What can a smear tell you? What does a smear on the flora show in women? Microscopic examination results

Women's examinations

The process of taking a smear

Gynecological examination of a smear is carried out today with modern devices (microscopes, etc.). Smear microscopy allows you to study in detail the microflora of the genital tract, determine the form of the disease, its severity, and also helps prescribe the necessary medications to promote recovery.

Female examinations should be carried out in sterile rooms, using disposable gynecological kits, in compliance with a regulated sequence of actions. Note that smears in gynecology are taken from the vagina, cervical or urethra, as well as from the rectum.

It is important not to damage the walls and tissues during the procedure. Otherwise, it may cause discomfort in the future or other diseases.

Let's take a step-by-step look at how smears are examined.

Insertion of a gynecological speculum. This stage is typical only for women who are sexually active.
Taking a smear using a spatula or spatula.
Applying material to a glass slide.
Sent to the laboratory for study.

After the material arrives at the laboratory, the specialist colors it, waits for it to dry completely, and only then begins to examine the gynecological smear. Using a microscope and staining, a laboratory technician can see various bacteria, fungi, infections, and determine their number and ratio. After research work The specialist writes down the results on a special form and passes them on to the attending physician.

Women's smears under a microscope, or rather, their results, will not take long to arrive - they arrive within one working day.

In turn, the leading gynecologist, based on the results of the analysis, writes down his final verdict and prescribes treatment. If there is any doubt about the correctness of the result, a repeat vaginal smear is prescribed.

Decoding the results

When you hold your results in your hands, the question involuntarily arises of what the smear at the gynecologist shows (the Latin letter and numbers next to it) and how to understand the encrypted results. Let's figure it out.

Latin "V" - vagina. The adjacent numbers show the contents of the smear.
The Latin "C" stands for "cervix". The numbers will tell the doctor about all the changes that can be observed in the area under study.
The Latin "U" means "urethra". The meaning of the numbers is the same as for a cervical smear.
Latin "L" - leukocytes.
"Ep" - squamous epithelium.
The line with “abs” indicates bacteria and infections that you have not detected.
“gn” and “trich” - gonococci (the causative agent of gonorrhea) and the bacterium trichomoniasis, the causative agent of trichomoniasis.

For visualization, you can view an atlas of gynecological smears, which will allow both gynecologists and the patient to understand or better understand the diagnosis and possible pathologies. All atlases are illustrated and have detailed comments.

Norms of smears for flora

Flora smear analysis has its own standards, which can be found below. The norm is affected by age. So, for example, for girls under fourteen years old there are one indicators, for women after menopause - different. Therefore, the presented norms are typical for women aged 14 to 45-50 years.

Leukocytes. (V) 0 - 10 in the field of view, (C) 0 - 30 in the field of view, (U) 0 - 5 in the field of view. In the case of an increased level of leukocytes, we can talk about inflammatory processes in a certain area.
Epithelium. In all positions (V, C, U) it should be “moderate”. If the indicator increases, one should talk about inflammation, and a decreased level indicates a lack of estrogen (female sex hormone).
Slime. In the case of (V) and (C) - “moderately”, and in the case of (U) - “moderately” or “absent”. A large amount of mucus indicates inflammation.
Gram-positive rods (gr.+). (V) - " a large number of", (C) - "absent", (U) - "absent". These results indicate good immunity and in good condition microflora.
Gram-negative rods (gr.-). (V), (C), (U) - “absent everywhere.” The presence of rods indicates dysbiosis and inflammation.

Reminder for those planning to take a smear test

How to prepare for a flora smear and what you should not do before taking it should be remembered right now, because compliance with the rules and hygiene standards is the key to the correct and reliable result of the study and the subsequent prescription of treatment.

A vaginal smear for flora involves stopping taking any vaginal medications for three days and abandoning all antibacterial agents.
A smear for microflora in women or any other type of smear is not given during menstruation or 1-2 days after its end.
Before the analysis (the night before and in the morning), it is forbidden to wash or douche.
It is necessary to abstain from sexual intercourse.

