Leukocytes 1 2 in a smear. Leukocytes in a smear for flora during pregnancy

In this article, we will find out what the norm of leukocytes in a woman’s smear should be.

Leukocyte level in smear

A smear to determine microflora is one of the main and most effective methods complex diagnostics various diseases female genitourinary system.

For workers in certain manufacturing industries, as well as pregnant women, this smear is mandatory.

Carrying out this laboratory analysis makes it possible to identify a woman's early stages development of quite serious diseases, and timely prescribe and carry out the necessary drug treatment.

Normal in an adult healthy woman the level of leukocytes in the smear should not exceed 14-15 units in the field of view. A slight increase in leukocytes may occur before and during menstrual cycle, when the indicator can reach 18-20 units.

For a pregnant woman, too, general content leukocytes in the smear are significantly higher than normal, and may be more than 16-22 units per field of view (this is normal).

With a significant increase in the level of leukocytes above normal, this may cause the development of some kind of acute or chronic inflammatory process in the female genitourinary system, which requires additional, comprehensive examination body.

As a rule, in older women, the total content of leukocytes in the smear may be very low or completely absent, as gradual atrophy of the vaginal tissue occurs.

The level of leukocytes in a smear in women can periodically fluctuate, which can be primarily influenced by hormonal changes, age, general state immunity, presence bad habits(smoking, alcoholism), menstrual cycle, intake medicines, stressful situations, therefore, when assessing the main results of a smear, it is necessary to take into account these influencing factors.

Main indications for a flora smear

• long-term painful sensations lower abdomen (periodic, constant, cramping) for 3-5 days or more;
• abundant vaginal discharge, the cause of which may be acute inflammatory processes (endometritis, colpitis, urethritis, etc.) requiring complex antibacterial treatment;
• infertility (carried out as additional method diagnostics to determine the microflora of a woman’s vagina, the presence of an infection in which may cause infertility);
• preventive examinations (recommended annually);
• frequent vaginal itching and burning in the female genital area;
• pregnancy planning.

How to properly prepare for a smear test?

• 1-2 days before the analysis, you need to completely eliminate any douching internal cavity vagina;
• it is temporarily recommended to limit possible sexual contacts;
• it is advisable not to empty the bladder 1.5-2 hours before the laboratory test;
• you should temporarily limit the intake of various vaginal medications (suppositories, tablets, ointments);
• Before performing a smear, it is strictly contraindicated to wash the genitals with various hygiene products(you are allowed to wash yourself only if you don’t big amount warm water).

Elevated leukocytes in the smear

Most common reasons elevated levels of leukocytes in a smear are:

• spicy or chronic endometritis(an inflammatory process that affects the mucous membrane of the uterus);
• urethritis - inflammation of the mucous membrane urethra;
• genitourinary infection (syphilis, genital herpes, gonorrhea);
• vulvovaginitis (inflammation of the mucous membrane of the vagina and vulva);
• adnexitis - inflammatory process of the uterine appendages;
• colpitis is an acute or chronic inflammatory process that affects the mucous membrane of the vaginal walls;
• intestinal or vaginal dysbiosis;
• the presence of an oncological (malignant) neoplasm (tumor) in the woman’s genital organs.

Every woman under 45-50 years of age is recommended at least 1 r. take a gynecological smear per year for flora, and for older women it is advisable to undergo this examination at least 1-2 times. per year, since today total serious illnesses The female genitourinary system is increasingly increasing.

Flora smear- a test often prescribed by gynecologists. What does it show and what misconceptions exist about it?

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

What exactly is the name of the analysis:

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

Used to diagnose infectious and inflammatory processes. Bacterioscopy allows you to detect bacteria in a woman’s genital organs: protozoan microorganisms - gonococci, which cause gonorrhea, Trichomonas - the causative agent of trichomoniasis. Also, a specialist will see through a microscope some bacteria, fungi (Candida), key cells(a sign of bacterial vaginosis). The type of microorganism is determined by its shape, size, and whether it is stained with a dye or not, that is, whether 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 there are, the more pronounced the inflammatory process. The amount of epithelium and mucus is assessed. especially in women reproductive age during ovulation - in the middle of the menstrual cycle.

