Leukocytes and epithelium in a smear. Norm and increased number of leukocytes in a smear

Before deciding what is elevated white blood cells in a smear in women, the causes of the appearance and ways to reduce them, it is necessary to understand some medical and anatomical terms.

Leukocytes are colorless blood cells that differ in appearance and the functional purpose of the human cellular blood structure. The main functional purpose of leukocytes is to protect the body from internal and external pathogenic agents. Mandatory testing of the general state of the microflora in the body of a woman with gynecological examination, is laboratory sample, or a smear from the vagina, according to the results of which it is possible to determine an increased number of leukocytes in a smear or, conversely, their normal number.

What does it mean - leukocytes in a smear are increased?

Reasons for a woman increased amount leukocytes at laboratory research may vary from physiological changes in the body, for example, associated with pregnancy, and ending with diseases caused by infectious and / or viral pathogens. Here are just some of the possible causal factors that determine elevated white blood cells in a smear:

1. The result of bacterial infection:

• chlamydia;
• gonorrhea;
• tuberculosis of the female genital tract;
• syphilis;
• inguinal granuloma;
• urogenital mycoplasmosis.

2. Protozoal infection, for example, trichomoniasis caused by an infectious vaginal pathogen - Trichomonas.

3. Viral infection:

• cytomegalovirus;
• papillomavirus;
• genital herpes.

4. Fungal infections:

• actinomycetes;
• candidiasis, or thrush and others.

Among other reasons that determine elevated leukocytes in a smear in women are:

• bacterial vaginosis, or vaginal dysbacteriosis;
• irritation of the organ of the reproductive system as a result of mechanical, thermal or chemical damage, violation of general sanitary and hygienic standards, as well as in some somatic conditions of the body, for example, diabetes, diseases urinary tract, kidney disease, hepatitis and other pathological conditions;
• allergic to dosage forms in vaginal douching, lubricants, and in some cases on male sperm.

As you can see, the palette of various causal factors that determine that the leukocytes in the smear are elevated is quite extensive.

The norm of leukocytes in a smear

Vaginal microflora is determined by special laboratory testing. When deciphering the analysis for a smear, leukocytes, the norm for women of which is no more than 15 units, it is most convenient to use special table, which allows you to give a more informative picture of the general state of the microflora of the female reproductive organ. For convenience, use the following notation:

• C - smear from the mucous membrane of the uterine cervical canal;
• V - a smear taken from the mucous membrane of the female vagina;
• U - a smear that determines the condition of the mucous membrane of the urethra, or urethra.

Leukocytes in a smear, the norm in women (table for example):

A lot of leukocytes in a smear, that is, an excess of 15 units, indicates the presence of inflammatory processes in the vagina associated with a violation of its microflora. This symptomatic sign needs to be investigated further, through a more thorough diagnosis. A slight deviation from the norm can be observed during the premenstrual cycle. A separate category is pregnant women.

A gynecological smear is a mandatory procedure for examination physiological state women during pregnancy. It can be definitely said that in a laboratory study, leukocytes in a smear during pregnancy are determined with a significant change in their functional tasks. Immune protection at this time in a woman is weakened, and accordingly defensive reactions organism are minimized, which is hidden threat before various infectious lesions organism. The permissible concentration of leukocytes in a smear of a pregnant woman should not exceed 20 units.

If after laboratory examination it was determined that there are a lot of leukocytes in the smear, what does this mean, and how to proceed in the future? Depending on the physiological state of the woman, taking into account all individual characteristics and contraindications, the observing gynecologist determines the causes of this condition and selects the appropriate method for further treatment. If leukocytes are found entirely in a smear of a pregnant woman, then special additional examination on the polymerase chain reaction (PCR), which will determine the presence of infectious pathogens with maximum accuracy.

What to do and how to treat?

A gynecological vaginal smear was taken, leukocytes were increased, what does this mean for a woman, and how to react in the future? First of all, do not panic, but surrender to qualified specialists who will conduct an adequate diagnosis and select the appropriate treatment. Exist various ways therapeutic impact to this clinical problem. At the initial stage, it is determined general state health of a woman, or the duration of her pregnancy, the sensitivity and reaction of microorganisms to medicines and so on.

With thrush, effective use antifungal agents medical impact. Preference is given to the following pharmacological combinations:

• sertaconazole;
• nystatin;
• pimafucin and others.

If gonorrhea is diagnosed, then pharmacological preparations antibacterial action, such as:

• erythromycin;
• cefixime;
• ceftriaxone;
• azithromycin and other drugs.