A smear in gynecology is more than just a necessity, because such tests are vital. Timely detection of diseases is the key to rapid and effective treatment. So don't ignore the rules preventive methods and visit your gynecologist regularly.

The female reproductive system is often exposed to bacteria and infection. Often, due to certain circumstances, inflammation of organs develops. There are quite serious organs here that cannot function fully on their own. In the case of pathology of one of them - the uterus, ovaries or fallopian tubes - the woman’s entire reproductive system is damaged, the development of cancer cannot be ruled out, and infertility is often diagnosed. Therefore, representatives of the fair sex must undergo appropriate examination with the required regularity. The examination includes a mandatory examination by a gynecologist with the necessary tests to identify pathologies.

The most informative analysis includes a smear on the flora in women, which presents a complete picture of the state of the microflora of the genitals and genitals. Women will understand that the usual and well-known thrush is diagnosed with a similar analysis. But more about it later in the article.

What is a smear? A smear is a characteristic movement of a gynecologist with a cotton swab to collect the mucous membrane of the vagina, cervix or urethra. Subsequently, a corresponding study of mucosal sampling is carried out in the laboratory. According to a complete study of the results, the spread of an infectious disease or the development of a bacteriological nature is determined.

A smear is taken during a gynecological examination during a comprehensive commission or when unpleasant symptoms and complaints from the patient. Unpleasant symptoms include pain, burning in the lower abdomen or in the vagina involving the outer labia; patients often complain of pain during urination. If these symptoms are detected, you should immediately consult a doctor - even itching in the urethral area can signal the development of a gynecological disease.

Not all women know exactly the rules for collecting mucous membranes. This leads to numerous deviations from the norm, and most importantly, to a significant distortion of indicators. Therefore, women should follow the rules for collecting mucous membranes, which include:

2 days before the expected examination by a gynecologist, do not have sex even with a regular partner. It is advisable not to use any suppositories or topical medications, and you should avoid all kinds of sexual activities, douching, and bathing.
A smear is taken in the absence of bleeding, because during menstruation the microflora completely changes its state and content.
Before visiting a gynecologist, you should not take a bath - washing is strictly prohibited.
It is forbidden to visit the toilet 2-3 hours before.

By following the rules, the woman ensures that the results of the analysis are true. The fence itself is carried out with a spatula or a special stick with a cotton tip. The sampling is carried out from three places - from the cervix, vagina and urethra. There should be no pain - if this occurs, it means that an infectious disease is developing with the presence of an inflammatory process.

Norms and deviations

In the microflora of a woman’s genital organs, 95% of lactobacilli should be present - they form lactic acid, providing the required acidity to protect against infections and other pathogens.

Depending on life circumstances (stress, decreased immunity), as well as during pregnancy, the number of lactobacilli is significantly reduced, which provokes the development of infectious lesions.

Interpretation of analyzes

As soon as a woman has received tests to determine the microflora of the genital organs, she is faced with a huge amount designations, symbols and numbers. Only a specialist can disassemble them, but with a detailed examination you can do it yourself.

So, first, determine the indicators for the smear sampling site being studied. The letters are highlighted here:

V– vagina;
C– cervical canal of the cervix;
U– urethra.

The designations identify the first letter of the place name in Latin.

L– leukocytes – are present in a healthy state and during the development of pathology. Their purpose is to protect the woman’s genitals from the penetration of bacteria. In normal condition, there should be no more than 10 in the vagina, no more than 30 in the cervix and no more than 5 in the urethra. When the indicators increase, an assumption is made about the presence of an inflammatory process.
Ep– epithelium – mucosal cells that must be present in a healthy and diseased state. The absence of epithelium indicates a disorder hormonal levels among women. Epithelium indicators for all mucosal sampling sites should not exceed the limit of 5-10 units. If it increases, it indicates the presence of inflammation.
Slime– is necessarily present in small quantities in the vagina and cervical canal of the cervix. An increase or presence at the sampling site in the urethra indicates the presence of inflammation.
General indicators of microflora - definitely in the vagina Dederlein sticks must be present a lot. These rods are the main defenders of a woman’s microflora, which have another name – lactobacilli.