Microscopic examination of the discharge of the 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(previously 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 - bacterial culture is performed.

Reasons for performing culture in gynecology

1. If the smear shows moderate or a large number of leukocytes, but the causative agent of the infection is unknown. Since with microscopy there is a lower limit for the detection of microorganisms: 10 to 4 - 10 to 5 degrees.
2. If a microbe is identified, to determine its sensitivity to antibiotics.
3. If there are signs of a fungal infection. To accurately determine the type of fungi and prescribe an effective antimycotic drug.

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

   Other types of Candida fungi may not be treated if not pathological symptoms.

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

What are the differences between bacterial culture, flora smear and degree of vaginal cleanliness?

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

That is, if we're talking about about the express analysis, you will be given a conclusion only about 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 assesses the relationship between normal, opportunistic and pathogenic microflora.

Classic assessment of vaginal cleanliness.

Updated table

What doctors don't see with microscopy

1. Pregnancy. To determine it, a smear is not needed and it does not matter what result it shows. It is necessary to take a blood test for hCG, undergo gynecological examination see a doctor or do an ultrasound of the uterus. Can be determined human chorionic gonadotropin in urine, but not in genital discharge!
2. Cancer of the uterus and cervix. To diagnose 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 diagnosed based on the results cytological examination. This analysis is taken directly from the cervix, from the transformation zone, using a certain method 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 using the PCR method. And it is impossible to determine the presence of the immunodeficiency virus from 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 obtain reliable result smear, 48 hours before taking it you cannot:

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

You need to take smears outside 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 probably be bad - a large number of leukocytes will be detected.

There are no prohibitions regarding drinking alcohol.

Is it possible to take a smear while taking antibiotics or immediately after treatment? It is not advisable to do this within 10 days after use. local action medications (vaginal) and one month after taking antibacterial agents inside.

Microscopic examination is prescribed:

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

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

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

Epithelium - quantity epithelial cells not considered, since it has no diagnostic value. But too scanty an amount of epithelium indicates an atrophic type of smear - which happens in women during menopause.

Leukocytes - counted in the “field of view”:

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

Mucus (mucus strands)- should be present normally, but a large amount occurs during inflammation. There should be no mucus in the urethra.

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

Trichomonas, gonococci and key cells in a healthy woman there should not be any in the cervix and vagina. Candida is also normally absent. By at least, V significant amount, which is detected during flora analysis.

The usefulness of the smear is not great. But if a woman is admitted to the hospital, then right there, at initial examination on the chair, take a fresh one.

Results are usually valid for 7-14 days. Therefore, if you need to take it before surgery, do it 3 days before entering the hospital. The last of the prescribed tests.

What is found in bacterial culture

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 by “crosses”:

• “+” – small amount;
• “++” – moderate amount;
• “+++” – large quantity;
• “++++” – abundant flora.

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

Below we describe other common terms that appear in research results or you may hear from your 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, is usually treated similarly to thrush.

Diphtheroids are opportunistic microorganisms; according to the results of scientific research, in most women about 10% of the microflora consists of them, as well as streptococci, staphylococci, coli, gardnerella. If the flora is disturbed, their number increases.

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

Enterococcus (Enterococcus)- representatives intestinal microflora, which sometimes end up in the vagina. Gram-positive cocci. We are talking about Enterococcus faecalis. There is also enterococcus coli - E. coli. Usually cause unpleasant symptoms at concentrations above 10 to the 4th power.

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

Polymorphic rod- a common representative of the vaginal biocenosis. If the number of leukocytes is normal and there are no complaints, its presence should not be alarming.

Red blood cells - may be present in small quantities in the smear, especially if it was taken during an inflammatory process or when there was slight bleeding.

Coccus or coccobacillary flora- usually happens when infectious process in the vagina or cervix. If a woman has complaints, it is required antibacterial treatment- sanitization of the vagina.