Syphilis in women is a particularly complex disease that is most dangerous during pregnancy. The main "fighters" with the disease are pharmacological agents from penicillin group. For pregnant women, the treatment of syphilis is provided by the method of specific therapy, which takes place in several stages.

Antiviral drug combinations have proven themselves well in the treatment of genital herpes.

How can traditional medicine help?

In addition to the official medical treatment, with a decrease in the number of leukocytes in a smear, does an excellent job, and, ethnoscience. All the recipes of alternative treatment described below can be carried out at home, in agreement with the attending physician. The only limitation is the reaction of the woman's body to one or another remedy in terms of allergic indicators, since everything folk recipes based on the use of various medicinal herbs and fees.

Recipe number 1. Two tablespoons of dry chamomile are poured into 500 ml of water and brought to a boil. Vaginal douching, can be started at a temperature herbal decoction no more than 37ºС. This method of treatment can be compared with a solution of furacilin prescribed by a doctor as a prophylaxis. All medical procedure It is recommended to take it twice a day, in the morning and in the evening before going to bed.

Recipe number 2. In absolutely equal proportions, bee honey and aloe juice are mixed. Having moistened a cotton swab in such a solution, it is necessary to further introduce it into the vagina. Experience suggests that after 5-7 days of daily two-time treatment, the number of leukocytes at the second examination is significantly reduced.

• chamomile (dry);
• St. John's wort;
• oak bark (pharmacy);
• red root;
• nettle.

All prepared medicinal components are taken in equal proportions, one tablespoon each, and poured with boiling water in an amount of 500 ml. The entire broth is cooled to an acceptable temperature for the body and the douching procedure can begin. After two weeks of daily treatment (once a day), some improvement in the state of the microflora is noticeable in laboratory testing.

Recipe number 4. Excellent prophylactic, will become brewed lime blossom tea. It will take one tablespoon of medicinal raw materials per glass of boiling water. After filtering, it is recommended to drink this tea at least 2-3 times a day.

Recipe number 5. You can reduce the number of leukocytes with the help of oats. To do this, you need two tablespoons of unpeeled oats and two cups of boiling water. After infusing for 15 minutes, remedy ready. It remains only to strain the broth and drink ½ cup 3 times a day. The course of treatment is designed for at least 30-40 days, after which it is recommended to undergo a second examination.

Recipe number 6. Normalize the level of leukocytes, will help herbal collection, which includes:

• strawberries - 2 tablespoons;
• nettle leaves - 30 g;
• rose hips - 50 g;
• nettle leaves - 50 g.

All ingredients are crushed, poured with half a liter of boiling water, and infused for 1.5 hours. After straining, take half a glass 3 times a day. The course of treatment is 2-3 weeks.

You can also boost your immunity with the help of some foods:

• natural honey;
• citrus fruits (lemon, grapefruit and others);
• blackcurrant, raspberries, apples, mountain ash, cranberries, blueberries;
• wheat germ, peppers, cabbage, tomatoes, beets.

However, it is worth warning that it is unlikely that it will be possible to reduce the number of leukocytes only with the help of folk remedies. Should be prioritized traditional methods official medicine which will hold adequate treatment, with appropriate diagnosis and general clinical condition female patients.

Laboratory diagnostic methods in obstetrics and gynecology - an important component of health assessment female body.

Among their diversity, a simple smear on the flora has stood apart for many decades.

Its other names: smear on the degree of purity, smear on GN, gynecological smear, bacterioscopy of discharge urinary organs, microscopy of discharge from the urethra, vagina and cervix.

This study allows you to evaluate the composition of the microflora, count the number of leukocytes and epithelial cells, and also diagnose some STDs (gonorrhea, trichomoniasis).

It is routine, non-invasive, economical and sufficient informative method widely used in the work of a gynecologist.

Based on its results, the doctor has the opportunity to determine further tactics for managing the patient and prescribe the appropriate treatment.

When is the analysis performed?

As a rule, a smear on the flora is taken at any initial visit of a woman to a gynecologist.

Also indications for taking a smear and its subsequent microscopy are:

1. 1 Planned preventive examinations and dispensary.
2. 2 Pathological leucorrhea (discharge of the vagina, cervix, urethra), their unpleasant smell, abundant character, discoloration.
3. 3 Preconception preparation in the framework of planning natural and IVF-induced pregnancy.
4. 4 Screening during pregnancy.
5. 5 Unpleasant, painful sensations in the lower abdomen, which a woman does not associate with the menstrual cycle.
6. 6 Painful urination, dysuria, including symptoms of urethritis, cystitis. Urological pathology in women, as a rule, requires consultation and examination by a gynecologist.
7. 7 The end of the course of antibiotics in order to determine the nature of the flora and the possibilities of its restoration.