When indicators increase, the laboratory records their excess - the usual “+” signs are placed next to each indicator. Their definition appears to be:

« + “- a small amount indicates an excess, but without the development of inflammation;
« ++ "- a moderate increase indicates the onset of the inflammatory process;
« +++ “—increased amount—inflammation develops and progresses;
« ++++ “- a copious amount can signal the presence of a serious disease of the genital organs, up to advanced stages or an oncological nature.

This is a simplified form of deciphering the results. The received documents contain many more indicators.

What should not be in the results

The above indicators are not all that the results of the survey show. The forms present indicators of certain components that, in principle, should not be present in a smear for flora. The presence of numbers indicates infection; a dash means the woman is healthy.

Components that should not include the following:

Gonococci are gram-negative bacteria, the presence of which indicates the development of gonorrhea in a woman, as well as inflammation of the urethra, cervix, fallopian tubes or rectum.
Trichomonas is a bacterium of a modified form, which is rarely detected by conventional flora analysis; additional culture is recommended. Its detection in a smear indicates infection with trichomoniasis.
Key cells are ordinary epithelial cells that are stuck together by Gardnerella and other pathogens. Their presence in the vaginal mucosa and other examined areas indicates bacterial vaginosis.
Candida is a fungus that is absent or present in small quantities in healthy women. But if the presence of candida is higher than the levels of lactobacilli, there is a high probability of developing candidiasis - the usual thrush. Moreover, the disease can progress at full speed, but the woman initial stage may simply not pay attention to mild itching during urination.

Atypical cells should also not be found in a woman’s microflora - cells of a modified form, which often indicate the development of cancer.

Microflora tests during pregnancy

Pregnant women undergo flora tests somewhat more often than “ordinary” women. This can be explained by a simple fear of infection or inflammation, because carrying a fetus significantly reduces the immunity of the expectant mother, which means it can lead to the development of diseases or inflammation that is not specific to the pre-pregnancy state.

The collection of the mucous membrane is carried out in exactly the same way, with the exception of the collection from the cervical canal - it is carried out more carefully so as not to provoke a miscarriage in the pregnant woman.

Why carry out such analyzes?

Surprisingly, even if a woman previously did not have any adverse symptoms, sexually transmitted infectious diseases are often detected with the onset of pregnancy. Here they highlight:

gonorrhea;
syphilis;
ureaplasmosis;
microplasmosis;
genital herpes and other diseases.

Timely detection of present infections will allow treatment to begin on time, and, therefore, protect the child from possible infection and the development of various pathologies. During pregnancy, women produce progesterone, which can significantly affect the production of white blood cells. That is why during pregnancy up to 20 units are allowed. Its excess indicates the onset of inflammation, which often leads to miscarriage in the early stages and premature birth in the third trimester.

Unfavorable test results indicate the presence of an inflammatory or infectious disease, and this may not always be associated with the genitals. For example, in pregnant women, elevated white blood cells can help detect malaria, typhus and other similar diseases. To clarify the diagnosis, doctors prescribe additional examinations for women - DNA diagnostics, bacteriological culture and other additional studies.

A woman should be attentive to her health, including the condition of her genital organs, especially if she plans to conceive a child. Infections and bacteria often become provocateurs for the development of cancer, so at the first unpleasant symptoms you should immediately consult a doctor.

A vaginal smear is a common gynecological procedure. This study directly helps to establish the composition of the microflora of the genital organs in women and identify the causative agents of gynecological diseases. Let's take a closer look at the procedure, name the goals and features of its implementation, and standard indicators.

What does a vaginal smear show?