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

And in conclusion, here are the common abbreviations that are written on test results forms:

• L – leukocytes;
• Ep – epithelium;
• Pl. ep. - flat epithelium;
• Gn (gn) – gonococcus, the causative agent of gonorrhea;
• Trich is a trichomonas, the causative agent of trichomoniasis.

All representatives of the fair sex sooner or later have to consult a gynecologist. Experts recommend undergoing an appropriate examination once a year. However, if pathological symptoms are detected or lifestyle changes are made, this should be done even more often. This article will tell you about leukocytes in a smear. The norm in women is determined in more cases. However, there are exceptions. Analysis of some representatives of the fair sex may show deviations. This will also be mentioned below.

Flora smear

To begin with, it is worth saying that this analysis is one of the simplest and most inexpensive. With its help, the doctor can say that the fair sex is healthy or has any diseases. Leukocytes in the smear must be examined. The norm for women is not always determined. Sometimes there may be an increase in the level of white cells.

A smear test for flora is given at every visit to the gynecologist. That's why if you go to to this specialist, you should be prepared for such an analysis.

normal for women

The normal result of this analysis is found when the woman is completely healthy. Material is collected to determine the number of white cells from three places: the vagina, cervix and urethra. How many leukocytes should there be in a smear (normal for women)?

In fact, doctors may classify vaginal cleanliness into several grades. Moreover, each of them has its own normal generally accepted values. Let's consider each of known to medicine degrees of vaginal cleanliness.

First degree: clean vagina

In this case, leukocytes in the smear (the norm for women is 1-3 in the field of view) may be completely absent. Sometimes the laboratory technician notes the presence of single white bodies. This suggests that there is no inflammatory process in the examined areas. In addition to leukocytes, lactobacilli and other microorganisms are present in the vagina.

Second degree of purity

The following indicators fall into this category. The laboratory technician detects leukocytes in the smear (the norm in women is exceeded, there are up to 15 of them in the field of view). In addition to this, there are beneficial microorganisms and bacteria. In some cases, the number of the latter may be reduced. Most often, such indicators are considered normal. Sometimes the doctor may ask the patient to retake the test, since an increase in white cells may be a consequence improper hygiene and violations during material collection.

Third degree and dysbiosis

In this subspecies, leukocytes are also detected in the smear. The norm for women before or after menstruation (with the third degree of vaginal cleanliness) is exceeded (up to 50 units). At the same time, additional indicators can also often be overestimated or underestimated.

In this case, the woman requires treatment. Since such white bodies indicate the presence of an inflammatory process.

Fourth degree of purity: vaginitis

This subgroup is the last. When examining the material, leukocytes are determined in the smear. The norm in women after menstruation or before them with vaginitis is exceeded (more than 50 units). Pathological indicators of additional cells are also noted. Most often, bacteria and fungi are present in this case.

A woman with fourth degree purity always needs treatment. Most often, the pathology is caused by a sexually transmitted infection.

Leukocytes in a smear for flora during pregnancy

When registering a pregnant woman, this test is always taken. The study is also carried out before childbirth. Leukocytes must be detected in the smear. The norm for women during pregnancy corresponds to the indicator of the first degree of vaginal cleanliness. Thus, during pregnancy, white cells should not exceed 1-3 in the field of view.

Some doctors admit normal values within 15 units. In this case, the woman’s microflora corresponds to the second degree. However, there are doctors who, in this case, insist on additional research.

Deviations from normal values

So, now you know the quantity of leukocytes in a smear (the norm in women). The norm is not always absolute. It is worth noting that the third and fourth degrees of vaginal cleanliness are a deviation from generally accepted values. Treatment in this case must be carried out after additional research. There are several reasons why there is an increase in white blood cells in the vagina, or urethra.

Viral infection

If a woman has a cold or catches viral infection, then it may be present on all mucous membranes slight increase number of white cells. That is why it is worth warning the doctor about your illness or even rescheduling the test.

Sexually transmitted diseases

In the presence of gonorrhea, syphilis, trichomoniasis and other ailments, an increase in the level of leukocytes in the smear is observed. In this case, the number of white bodies will be large in all sources of material collection. In this case it is worth passing additional tests and find out what is the cause of the pathology.