2. Collection of material for research

Taking a gynecological smear is possible from three points: the urethra (if necessary), the posterolateral fornix of the vagina and the vaginal part of the cervix.

The material for analysis is vaginal discharge, selections from cervical canal, separated from the urethra (according to indications).

Vaginal secretions are multicomponent, they include:

1. 1 Mucus of the cervical canal - is needed for the penetration of spermatozoa into the uterine cavity and above for fertilization. Its density depends on the level of estrogen in the body of a woman; its viscosity can be used to judge the phase of the menstrual cycle.
2. 2 The secret of the glands of the external genital organs.
3. 3 Desquamated epithelium of the vagina.
4. 4 Bacteria (vaginal flora). Normally, the microflora in the smear is represented by a large number of lactic acid bacteria (gram-positive Doderlein rods) and a small amount of conditionally pathogenic flora (most often coccal).

2.1. Preparing for a swab collection

Before taking the material, a woman must meet certain conditions:

1. 1 It is better to take the analysis for 5-7 days. the fence separated is not carried out.
2. 2 Exclude the use of vaginal suppositories, lubricants, douching and sexual intercourse 24 hours before the study.
3. 3 Before taking a smear, you do not need to use scented products for intimate hygiene, the toilet of the external genitalia is best done with running water.
4. 4 Undesirable to take hot bath on the day of the analysis.

2.2. Technique for obtaining material

• A smear on the flora is taken strictly before the bimanual examination, the woman is on the gynecological chair.
• A bicuspid Cusco-type speculum is inserted into the vagina, exposed (removed) vaginal part cervix.
• Focusing on it, the doctor with a special spatula takes material from the posterolateral fornix of the vagina and transfers it to a glass slide, which, after filling the direction, is delivered to the laboratory for microscopic examination.
• Analysis from the external opening of the urethra is taken with a bacteriological loop or a Volkmann spoon. If available, it is advisable to take them, slightly pressing on the outer hole from the outside.
• Analysis from the surface of the vaginal part of the cervix is ​​taken with an Erb spatula.

3. How to decipher the results?

3.1. normal flora

Recently normal composition vaginal microflora began to be given Special attention, since it has been proven that it is this factor that determines the reproductive health of a woman, provides local immunity, protection against pathogenic bacteria, and the normal onset and course of pregnancy.

Normally, 95% of the flora in a woman is lactic acid bacteria (otherwise Doderlein sticks, lactobacilli, lactobacilli).

In the course of their vital activity, lactobacilli process glycogen released from epithelial cells, with the formation of lactic acid. It is she who provides the acidic environment of the vaginal contents, which prevents the reproduction of facultative and pathogenic flora.

Every woman has 1-4 types of lactobacilli in her vagina, and their combination is purely individual.

When deciphering the results of the analysis, it is impossible to carry out detailed analysis vaginal microflora, the laboratory assistant evaluates only the ratio of rods and cocci.

The absence of cocci and a large number of gram-positive rod flora (++++) are equated to 1 degree of purity of the vagina. This is observed quite rarely, this situation is more typical for control smears after vaginal sanitation or antibiotics.

A small amount of cocci (+, ++) is considered normal and indicates a 2nd degree of purity, but only if rod flora (++, +++) is also found. This is a good smear.

It is considered pathological (+++, ++++) against the background of a decrease in the number of rods (+, ++). This result is called the 3rd degree of purity of the vagina. This situation requires a detailed examination.

A large number of cocci (++++) and the complete absence of gram-positive rods (Gram + rods) in the smear indicate 4 degrees of purity. In this case, the woman needs mandatory treatment.

Table 1 - Normal indicators evaluated when deciphering the results of smear microscopy for flora and GN. Click on the table to view

3.2. Gonococci and Trichomonas (Gn, Tr)

3.7. Yeast-like mushrooms

- single-celled microorganisms of a rounded shape. The vaginal environment is ideal for their growth and development through high content glycogen.

But due to the competing lactobacillus flora with normal level immunity of their active growth is not observed. For the acquisition of pathogenic properties by fungi of the genus Candida, certain conditions are necessary:

1. 1 State of immunosuppression,
2. 2 The presence of endocrine pathology,
3. 3 Malignant neoplasms,
4. 4 Pregnancy, childhood and old age,
5. 5 Therapy with glucocorticosteroids.