Women who are referred to this study for the first time are often interested in the question of what a gynecological smear shows and why it is done. This microscopic laboratory study characterizes the content of microflora in the urethra (urethra), vagina and cervix. These organs of a woman’s genitourinary system are directly exposed to pathogenic microorganisms.

Based on the results of the study, the doctor can judge general condition reproductive system, identify any existing disorders early stages when they do not appear clinically. When performing a smear, the following indicators are assessed:

leukocyte count;
number of epithelial cells;
presence of lactobacilli;
the presence of pathogenic microflora (Trichomonas, gonococci, fungi).

Flora smear - how to prepare?

In order for a gynecological smear to show the objective state of the reproductive system, it is necessary to follow a certain number of rules:

Avoid sexual intercourse 3 days before the procedure.
Do not use medicines local therapy - creams, vaginal suppositories.
If a woman does douching, the procedures are stopped for 1-2 days before taking a smear.
You are prohibited from urinating 2-3 hours before the test.
The procedure must be carried out almost immediately after menstruation - on the 4-5th day of the cycle.

How is a vaginal smear taken?

A smear for vaginal microflora is taken by a gynecologist. The woman sits in a gynecological chair. The doctor carefully places a speculum to gain access to the vaginal walls. The material is removed with a disposable, sterile spatula. The procedure itself is painless. The girl feels slight discomfort only at the moment of collecting the material.

The resulting vaginal smear is transferred to a glass slide. The sample is delivered to the laboratory. The laboratory technician examines the smears microscopically, counting the number of each type of cell, and enters the values in the conclusion. The woman receives the results of the procedure on the same day or after a few days. This depends on the workload of the laboratory and the number of material samples taken.

Gynecological smear - interpretation

A gynecological smear on the flora, which is interpreted exclusively by a doctor, helps determine the quantitative ratio of beneficial microorganisms to pathogenic ones. In conclusion, doctors use certain Latin abbreviations:

V – vagina. The numbers located next to this letter reflect the contents of this part of the reproductive system;
C (cervix) – cervix. The numbers indicate quantitative changes in the composition of microorganisms in this area;
U (urethra) – urethra.

In healthy women, only lactobacilli and single leukocytes are found in the smear. Coccal flora, red blood cells, and a large number of leukocytes indicate inflammatory processes in the reproductive system. So, when trichomonas are detected, doctors diagnose “trichomoniasis”; the presence of gonococci is a sign of a disease such as gonorrhea. Such results are an indication for further examination.

Gynecological smear is normal

When assessing a vaginal smear, the norm of which is set equally for all women, doctors pay attention to the following indicators:

1. Leukocytes. The norm of leukocytes in a gynecological smear is established as follows:

in the vagina - up to 10 cells in the field of view;
neck – 0-30;
urethra - up to 5 units in the field of view of the microscope.

2. Epithelial cells– in the results in all indicated positions they write “moderately”. When the values increase, they speak of an inflammatory process; a deficiency may indicate a decrease in estrogen concentration.

3. Slime:

vagina and cervix – moderate;
urethra – absent or moderate;

4. Gram-positive rods (gr.+):

vagina - a large number;
cervix – absent;
urethra – absent.

5. Gram-negative rods (gr.-)- absent everywhere. The presence indicates vaginal dysbiosis and inflammatory processes.

Leukocytes in a gynecological smear

Leukocytes in the vaginal smear are present in single quantities. With a significant increase in the number of these cells, the inflammatory process is excluded. To accurately establish the disease, additional diagnostic procedures are performed: pelvic ultrasound, blood and urine tests, blood tests for hormones. Among frequent illnesses, at which the concentration of leukocytes increases, it is necessary to highlight:

– the vaginal mucosa is inflamed;
– inflammation of the cervix;
urethritis - an inflammatory process in the urinary system;
– inflammation of the appendages;
– an inflammatory disorder in the uterus.

What are “clue cells” in a gynecological smear?

