Every woman who cares about her health must visit the gynecologist regularly and take the necessary tests. During the bearing of the child, the state of the vaginal microflora is of particular importance. A smear during pregnancy allows you to make a true picture of the health of a woman and exclude the development of serious diseases. It is worth considering in more detail this type of diagnosis and the possible results of the analysis.
Importance of Analysis
The vaginal microflora is largely composed of lactobacilli, which produce lactic acid, which is necessary to protect the body from pathogenic microorganisms. A decrease in the number of lactobacilli will lead to the multiplication of "bad" bacteria and the development of the disease.
Pregnancy is a period when you need to pay special attention to health, because normal intrauterine development of the baby will depend on this. It should be understood that any inflammatory process can adversely affect the bearing of the fetus. Vaginal smears during pregnancy should be given to women even in the absence of symptoms of the disease. The infection may not manifest itself for a long time, but at the same time the expectant mother will be its carrier. If, during the next examination, the doctor finds abnormalities in the results of the analysis, the woman will be able to undergo appropriate treatment and prevent infection of the baby during childbirth.
Smears during pregnancy: how many times do you need to take?
The first mandatory examination of the vaginal microflora of the expectant mother takes place during the initial appeal to the antenatal clinic for registration. The results will show the condition of the vaginal mucosa, the presence of good and pathogenic microflora (balance) and the degree of purity. If pathogenic bacteria are detected, gentle treatment will be prescribed, after which a smear should be additionally passed for a control check.
According to the schedule of studies shown by the pregnant woman, the diagnosis of the vaginal microflora should also be passed in the last trimester. Smears on the 30th week of pregnancy should be done without fail in order to verify the health of the future mother and baby. Deviations from the norm in the last stages are often found, which is dangerous for the fetus and is fraught with undesirable consequences.
Without waiting for the next direction for examination, a woman should unscheduledly pass an analysis if she finds symptoms such as itching, burning, and the appearance of copious discharge from the genital tract. Such signs often accompany dangerous diseases that are extremely undesirable during the period of gestation.
“Good flora” - what does it mean?
Microflora is a collection of various bacteria that constantly inhabit the vagina. With an ideal state of health, there are mainly lactobacilli - Doderlein sticks that produce useful lactic acid. With a sufficient number of pathogens, there is no chance to survive in the acidic environment of the vagina.
During pregnancy, test indicators vary slightly. The number of vaginal epithelial cells increases significantly, which contributes to the accumulation of glycogen, necessary for the production of lactic acid with Doderlein bacilli. Maintaining the necessary acid-base balance (pH 3.3-4.5) throughout pregnancy, due to its good microflora, helps to block the development of pathogenic bacteria and prevent infection of the embryo (or fetus).
What is the danger of microflora disturbance?
Quite often, women are faced with a situation where, having passed smears during pregnancy, they find out that they have a violation of the vaginal microflora. Reducing the number of lactobacilli is extremely undesirable in this critical period and therefore it is necessary to establish the cause of the pathogenic condition. Conditionally pathogenic microorganisms, of course, are present in the vagina of every healthy woman, but their number should be small. If the number of bad bacteria increases, then dysbiosis begins to develop, most often causing vaginal candidiasis (thrush).
For an accurate diagnosis, smears must be taken. During pregnancy, in the early stages, such a violation can develop against a background of reduced immunity. Any deviation from normal values is dangerous, first of all, for the baby and the further development of pregnancy.
When should microflora be tested?
In the early stages of pregnancy, it is important for a woman to monitor the body's signals. Seek medical advice if:
- Itching appeared in the genital area.
- Vaginal discharge became abundant and has a curdled consistency.
- After urination, a burning sensation appears.
- The discharge has a sharp unpleasant odor.
- Periodically, pulling pains occur in the lower abdomen.
The listed symptoms indicate the development of the inflammatory process and the need for urgent treatment. A smear on the flora helps determine the type of pathogen, but in some cases the infection may be hidden. In this case, it is necessary to pass additional tests.
Types of Smears
When registering expectant mothers in the antenatal clinic, she is interested in what smears are taken during pregnancy and whether this is really necessary. It should be noted right away that examining a woman’s health status in early pregnancy is of particular importance to the doctor. Only diagnostics will show the true picture and eliminate the threat of abortion.
In gynecological practice, there are several types of smears showing the state of women's health. Classify them as follows:
- A smear on the flora - allows you to identify an imbalance of good and bad vaginal microflora. The analysis shows the number of red blood cells, white blood cells and dead epithelial cells. The results assess the degree of purity of the smear;
- A smear for cytology - is necessary to diagnose changes in cervical cells;
- A smear for sterility - is prescribed to determine the composition of the microflora of the vagina, helps to see deviations in the hormonal background;
- Smear for hidden infections - PCR diagnosis is extremely important during pregnancy. The method allows you to detect infections that are not determined by a smear on the microflora.