Should not be found. AT exceptional cases their single detection is allowed in the material taken from the posterolateral fornix of the vagina, as an integral part of the facultative flora. It is important to take into account the presence / absence of complaints and clinical manifestations.

The detection of spores and mycelium of the fungus in a smear indicates vaginal candidiasis and requires appropriate specific treatment.

Although it is a fairly informative diagnostic method, it is relevant only when comparing the result of microscopy with complaints and clinical manifestations.

The main disadvantage of this research method is the impossibility of identifying a specific pathogen. According to the results of the smear analysis, it is impossible to assess the level and depth of tissue damage.

Therefore, when an inflammatory process is detected in a smear, the doctor may prescribe additional methods diagnostics aimed at identifying the pathogen (PCR, bacteriological examination of the discharge of the genitourinary organs and determining sensitivity to antibiotics).

A gynecological smear allows you to identify a whole list of diseases reproductive system. With its help, the presence in the vagina of pathogenic microbes, blood elements, epithelial cells and other indicators. The number of leukocytes in a smear allows you to identify the presence of infectious and inflammatory diseases, as well as determine the severity of their course.

And now let's dwell on this in more detail.

What are leukocytes?

Leukocytes are called white blood cells. This group includes a whole list of cells that perform a protective function. So, if in urinary tract Pathogenic microorganisms have penetrated a person, and leukocytes will also get there from the bloodstream through the capillary wall. Upon encountering a foreign flora, phagocytosis begins. During it, leukocytes neutralize pathogenic microorganisms. If there are too many foreign bacteria, leukocytes die. As a result, there appears local inflammation. If the infection is not stopped, the number of dead leukocytes increases. As a result, pus is formed.

Normally, leukocytes may be present in a smear for flora. However, their number should not be too large. Slight excess may occur physiological reasons. If there is a significant deviation in the number of leukocytes in the smear from the norm, and there are signs of phagocytosis, this indicates the presence of an infection that could be provoked by various types of pathogens.

smear on flora

It can be performed as one of the elements of a preventive examination, or prescribed if you suspect the presence gynecological diseases. Indications for passing the analysis are:

• presence;
• failures in the menstrual cycle are observed;
• a woman experiences discomfort during intercourse;
• observed pathological discharge from the vagina;
• the woman is pregnant;
• there is itching and burning during urination;
• a woman is forced to take antibiotics for a long period of time, hormonal agents and other drugs.

Many pathologies in the early stages are asymptomatic. In order to identify them in advance, it is recommended to take a smear every three months. The material is taken from the walls of the vagina, cervix or urethra. For the procedure, a disposable spatula is used. The process does not take much time. It is not associated with pain. The smear collection causes discomfort only in case of damage to the walls of the urethra. This is possible if there is an infection or inflammatory process.

To take a smear, you need to prepare. It must be taken into account that a number of factors can lead to distortion of the results. Therefore, experts recommend giving up sexual intimacy 3 days before a visit to the doctor. A week before the study, it is necessary to stop the use of drugs of any form. Soap and gel should not be used for hygiene of the external genital organs 2 days before the test. Only warm water is allowed. The last cleansing of the external genital organs is carried out the evening before visiting the doctor. Do not urinate 3 hours before the visit to the specialist.

Taking a smear during menstruation is not carried out. The exceptions are situations where it is necessary to carry out urgent diagnosis. by the most best time the first days after menstruation or the moment shortly before its onset are considered.

The rate of leukocytes in a smear in women (table)

When the smear is taken, it will be sent to the laboratory for analysis. Here, under a microscope, the number of leukocytes in the field of view will be counted. Normally, the value of the indicator should not exceed 15. healthy woman white blood cells in a small amount are always present in the vagina. If an infection occurs, they recognize the foreign cells and begin management. active struggle. This leads to an increase in the number of leukocytes.

Can be obtained from one of three points- urethra, vagina or cervix. Depending on where the biomaterial was taken from, it may vary. It is:

• 0-10 if the swab was taken from the urethra;
• 0-15 if the swab was taken from the vagina;
• 0-30 if the smear was taken from the cervix.

In order to determine the condition of the woman, the doctor will pay attention to the presence of other microorganisms in the smear. So, chlamydia, gardnerella, yeast-like fungi, gonococci, atypical cells and Trichomonas should not be found in it. The result of the analysis can be found out very quickly. Usually the result of the study is known already on the day of taking a smear. Sometimes the deadline is shifted by two or three days.

During pregnancy

During pregnancy, changes occur in the functioning of the organs and systems of the female body. This is due to the change hormonal balance. There is an increase in the load on the kidneys. The microflora of the vagina also undergoes changes.

