Every woman who cares about her he alth must regularly visit a gynecologist and take the necessary tests. During the bearing of a child, the state of the microflora of the vagina is of particular importance. A smear during pregnancy allows you to get a true picture of a woman’s he alth and exclude the development of serious diseases. It is worth considering in more detail this type of diagnosis and possible results of the analysis.
Importance of analysis
The microflora of the vagina is largely composed of lactobacilli, which produce lactic acid, which is necessary to protect the body from pathogenic microorganisms. A decrease in the number of lactobacilli will lead to the multiplication of "bad" bacteria and the development of the disease.
Pregnancy is a period when it is necessary to pay special attention to he alth, because the normal intrauterine development of the baby will depend on it. It should be understood that any inflammatory process can adversely affect the bearing of the fetus. Vaginal swabs during pregnancy should be taken by women even ifno symptoms of the disease. The infection may not manifest itself for a long time, but at the same time, the expectant mother will be its carrier. If, during the next examination, the doctor finds abnormalities in the results of the analysis, the woman will be able to undergo appropriate treatment and prevent infection of the child during childbirth.
Pap smears during pregnancy: how many times should I take?
The expectant mother undergoes the first mandatory examination of the microflora of the vagina during the initial visit to the antenatal clinic for registration. The results will show the condition of the vaginal mucosa, the presence of good and pathogenic microflora (balance) and the degree of cleanliness. If pathogenic bacteria are detected, a sparing treatment will be prescribed, after which an additional smear should be taken for a control check.
According to the schedule of studies shown to the pregnant woman, in the last trimester, the vaginal microflora should also be diagnosed. Smears at the 30th week of pregnancy should be done without fail in order to ascertain the he alth of the expectant mother and baby. Deviations from the norm in the last stages are found quite often, which is dangerous for the fetus and is fraught with undesirable consequences.
Without waiting for the next referral for examination, a woman should take an unscheduled test if symptoms such as itching, burning, and the appearance of copious discharge from the genital tract are detected. Such signs often accompany dangerous diseases that are highly undesirable during the period of gestation.
"Good flora" - what does it mean?
Microflora is a collection of various bacteria that constantly inhabit the vagina. In an ideal state of he alth, there are predominantly lactobacilli - Doderlein sticks, which produce useful lactic acid. With enough of them, pathogens have no chance to survive in the acidic environment of the vagina.
During pregnancy, the test results change somewhat. The number of cells of the vaginal epithelium increases significantly, which contributes to the accumulation of glycogen, which is necessary for the production of lactic acid by Doderlein sticks. Maintaining the necessary acid-base balance (pH 3, 3-4, 5) throughout pregnancy, thanks to good microflora, helps block the development of pathogenic bacteria and prevent infection of the embryo (or fetus).
How dangerous is the violation of microflora?
Quite often, women are faced with a situation where, having passed smears during pregnancy, they find out that they have a violation of the vaginal microflora. A decrease in the number of lactobacilli is highly undesirable during this crucial period, and therefore it is necessary to establish the cause of the pathogenic condition. Opportunistic microorganisms, of course, are present in the vagina of every he althy woman, but their number should be small. If the number of bad bacteria increases, then dysbacteriosis begins to develop, most often causing vaginal candidiasis (thrush).
Pap smears are required for an accurate diagnosis. During pregnancy,in the early stages, such a violation can develop against a background of reduced immunity. Any deviation from normal indicators is dangerous, first of all, for the baby and the further development of pregnancy.
When should I check the microflora?
In the early stages of pregnancy, it is important for a woman to follow the body's signals. Seek medical advice if:
- Itching appeared in the genital area.
- Vaginal discharge has become copious and curdled.
- After urination there is a burning sensation.
- Discharge has a strong odor.
- Periodically there are pulling pains in the lower abdomen.
The above symptoms indicate the development of the inflammatory process and the need for urgent treatment. A smear on the flora helps to determine the type of pathogen, but in some cases the infection may be hidden. In this case, it is necessary to pass additional tests.
Types of strokes
When registering with a antenatal clinic, expectant mothers are interested in what smears are taken during pregnancy and whether it is really necessary. It should be noted right away that the examination of a woman's he alth status at an early stage of pregnancy is of particular importance for the doctor. Only diagnostics will show the true picture and eliminate the threat of abortion.
In gynecological practice, there are several types of smears that show the state of women's he alth. classify themas follows:
- Smear on flora - allows you to identify the imbalance of good and bad vaginal microflora. The analysis shows the number of red blood cells, white blood cells and dead epithelial cells. According to the results, the degree of purity of the smear is evaluated;
- Smear for cytology - necessary to diagnose changes in the cells of the cervix;
- Smear for sterility - is prescribed to determine the composition of the vaginal microflora, helps to see deviations in the hormonal background;
- Smear for latent infections - PCR diagnosis is extremely important during pregnancy. The method allows you to detect infections that are not detected by a microflora smear.