Inflammation of the urinary system

In some cases of infection urinary tract may cause an increase in leukocytes in the smear. It is worth noting that the number of white bodies is increased only in the urethra. Determined in the vagina and cervix normal amount leukocytes.

Inflammation of the uterus and appendages

Diseases such as endometritis, adnexitis, salpingitis and metritis can increase the level of leukocytes. Most often, pathology is detected in the cervix and vagina. gives normal results number of leukocytes.

It is worth noting that the more acute the inflammatory process, the greater the number of white cells will be detected. In the event that the disease becomes chronic form, the level of leukocytes decreases to normal values.

Poor hygiene

A pathological number of white cells can be detected when improper preparation for the test is carried out. If the genitals have not been washed, the number of bacteria may be higher. This is why it is so important to properly prepare for a visit to a gynecologist and undergo such tests.

Conclusion

Now you know what number of leukocytes in a smear is considered normal. However, you should not decipher the results yourself. Consult a doctor and get the correct conclusion and, if necessary, treatment.

Get tested on time and be healthy!

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In gynecological practice, this diagnostic method, such as a smear, is used very widely and is used often. This is one of the main standard procedures that helps assess the condition of the reproductive system organs in women.

Of course, absolutely all pathologies cannot be identified using this diagnostic method, but at least many of them can be suspected based on the smear results. That is why analysis is paramount: it allows you to determine the course of further diagnostics, select deeper and informative methods research.

What do you pay attention to when deciphering an analysis?

Analysis of the smear allows you to evaluate the following indicators: leukocytes, squamous epithelial cells, key cells, mucus in the biomaterial, as well as the content of normal, pathogenic and conditionally pathogenic flora. The last category includes yeast of the genus Candida. Among pathogenic microorganisms, trichomonas and gonococci can be detected using a flora smear.

A very important diagnostic indicator is the leukocyte count. These cells immune system protect the body from foreign agents, be it microorganisms or destroyed or altered structural elements.

It is leukocytes or white blood cells that rush to the pathological focus of inflammation in the body, wherever it is. And if pathology develops in the organs of the reproductive system, these cells will go there.

In women, leukocytes are always present in a smear for flora, and their norm is a rather arbitrary concept. The point is that in different areas their genitourinary system permissible value varies. Most white blood cells are in the cervical area; their lowest content is normally observed in the urethra.

However, to diagnose inflammatory processes, it is important to evaluate not so much the number of leukocytes as their morphology. This is due to the fact that white blood cells, which have fulfilled their function of “cleansing” the body of pathogens, are destroyed. Such leukocytes are called neutrophils.

• Accordingly, the more of them in the smear, the stronger the inflammatory reaction.

In addition, it is important to take into account the fact that the concentration of whites blood cells changes during the menstrual cycle under the influence of sex hormones, so if leukocytes in a smear are slightly elevated, this is not necessarily a sign of a serious pathology.

In any case, the content of these cells should only be assessed in conjunction with other diagnostic criteria: composition of normal flora and opportunistic microorganisms, the presence or absence of pathogenic bacteria, the number of epithelial and key cells.

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 assessed, but the norms of some of them differ depending on the area of ​​localization. Below is a table explaining the normal content of leukocytes, normal and pathogenic flora, cellular elements and mucus in a smear in women.

A smear that fully corresponds to the normal parameters is a rather rare phenomenon. However, minor deviations from the norm are allowed when it comes to the vagina. The urethra and cervix, if there are no pathologies, must be sterile - there should be no microflora there. Regarding the vagina, the situation is ambiguous.

Depending on the content of various microorganisms, there are 4 degrees of purity.

An ideal smear, free of leukocytes and pathogenic flora, corresponds to the first. However most of women cannot boast of such results. Often, individual leukocytes are found in the vaginal discharge within the normal range (up to 10 pcs.), an insignificant content of epithelial cells and opportunistic bacteria. This picture is not characterized as pathological, and the smear belongs to the second degree of purity.