During the bearing of a child, a smear is taken from a woman several times. Initially, the action is carried out at registration. Normally, the number of leukocytes in pregnant women is 15-20. Exceeding the value of the indicator may indicate acute pathological process or current hidden infections, which have become aggravated as a result of bearing a child. Most often, this phenomenon is provoked by sexually transmitted diseases, or. With an increase in leukocytes, additional diagnostic tests on which the treatment is based.

Before and after menstruation

The period before and after menstruation is considered the most favorable for taking a smear on the flora. During this period of time, a change in the number of white blood cells can be observed. Experts attribute this phenomenon to the presence of latent STIs in the body. Only in one percent of cases such changes are natural. The number of leukocytes before menstruation can be 35-40 if the smear was taken from the vagina, up to 10 if the swab was taken from the urethra, up to 30 if the material was taken from the cervix.

If a flora smear is taken immediately after menstruation, there is a significant deviation of white blood cells from the standard. The difference can be 1-3 units. This is due to the fact that in the first 2-3 days after menstruation, the uterus has not yet been completely cleansed.

If a woman does not adhere to the rules of personal hygiene during menstruation or uses tampons illiterately, the number of leukocytes can increase significantly. However, the value of the indicator usually normalizes within a few days if hygiene is normalized.

Possible causes of an increase in leukocytes

If the number of leukocytes in a smear is greatly increased, this indicates the development of a disease or pathologies internal organs. The number of white blood cells increases with the following diseases:

• inflammation of the vagina, appendages, uterine mucosa, urethra or cervical canal;
• the appearance of dysbacteriosis of the vagina or intestines;
• the occurrence of hormonal imbalance;
• the presence of sexually transmitted diseases;
• the presence of benign and malignant neoplasms in the genitourinary system;
• development of systemic diseases.

Frequent stress, long-term medication, and chronic overwork can also provoke an increase in the number of leukocytes in a smear. Sometimes a similar phenomenon causes an active sexual life. In this situation, the number of leukocytes can increase to 25 cells.

There are a number of signs that make it possible to suspect an increase in the level of leukocytes and the development of an inflammatory process in the urinary system. Symptoms of the onset of the disease are:

• problems with conceiving a child;
• the appearance of secretions of an unusual nature;
• during urination, a woman experiences pain;
• during intercourse, the patient experiences discomfort;
• there are false urges to urinate;
• secretions from the genitals have a pungent odor;
• there is a failure of the menstrual cycle.

It must be taken into account that on initial stage the inflammatory process may not be accompanied by severe symptoms.

Ignoring an increase in the level of leukocytes in a smear can lead to a complication of diseases that provoked similar phenomenon. Lack of treatment often leads to the transition of pathology to chronic stage. Sometimes the disease can begin to progress, affecting the urinary system and kidneys. The hormonal balance of the body is disturbed. Against the background of diseases, the appearance of benign and malignant tumors is possible. A woman can develop ovarian dysfunction and even infertility. If the pathologies present are ignored by a woman who is expecting a child, this can lead to a miscarriage or pregnancy fading.

If the number of leukocytes is reduced

A decrease in the number of leukocytes or their complete absence in a smear is not considered a deviation from the norm. If a woman does not use intrauterine device to protect against an unplanned pregnancy, adheres to the rules of hygiene and does not have a sexual life, white blood cells will not be detected during the analysis. However, there are other factors that lead to a general decrease in the number of leukocytes. A decrease in the level of these cells in the vaginal flora may indicate the presence of:

• diseases of a viral nature;
• general depletion of the body;
• diseases of the gastrointestinal tract;
• pathologies of the endocrine system.

Diagnosis and treatment

If a woman has an increase in the number of leukocytes in a smear, it is necessary to establish the cause that provoked this phenomenon. Usually, an increase in the number of white blood cells is accompanied by an increase in opportunistic microflora, which makes it possible to immediately suspect a particular disease. However, in practice, only leukocytes can increase, and specific pathogens are absent. In this situation, the gynecologist will refer the woman to re-smear, choosing the most successful day of the menstrual cycle and recommending to properly prepare for the test. If an increase in the number of white blood cells is observed in the second smear, an extended examination is performed. Can be done:

1. PCR for sexual infections. The method allows you to identify hidden diseases, which may not manifest themselves clinically, but can lead to infertility.
2. Colposcopy. The study is an examination of the cervix under multiple magnification. The method allows to detect leukoplakia, dysplasia or oncological diseases at the initial stage.
3. Ultrasound of the pelvic organs. To provoke an increase in the number of leukocytes can various tumor formations that can be diagnosed by ultrasound.