Urogenital infections pose a serious threat to the life and normal development of the fetus. Therefore, having received a referral from the attending physician for the diagnosis of latent infections, the expectant mother should not delay the examination.
Sexual infections
Smears during pregnancy for infections - sexually transmitted diseases - should be taken without fail. Diseases such as ureplasmosis, herpes, chlamydia, toxoplasmosis, cytomegalovirus do not always make themselves felt, but this does not mean at all that they are not dangerous.
Latent infections can be detected using PCR diagnostics, culture and Gram stain. Another popular method is the enzyme immunoassay of blood serum.
Transcription of analysis
In the results of the analysis on the microflora of the vagina, you candiscover the following indicators:
- Leukocytes - an increase in the norm indicates the development of inflammation. In the vagina, there should be 10-15 of them in the field of view, in the urethra - no more than 5, and in the cervical - up to 5.
- Epithelium - normally this value should not be more than 10 in the field of view.
- Gram-positive bacteria - the majority (approximately 90%) consists of lactobacilli.
- Gram-negative bacteria - pathogenic microflora is normally completely absent.
- Mucus - Pregnancy swabs allow for no or moderate amounts of mucus in the vagina and cervix.
- Mushrooms of the genus Candida - a small amount is acceptable in the vagina, but they are completely absent in the urethra and cervical canal.
- Cocci - Streptococci, staphylococci and enterococci may normally be present in small numbers. The presence of gonococci indicates the development of gonorrhea.
- Trichomonas - they are absent in a good smear.
Leukocytes in smear
Leukocytes are white blood cells that are part of the immune system. During pregnancy, it is especially important to monitor their number in a smear for microflora, because even a slight change may indicate the development of an inflammatory process. The main purpose of leukocytes is to protect the body and fight pathogenic bacteria. Therefore, you should not worry about the detection of a small number of protective cells in the test results. For women in position, the norm of leukocyte smear is in the range of 15-20 in the field of view.
Increased quantityleukocyte smear
Pap smears during pregnancy are an important diagnostic method that allows you to determine the slightest deviation from normal values. A slight increase in the number of leukocytes during the period of bearing a child is quite acceptable. If the value exceeds 20 units in the field of view, additional diagnostics should be carried out and the cause of the pathogenic condition should be established. An increased number of white blood cells indicates the presence of an inflammatory process in the body of the expectant mother.
Bad smears during pregnancy can negatively affect the development of the fetus. Therefore, it is important to detect abnormalities in the test results in a timely manner and undergo appropriate treatment. Common causes of an increase in leukocytes in a smear in pregnant women are candidiasis (thrush), vaginosis, inflammation of the vaginal mucosa, infectious diseases (mycoplasmosis, gonorrhea, ureplasmosis).
Degree of Purity
When conducting a study in the laboratory, indicators such as the smell and viscosity of the material being diagnosed are evaluated. Depending on the indicators of pathogenic microflora, which may contain smears during pregnancy, the specialist evaluates the degree of purity. There are four such degrees in total:
- The first degree indicates an ideal microflora smear. The number of lactobacilli reaches 95%, which indicates the correct acid-base balance and good protection against the development of pathology.
- The second degree is given if the smear was founda small amount of conditionally pathogenic microflora, but these values are within the normal range. The number of lactobacilli, as in the first degree, should prevail over the rest and be at the level of 90%.
- The third degree indicates the development of dysbiosis (bacterial vaginosis). There are fewer Doderlein sticks in such a smear than is necessary for the normal state of the flora. Gram-negative bacteria increase.
- The fourth degree is characteristic of vaginitis. In such a smear, an alkaline environment prevails, an increased number of leukocytes and epithelium is observed. Bad smears during pregnancy are a reason for re-examination.
How to prepare for analysis?
To obtain accurate results of the study of the microflora of the vagina, you should properly prepare before taking the test. First of all, it is necessary to refrain from sexual contact 2-3 days before the material is taken. You should also exclude the use of vaginal suppositories, creams and ointments. The results can be affected by douching with medicinal herbs, soda. Therefore, similar manipulations before the examination are not allowed.
For hygiene procedures, special products should be used: intimate soap or gel. Their composition is specially designed taking into account the peculiarities of the acid-base balance of the female reproductive system. The use of ordinary cosmetic soap distorts the true state of the vaginal microflora and negatively affects the condition of the external genital organs, causing burning and itching.
Howtreat?
Bad smears in early pregnancy can lead to fetal failure or miscarriage. Therefore, it is so important to contact the antenatal clinic in a timely manner for registration and testing. Treatment will depend on the type of pathogen and the duration of pregnancy. The treatment regimen should be selected only by a specialist, having previously determined the sensitivity of pathogenic microorganisms to medications. In the later stages, treatment is also necessary, because a neglected disease can damage the fetal membrane and infect an unborn baby.