Urogenital infections pose a serious danger to the life and normal development of the fetus. Therefore, having received a referral from the attending physician for the diagnosis of latent infections, the expectant mother should not delay the examination.
Genital infections
Smears during pregnancy for infections - sexually transmitted diseases - must be passed without fail. Diseases such as ureplasmosis, herpes, chlamydia, toxoplasmosis, cytomegalovirus do not always make themselves felt, but this does not mean at all that they are not dangerous.
Hidden infections can be detected using PCR diagnostics, culture and Gram smear staining method. Another popular method is an enzyme-linked immunosorbent assay .
Decryption analysis
In the results of the analysis on the microflora of the vagina, you can find the following indicators:
- White blood cells - an increase in the norm indicates the development of inflammation. In the vagina they should be 10-15 in the field of view, in the urethra - not more than 5, and in the cervical - up to 5.
- Epithelium - normally this value should not be more than 10 in the field of view.
- Gram-positive bacteria - the main part (approximately 90%) consists of lactobacilli.
- Gram-negative bacteria - pathogenic microflora is normally completely absent.
- Mucus - smears during pregnancy allow the absence or moderate amount of mucus in the vagina and cervix.
- Mushrooms of the genus Candida are permissible a small amount in the vagina, but in the urethra and cervical canal they are normally completely absent.
- Cocci - Streptococci, staphylococci and enterococci in a small amount may normally be present. The presence of gonococci indicates the development of gonorrhea.
- Trichomonas - in a good smear they are absent.
White blood cells in a smear
White blood cells are white blood cells that are part of the immune system. During pregnancy, it is especially important to monitor their amount in a smear on the microflora, because even a slight change can indicate the development of the inflammatory process. The main purpose of white blood cells is to protect the body and fight against pathogenic bacteria. Therefore, it is not worth worrying about the detection of a small number of protective cells in the test results. For women in position, the white blood cell count of the smear is within 15-20 in the field of view.
Increased white blood cell smear
Swabs during pregnancy are an important diagnostic method, allowing you to determine the slightest deviation from normal values. A slight increase in the number of white blood cells during the period of bearing a child is quite acceptable. If the value exceeds 20 units in the field of view, additional diagnostics should be carried out and the cause of the pathogenic condition should be established. An increased number of white blood cells indicates the presence of an inflammatory process in the body of a future mother.
Bad smears during pregnancy can negatively affect the development of the fetus. Therefore, it is important to timely detect deviations in the test results and undergo appropriate treatment. Common causes of an increase in white blood cells in a smear in pregnant women are candidiasis (thrush), vaginosis, inflammation of the vaginal mucosa, infectious diseases (mycoplasmosis, gonorrhea, ureplasmosis).
"Degree of purity"
When conducting research in the laboratory, indicators such as smell and viscosity of the diagnosed material are evaluated. Depending on the indicators of pathogenic microflora, which may contain smears during pregnancy, a specialist estimates the degree of purity. There are four such degrees:
- The first degree speaks of an ideal smear on the microflora. The number of lactobacilli reaches 95%, which indicates the correct acid-base balance and good protection against the development of pathology.
- The second degree is set if a small amount of conditionally pathogenic microflora is found in the smear, but these values are within the normal range. The number of lactobacilli, as in the first degree, should prevail over the rest and be at the level of 90%.
- The third degree speaks of the development of dysbiosis (bacterial vaginosis). Doderlein rods in such a smear are less than necessary for the normal state of the flora. The number of gram-negative bacteria is increasing.
- A fourth degree is characteristic of vaginitis. In such a smear, an alkaline environment prevails, an increased number of leukocytes, epithelium is observed. Poor smears during pregnancy are the reason for the re-examination.
How to prepare for the analysis?
To obtain accurate results of the study of the vaginal microflora, you should properly prepare before passing the analysis. First of all, it is necessary to refuse sexual contacts 2-3 days before the material is taken. Also, the use of vaginal suppositories, creams and ointments should be excluded. Douching with medicinal herbs, soda can affect the results. Therefore, similar manipulations before the examination are not allowed.
For hygiene procedures, special means should be used: an intimate soap or gel. Their composition is specially designed taking into account the characteristics of the acid-base balance of the female reproductive system. The use of ordinary cosmetic soap distorts the true state of the vaginal microflora and negatively affects the condition of the external genital organs, causing burning and itching.
How to treat?
Poor smears in the early stages of pregnancy can lead to a stunted embryo development or miscarriage. Therefore, it is so important to contact a antenatal clinic in a timely manner for registration and analysis. Treatment will depend on the type of pathogen and gestational age. The treatment regimen should be selected only by a specialist, having previously determined the sensitivity of pathogenic microorganisms to medications. In the later stages, treatment is also necessary, because a neglected disease can damage the membranes and infect an unborn baby.