Based on the data obtained, the doctor can refer the patient to related specialists. So, if a woman has the presence overweight, diseases or, you will need to consult an endocrinologist. If diseases of the urinary system are detected, they are referred to a nephrologist. Consultation with an allergist is required if there is a suspicion of an increase in the number of leukocytes as a result of exposure to various annoying factors. If neurosis became the reason for the deviation from the norm, the treatment is prescribed by a neurologist.

Therapy directly depends on the cause that provoked an increase in the number of leukocytes. Most often, their growth occurs as a result of inflammation. In this situation, local or general treatment. The first category includes therapeutic douching. The course is short. Its duration usually does not exceed 4-5 days. Additionally, the doctor may prescribe the use of candles. Then the normal microflora of the vagina is restored. If the patient has infections or venereal diseases, antiviral drugs or antibiotic therapy are prescribed.

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

When examined by a gynecologist, patients often have to take a scraping. This is one of the main ways to learn about the patient's sexual health.

According to statistics, modern women Today, more and more often they have problems in the field of reproductive health - poor ecology, early sexual life and irregular intimate hygiene often have a bad effect on analysis indicators.

Leukocytes are necessary to fight pathogenic bacteria, cleanse the body as a whole, and normalize metabolic processes.

In a broad sense, a smear is a scraping that is taken from various places for subsequent bacteriological research. For example, scraping from the urethra is indicated by the letter U, and from the vaginal canal - V.

The laboratory assistant directly diagnoses, he also determines the number of bacteria. Leukocytes are small white blood cells essential function- protection against ingress of infectious pathogens.

The normal number of leukocytes (LE) should not exceed 15 cells. If the indicator is higher, the diagnosis of "leukocytosis" is made.

To avoid leukocytosis, the following preventive actions can be carried out:

• carefully choose a sexual partner, do not neglect contraception;
• to carry out the procedure of intimate hygiene;
• undergo scheduled examinations by a gynecologist;
• contact only qualified and trusted doctors. Examination of the vagina and internal genital organs is a very delicate procedure and should be entrusted only to an experienced doctor with a good medical reputation;
• stick to healthy lifestyle life, use required amount vitamins to include in diet large quantity fresh vegetables and fruits.

If, when deciphering the analysis, the number of leukocytes in the smear is higher than normal, then an inflammatory process is going on in nearby tissues or organs. Why?

The number of leukocytes in a smear is one of the main parameters of this analysis. Scrapings are performed alternately in the following order and their rate in each "subsection" is different:

1. U (at the entrance to the urethra) - single, no more than 5.
2. V (from the walls of the vagina) - no more than 10.
3. C (from the cervical canal of the cervix) - no more than 15 units in the field of view.

In the same way as elevated leukocytes in the blood, it is pointless to treat high leukocytes in a smear, since this is not a disease, but a laboratory indicator. It is necessary to establish a diagnosis, begin to adequately treat the disease, and then the question of how to lower leukocytes in a smear will become irrelevant.

However, in the case when the cause of a significant increase in leukocytes in a smear still could not be established, and this level persists for a long time, the gynecologist may suggest the following treatment regimen:

• normalize sleep patterns;
• balance the diet;
• avoid overheating and hypothermia, and sudden changes temperatures;
• appoint vitamin complexes and drugs that increase immunity;
• sometimes, stop (prohibit) taking hormonal contraceptives;
• pick up medical vaginal remedies external use - suppositories or suppositories, capsules, tablets, liquids for douching, washing agents, creams and gels in applicators, special tampons.

The woman's vagina, like other parts of the body, actively interacts with environment. It is not sterile, because a large number of different bacteria are constantly present in it. Thanks to such microorganisms, a normal microflora is created in the vagina.

Various microscopic organisms live in the vagina, and one of them is Dederlein's stick. Such lactobacilli maintain normal acidity in the body, and this happens due to the release of hydrogen peroxide. Creation in the vagina of a special acid environment helps prevent reproduction pathogenic microorganisms that cause the development of many gynecological diseases.

In the event that any pathology develops in the genital organs, a change in the microflora is noted.

It is thanks to such indicators that specialists can diagnose the disease in a timely manner and determine the cause of its occurrence. With the help of a bacteriological smear on the flora from the vagina, it is possible to determine the composition of the microflora, which begins to change depending on the bacteria that have begun their active reproduction.

