conditionally pathogenic flora will receive an impetus for activation and will provoke various diseases. Some diseases: bacterial vaginosis, gonorrhea, trichomoniasis - loosen and weaken the walls of the vagina, and there may be tears during the birth of the baby.
Cytomorphological analysis of smears
This type of study is prescribed after a gynecological smear on the flora has been prescribed. Decoding (norm or pathology) of the results will help in making an accurate diagnosis. With the help of this analysis, oncology or cervical dysplasia, papillomavirus infection are detected.
The biomaterial for atypical cells is taken from the urethra and cervix, its vaginal part. There are several types of smears:
- Type 1 means that the condition of the cervix is normal.
- Type 2 is the presence of an inflammatory process or mild dysplasia. In this case, the doctor prescribes anti-inflammatory drugs, and after a full course of treatment, a second analysis for cytology.
- Type 3 is severe or moderate dysplasia. Upon receipt of such a result, an additional examination is prescribed, namely a biopsy of the cervical tissue and their cytomorphological examination, colposcopy, with the help of which foci of lesions of epithelial tissues are detected, their localization and nature.
- Type 4 is characterized as a precancerous condition. As with the third type, a new examination and consultation of a gynecological oncologist is recommended.
- Type 5 is an oncological disease. All examinations and treatment takes place in a specialized medical institution.
Preparation for cytological examination
The information content and accuracy of the result depends on the proper preparation:
- they do the analysis no earlier than the fifth day of menstruation and no later than five days before the next menstrual cycle;
- 24 hours before the biomaterial is taken, it is not recommended to use medicines, including contraceptives;
- at least a day before going to the doctor should refrain from sexual intimacy.
Conclusion
Thus, a gynecological smear on the flora (the decoding of which is given above) and a smear on cytology can detect various diseases of the female genital area and, with properly prescribed therapy, gives a great chance for a quick recovery.