A gynecological smear examination involves counting key cells. This term is usually used to designate the cellular structures of squamous epithelium. Microorganisms are often located on their surface. Most often these are small sticks - gardnerella. They are classified as opportunistic - at low concentrations they do not cause pathology. However, their appearance in a smear is a signal for doctors to conduct further research. This condition is directly recorded in dysbacteriosis - a violation of the ratio of beneficial microorganisms to pathogenic ones.

Rods in a gynecological smear

Microscoping a gynecological smear for flora, the laboratory assistant also counts the number of rods. The basis of the total number of these cellular structures in the smear are lactobacilli - Doderlein bacilli. They are useful and form normal vaginal microflora. A decrease in their number indicates dysbacteriosis, requiring drug treatment.

By the purity you can judge the microflora, whether it is normal or pathogenic. There are 4 degrees in total, but only the first two are the norm.

Characteristic:

I degree. It is rare. The environment is acidic, pH=4-4.5. Leukocytes, Dederlein bacilli and other indicators are within the normal range.
II degree. The acidity of the vagina decreases, the pH increases to 5. This indicates that the flora is populated by a small number of pathogenic microorganisms. There is no inflammatory process, so leukocytes are not exceeded. The infection is at an early stage of development, so Candida and cocci fungi may appear.
III degree. An increase in pathogenic microflora is detected, but the number of lactobacilli is significantly reduced. The vaginal environment becomes alkaline, pH = 5-7. Epithelial cells indicate inflammation.
IV degree. The pH changes, it is 7-8. Leukocytes, mucus and other inclusions far exceed normal indicators. There are no lactobacilli, the flora is pathogenic.

Grades III and IV require treatment.

To assess the state of the microflora, the concept of “degree of vaginal cleanliness” is used.

1 degree of vaginal cleanliness

The first degree of vaginal cleanliness - this indicator indicates that the woman is completely healthy. The content of lactobacilli in the smear in this case reaches the norm of 95%.

Single squamous epithelial cells may be present, and the vaginal pH is acidic. Pathogenic microorganisms and leukocytes are absent.

Level 2 vaginal cleanliness

With the second degree of vaginal cleanliness, the smear reveals 80-95% lactobacilli and a small number of opportunistic microorganisms, as well as single epithelial cells (no more than 5) and leukocytes (no more than 10) and epithelial cells, the pH of the vagina is acidic.

The second degree is typical for most healthy women and, like the first, is considered the norm.
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3 degree of vaginal cleanliness

With the third degree of vaginal cleanliness, the smear contains more opportunistic microorganisms than lactobacilli, and this indicates the presence of an inflammatory process, the pH of the vagina is alkaline or neutral.

The smear reveals leukocytes (10 – 30) and epithelial cells. A woman may be bothered by pathological discharge, itching and burning in an intimate place.

4 degree of vaginal cleanliness

The fourth degree of vaginal purity - this means that the analysis revealed a lot of pathogenic bacterial flora, leukocytes (more than 50) and epithelial cells (more than 15 - 20) with a small number of Doderlein rods, the vaginal environment is strongly shifted to the alkaline side.

In some patients, lactobacilli are not detected at all. This condition indicates the development of bacterial vaginosis or another infectious and inflammatory disease.

The woman has clear symptoms of an infectious disease.
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With the third and fourth degree of vaginal cleanliness, drug treatment with broad-spectrum antibiotics is required. Antibacterial therapy is prescribed taking into account the sensitivity of pathogenic microorganisms.

Interpretation of smear results for flora in women

It's no secret that with the development of technology, medicine and the improvement in the quality of life, the number of various diseases not only does not decrease, but is constantly growing.

To date infectious diseases Every fifth person suffers from the reproductive system, and often a person finds out about the disease too late. That is why doctors strongly recommend using contraceptives and regularly undergoing tests for hidden infections.

Smear for infections: purpose

A smear for infection has important, as it can reveal hidden diseases