Briefly about leukocytes

Leukocytes are white blood cells that protect the body from all types of harmful agents (bacteria, viruses, etc.). That is, the main function of leukocytes is the implementation of the protection of the body, as specific, for example, from a certain kind microorganisms, and nonspecific or general.

The concentration of leukocytes increases in areas of inflammation, where they capture and digest foreign agents. When large cluster pathogenic agents, white blood cells increase significantly in size and begin to break down. The process of destruction of leukocytes is accompanied by local inflammatory reaction: edema and hyperemia of the damaged area, an increase in local temperature.

What is dangerous leukocytosis in a smear

A condition characterized by an excess of white blood cells (leukocytes) in the blood is called leukocytosis. Cells protect a person from the invasion of viruses and do not allow their reproduction. Constant elevated level leukocytes - the result of an inflammatory process of various etiologies, which is often accompanied by the following symptoms:

• burning sensation and bad smell from the vagina;
• pain when urinating;
• white curdled discharge from the vagina;
• painful intercourse;
• failure of the menstrual cycle;
• itching of the genitals;
• unsuccessful attempts to get pregnant;
• temperature rise;
• dizziness.

Assignment of a smear for flora

A smear on flora is called so because during the diagnosis it turns out which flora (environment) prevails on this moment in the uterus - disease-causing or normal. Indicators for the collection of analysis are scheduled inspection specialist, specific complaints of the patient: burning, pain in the genitals, abdominal pain, poor urination.

Also, the study is carried out when planning conception, after a course of taking antibiotics, directly during pregnancy, after childbirth. In the first two trimesters, scraping for flora is examined at least 3 times, and if there are complications or complaints from the patient, even more often.

During a visit to the gynecologist, a woman often has to take a smear for the flora. What does this analysis mean and what are its norms you will learn from the following article.

As you know, any disease is much easier to prevent than to subsequently treat its advanced form. Women Health everything is exposed today greater risk. And this is due to poor ecology, vulnerable entry into sexual life, an increase in the number of genital infections and various neoplasms. That is why every woman should visit a gynecologist at least once a year, and if living conditions change, if any complaints appear, this should be done more often.

Be sure to make a gynecological smear on the flora during a visit to the doctor, the rate of leukocytes will be determined necessarily.

How is the analysis carried out?

A smear for flora is a bacterioscopic examination of a scraping taken from different places. The analysis allows you to determine the presence of an inflammatory process, pathogenic microflora, protozoa, to suspect a violation of the hormonal status. Usually, the gynecologist takes the contents from the urethra, vagina and cervix for examination. For these purposes, special vaginal mirrors are used, as well as a disposable spatula with a rounded end. Material is collected from all suspicious places, applied in a thin layer on a glass slide, then sent to the laboratory.

With the help of a smear, you can find out about inflammation in the body

Smears from different places are applied to different glasses, which are marked in a special way. For example, a swab from the urethra is designated "U", from the vagina - "V", from the cervical canal - the letter "C".

The study is carried out by a laboratory assistant using a microscope. It's inexpensive and quick analysis, which allows for short time obtain a preliminary opinion on the woman's health. Depending on the results, the doctor decides in which direction to move on.

Unfortunately, gynecologists do not always devote their patients to all the subtleties of the analysis; most often they get off with general phrases. But after all, every woman wants to know everything in detail: is she healthy, are there any infections and other disorders? You can get answers to these questions from this article. A smear on the flora, the norm of leukocytes, pathological microorganisms, possible infections - all the details of the study are described below.

What do these strange characters mean?

In addition to the indicated designation of the scraping site, you will find the following designations on the form:

"L" - the number of leukocytes in the field of view of the microscope.

"Ep" - pure squamous epithelial cells in a smear. It may be referred to as "Pl. ep." or in words "squamous epithelium".

"Gn" is the designation of the causative agent of gonorrhea (gonococcus).

Usually doctors, when they want to say about the absence of any element, write in Latin “abs”. This means not found.

"trich" - refers to the protozoan "Trichomonas vaginalis", the causative agent of trichomoniasis.

Most often, the columns "Gn" and "trich" in the form are written side by side.

It is desirable to understand the results of the analysis

Deciphering the analysis

squamous epithelium

it surface layer cells that lines the vagina and the entrance to the cervix. Normally, it must be present in gynecological smear in a woman of reproductive age.

When it changes hormonal background, reducing the amount of estrogens in the body, the number of squamous epithelial cells decreases.

With the onset of menopause in a smear on the flora, the epithelium of the lower layers of the vaginal mucosa is found - basal and parabasal cells. Finding them in a woman childbearing age may indicate an increase in the level of male sex hormones, as well as inflammatory changes.