If gram-variable coccal flora, gram-negative bacilli or yeast cells are detected in the vaginal discharge against the background of a decrease in the concentration of lactobacilli and bifidobacteria (Doderlein bacilli), this is a reason for further diagnosis. Such a smear is classified as the third degree of purity. White blood cells in it exceed the norm, and also contain a lot of mucus.

In a smear of the fourth degree of purity, there are very few or no Doderlein rods (normal flora), leukocytes cover the entire field of view, the content of mucus and epithelial cells is increased. In addition, pathogenic microorganisms are found in large numbers. This condition requires prompt treatment.

Causes of elevated white blood cells in a smear

If a woman’s smear has elevated leukocytes, the reasons for this are related to inflammatory processes. The greater the concentration of these cells, the more pronounced the process. However, this indicator must be assessed in conjunction with other diagnostic aspects.

For example, an increase in mucus content is observed with the development of infections. This is how the body strives to “cleanse itself” of pathogens. An increase in the number of epithelial cells, as well as leukocytes, warns of inflammation.

According to some laboratories, the content of these elements up to 10 in the field of view is allowed, but this indicator varies depending on the phase of the menstrual cycle and interpret its values ​​without regard to others diagnostic signs do not do it.

Key cells are epithelial cells dotted with Gardnerella bacteria. This is the so-called “bacterial sand”. If such cells are detected in a smear, there is a high probability of developing bacterial vaginosis (gardnerellosis).

The detection of a large number of candida in a smear against the background of suppression of normal flora is a sign of thrush. This is due to the fact that when the concentration of Doderlein rods, which produce lactic acid, decreases, the pH of the vagina increases.

This condition leads to the active growth of opportunistic flora, including candida. IN acidic environment these microorganisms cannot reproduce, and thus bifidobacteria and lactobacilli inhibit the process of colonization of the vagina.

Gonococci and Trichomonas are pathogenic microorganisms. Under no circumstances should they be in the smear. The detection of these bacteria signals the development of gonorrhea or trichomoniasis.

Conception triggers a cascade of processes in a woman’s body, and for them all to proceed smoothly, balanced work is important endocrine organs producing hormones. Changing their balance causes powerful changes in the functioning of organs and systems.

Thus, sex hormones - progesterone and estrogens - stimulate the work of squamous epithelial cells. They begin to actively synthesize glycogen, which supports the reproduction of normal flora. By destroying this connection, Doderlein's bacilli produce large amounts of lactic acid, which acidifies the environment, and thereby provide protection against infections.

However, given the physiological decrease in immunity during pregnancy, this measure is often not enough. Many expectant mothers, when the balance of hormones changes, begin to suffer from thrush or other pathologies caused by opportunistic microorganisms.

Against this background, the smear marks increased content leukocytes. Often the concentration of such cells in the vagina of pregnant women exceeds the norm - up to 10 pieces. in one field of view.

• If their content is no more than 15-20, and the expectant mother does not experience any signs of pathology, and the rest of the smear indicators are normal, there is no need to worry.

It is important to note that the concentration of leukocytes in the urethra and cervix should not change. The norms for these indicators are the same as for non-pregnant women. Elevated white blood cells in the urethra - a sign of inflammation. This condition requires diagnosis and treatment.

During pregnancy, the leukocyte count should be monitored especially carefully, as it warns of the manifestation of pathologies chronic course. It is better for the expectant mother to undergo an examination once again.

Proper preparation for a smear test

Like most diagnostic studies in medicine, a smear on flora requires preparation. When going to the gynecologist, a woman should remember that the test result will be reliable only if the following recommendations are followed:

• maintain sexual rest for at least 2 days before donating the biomaterial;
• stop using lubricants, vaginal suppositories, creams on the eve of the study;
• do not wash your face using gels or other intimate hygiene products;
• refrain from taking a test after a course of antibiotics (at least 10 days);
• do not urinate less than 2 hours before visiting a gynecologist;
• Do not get tested during menstruation.

Intimacy, by any means local application, antibiotics distort data about the real state of the microbial biocenosis of the genitourinary system in a woman.