Leukocytes

White bodies, which are designed to protect a person from various infections. Normally, the number of leukocytes in a smear should not exceed 15 cells.

If the number of white bodies is above this limit, it can be assumed inflammatory disease genitals. Most often, the doctor makes a diagnosis: "colpitis", "vaginitis", "cervicitis".

The more leukocytes in the smear, the more acute the inflammatory process. For example, a huge number of inflammatory elements are found in gonorrhea or trichomoniasis.

Slime

In a small amount, it is found in the material taken from the vagina, and this is not a deviation from the norm. If mucus is found in a scraping from the urethra, it is necessary to exclude the disease urinary system. An increase in mucus in the smear occurs during inflammatory processes.

Taking a swab for flora

Doderlein sticks. What it is?

Normally, a woman's smear contains bacteria in the form of sticks - these are lactic acid microorganisms. A high number of rods in a smear indicates a normal hormonal status and the absence of inflammation.

The epithelial cells of the vagina produce glycogen, which is used to feed the Doderlein sticks. When glycogen breaks down, lactic acid is released, which creates an acidic environment in the vagina. It's natural defense mechanism, protecting the genitals of a woman from the introduction of pathogenic microorganisms.

If the number of sticks decreases, this indicates a shift in the pH of the vagina to the alkaline side and possible dysbacteriosis.

Staphylococcus aureus

In addition to rods, a small amount of other flora is present in the vagina. Most often found Staphylococcus aureus. If the number of these microorganisms is not more than 5%, you should not worry.

In the case when there is an increase in staphylococcus and a decrease in the number of Doderlein sticks, we should talk about inflammation of the vagina or cervical canal.

Squamous epithelial cells, Doderlein sticks, a small amount of mucus and leukocytes indicate a normal gynecological smear. In addition, the smear should be free of gonococci, chlamydia, gardnerella, yeast fungi.

Other detected elements indicate the presence of any pathology of the genital organs.

coccal flora

These are bacteria that have a spherical shape. A small amount of cocci is not dangerous, but when the percentage of these microorganisms exceeds the number of lactic acid sticks, this indicates a decrease in immunity or the presence of inflammation. In a smear on the flora, you can find the entry: Gr (+) or Gr (-).

All bacteria are divided into Gram-positive and Gram-negative organisms. Gram-positive microbes are lactobacilli, enterococci, staphylo- and streptococci. Gram-negative - gonococci, Proteus and E. coli.

If gram-negative cocci located inside the cells are found in the smear, one should think about the presence of gonorrhea.

Gardnerella

These are very small sticks that appear with vaginal dysbiosis ( bacterial vaginosis). They are the causative agents of the disease called "gardnerellosis".

key cells

They are also called atypical cells. Appear with gardnerellosis and violation of the vaginal microflora. These are squamous epithelial cells glued together with small sticks.

Yeast-like fungi

Detection of spores and mycelium of yeast-like fungi occurs with thrush - vaginal candidiasis. Fungal spores testify to latent (sleeping) candidiasis.

If a woman's immunity is impaired, this leads to the activation of pathogenic vaginal microflora, including the fungus of the genus Candida. With an exacerbation of thrush, Candida mycelium filaments are found in the smear.

Leptothrix

It is a very thin Gram-negative bacterium that can be found in a woman's swab. Leptothrix is ​​not the causative agent of a single disease, however, the bacterium often accompanies others. infectious agents. For example, leptothrix is ​​found in mixed infections (trichomoniasis, candidiasis, chlamydia). Many doctors consider the presence of bacteria a manifestation of dysbacteriosis.

Trichomonas

it unicellular organisms, are the causative agent of the disease "vaginal trichomoniasis".

If fungi are detected in the flora smear, key cells, cocci and leptothrix, vaginal dysbacteriosis can be suspected. However, the final diagnosis is established by the doctor after additional diagnostics.

How to prepare for research?

Of course, you should not analyze during menstruation: the entire field of view in the microscope will be occupied by red blood cells, and the doctor will not be able to detect the presence of pathological elements.

Before visiting the gynecologist, it is allowed to wash the genitals with soap, but you can not use others for this purpose. detergents(gels, shampoos).

What else can't be done?

• Take baths and douche before visiting a doctor.
• Use any ointment the night before and in the morning, vaginal suppositories and tablets.
• Lead a sexual life. All relationships should be terminated 1-2 days before visiting the doctor.

An experienced doctor should deal with the decoding of the analysis; you cannot rely on friends, relatives or incompetent medical workers in this matter.