During urination, diagnostically significant objects of study are washed away: cellular elements, microorganisms, which also changes big picture. Menstruation makes it more difficult to obtain material for diagnosis - it will be “contaminated” with a large number of red blood cells.

Indications for taking a smear

A smear in women involves taking biomaterial not only from the vaginal mucosa. Samples for analysis are also taken from the urethra and cervix.

This diagnostic procedure After the start of sexual activity, every woman should undergo regular testing: at least once a year. Except preventive examinations, a smear should also be taken during pregnancy. If there are no alarming symptoms, to the expectant mother you will have to go through this procedure twice: at the very beginning of pregnancy when registering and in the third trimester, after 30 weeks.

However, a compelling reason To take a smear test, any woman, whether pregnant or not, has the following symptoms:

• change in color and consistency of discharge;
• the appearance of discomfort when urinating;
• itching in the groin area;
• unpleasant odor of discharge;
• burning sensation in the vagina;
• abdominal pain at rest or during intimacy.

In addition, it should be remembered that long-term treatment antibiotics can affect the vaginal microflora in a negative way: cause death beneficial bacteria, which will be replaced by opportunistic inhabitants. Against this background, candidiasis and bacterial vaginosis often develop and can be diagnosed using a smear on the flora. That is why it is advisable to take such an analysis after completing a course of antibiotic therapy.

NORMAL AND INCREASED NUMBER OF LEUKOCYTES IN THE smear

Leukocytes in a smear - the norm is up to 15 units in the field of view (in the urethra up to 5, in the vagina up to 10 and in the cervix up to 15 units in the field of view). In particular, as soon as a woman registers for pregnancy, she needs to take the first test to determine leukocytes in a smear. Leukocytes in a smear in pregnant women are determined repeatedly during pregnancy. The first analysis is performed when registering for pregnancy.

The number of leukocytes in a smear increases sharply with inflammation of the vagina (colpitis, vaginitis). The more leukocytes in the smear, the more acute the disease. In case of acute inflammation, the leukocyte value of a gynecological smear will be “up to 100 leukocytes in the field of view” or “leukocytes cover the entire field of view.” One of the most important indicators of this analysis is leukocytes in the smear, which indicate the presence of inflammation. Also, an increased content of leukocytes in the smear may be associated with infectious diseases sexually transmitted diseases.

WHEN LEUCOCYTES IN A Smear are Elevated

Leukocytes are considered one of the most important indicators in medicine. In the field of view in a smear, there should normally be no more than 15 leukocytes. An increase in the number of leukocytes in a smear analysis, as mentioned above, is usually associated with an inflammatory process. Under what pathological conditions in gynecology are leukocytes in the smear increased?

If the leukocytes in the smear are elevated, then this may indicate colpitis or vaginitis - the most common diseases of the vagina. Most often, leukocytes in a smear are elevated in diseases such as:

• Colpitis - inflammation of the vaginal mucosa,
• Cervicitis - inflammation of the cervical (cervical) canal,

Urethritis - inflammation of the urethra (urethra),

• Endometritis - inflammation of the uterine mucosa,
• Adnexitis - inflammation of the uterine appendages (ovaries, tubes),
• Oncological diseases of the genital organs,
• Sexually transmitted infections (gonorrhea, chlamydia, syphilis, etc.)
• Vaginal dysbiosis,
• Intestinal dysbiosis.

To clarify the reason for the increase in leukocytes in the smear, it is necessary to carry out an appropriate laboratory examinations- pass PCR tests and cultures. Based on the results of the diagnosis, the gynecologist individually selects a treatment regimen for the inflammatory process or recommends consultations with relevant specialists. In both women and men, the doctor takes a smear of the flora with a special sterile spatula or gauze swab.

Rarely, a situation occurs when treatment is carried out, but leukocytes in the smear remain elevated. This is one of the most difficult problems to solve. It seems that the increase in leukocytes in the smear in such cases is associated with dysbiosis at the level of the vagina and cervix. Even multiple courses of antibiotic therapy often do not help; infections after treatment with antibiotics may also not be detected. And the leukocytes in the smear are elevated and remain at a high level.