What smears take during pregnancy? How many times? Bad smears during pregnancy

Every woman who cares about her health must definitely visit the gynecologist on a regular basis and take the necessary tests. During pregnancy, the condition of the microflora of the vagina is of particular importance. Smear during pregnancy can make a true picture of a woman's health and exclude the development of serious diseases. It is worthwhile to consider in more detail this type of diagnosis and the 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 against the entry of pathogenic microorganisms. Reducing the number of lactobacilli will lead to the reproduction of "bad" bacteria and the development of the disease.

Pregnancy is a time when you need to pay special attention to health, because this will determine the normal intrauterine development of the baby. It should be understood that any inflammatory process can adversely affect the bearing of the fetus. Smears from the vagina during pregnancy should be taken by women even in the absence of symptoms of the disease. Infection can not behave in any way for a long time, but the future mother will be its carrier. If, at the next examination, the doctor finds deviations from the norm in the results of the analysis, the woman will be able to undergo appropriate treatment and prevent infection of the child during childbirth.

Smears during pregnancy: how many times should I take?

The first obligatory examination of the microflora of the vagina, the expectant mother is going through a primary appeal to the women's consultation for registration. The results will show the condition of the mucous surface of the vagina, the presence of a good and pathogenic microflora (balance) and the degree of purity. If pathogenic bacteria are detected, a gentle treatment will be prescribed, after which you should additionally give a smear for a control check.

According to the schedule of studies shown pregnant, in the last trimester also should be diagnosed with microflora of the vagina. Smears at 30 weeks of pregnancy should be done on a mandatory basis in order to make sure the health of the future mother and baby. Deviations from the norm on the last terms are found quite often, which poses a risk to the fetus and is fraught with undesirable consequences.

Without waiting for the next direction for the examination, a woman should unscheduledly pass the test if there are such symptoms as itching, burning, the appearance of abundant secretions from the genital tract. Such signs often accompany dangerous diseases, which are extremely undesirable in the period of gestation.

"Good flora" - what does this mean?

Microflora is a collection of different bacteria that constantly inhabit the vagina. With an ideal state of health, lactobacilli, Doderlein's sticks, which produce useful lactic acid, are predominantly there. If their number is sufficient, pathogenic microorganisms do not have a chance to survive in the acidic environment of the vagina.

During pregnancy, the test results vary slightly. The number of cells of the vaginal epithelium increases significantly, which contributes to the accumulation of glycogen necessary for the production of lactic acid by Dodderlein sticks. Maintaining the necessary acid-base balance (pH 3,3-4,5) throughout pregnancy, thanks to a good microflora, helps to block the development of pathogenic bacteria and prevent infection of the embryo (or fetus).

What is dangerous for a microflora disorder?

Quite often, women are faced with the situation when, having given smears during pregnancy, they learn that they have a violation of the vaginal microflora. Reducing the number of lactobacilli is highly undesirable during this critical period and therefore it is necessary to establish the cause of the pathogenic condition. Conditionally pathogenic microorganisms, of course, are present in the vagina of every healthy woman, but their number should be small. If the number of bad bacteria increases, then begins to develop dysbacteriosis, which most often causes vaginal candidiasis (thrush).

To make an accurate diagnosis, you need to hand over smears. In pregnancy, early in life, such a disorder can develop against a background of reduced immunity. Any deviation from normal indicators is dangerous, first of all, for the baby and further development of pregnancy.

When should the microflora be checked?

In the early stages of pregnancy, it is important for a woman to monitor the body's signals. Seek medical advice if:

• There was an itch in the genital area.
• The vaginal discharge became abundant and had a curdled consistency.
• After urination, a burning sensation appears.
• The discharge has a sharp unpleasant odor.
• Periodically, there are pulling pains in the lower abdomen.

These 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 can be hidden. In this case, you need to pass additional tests.

Types of smears

When being registered with a women's consultation, expectant mothers are interested in what strokes they take during pregnancy and whether it is really necessary. It should be noted immediately that a survey of the state of health of a woman at an early pregnancy is of particular importance for the doctor. Only diagnosis will show the true picture and exclude the threat of termination of pregnancy.

In gynecological practice, there are several types of smears that show the state of women's health. Classify them as follows:

• Smear on the flora - allows you to identify the imbalance of good and bad vaginal microflora. The analysis shows the number of erythrocytes, leukocytes and dead cells of the epithelium. The results assess the degree of purity of the smear;
• A smear for cytology is necessary for diagnosing changes in cervical cells;
• Smear for sterility - is assigned to determine the composition of the microflora of the vagina, helps to see deviations in the hormonal background;
• Smear for hidden infections - PCR diagnosis is extremely important during pregnancy. The method makes it possible to detect infections that do not determine a smear on the microflora.

Urogenital infections pose a serious risk to life and normal fetal development. Therefore, having received from the attending physician the direction for the diagnosis of hidden infections, the expectant mother should not delay with the passage of the examination.

Sex infections

Smears during pregnancy for infection - sexually transmitted diseases - should be taken without fail. Such diseases as ureplasmosis, herpes, chlamydia, toxoplasmosis, cytomegalovirus do not always make themselves felt, but this does not mean that they are not dangerous.

Hidden infections can be detected by PCR diagnostics, inoculation and Gram staining method. Another popular method is the enzyme immunoassay .

Analysis of the analysis

In the results of the analysis on the microflora of the vagina, the following indices can be detected:

• Leukocytes - increasing the norm indicates the development of inflammation. In the vagina they should be 10-15 in the field of vision, in the urethra - no more than 5, and in the cervical channel - up to 5.
• Epithelium - Normally this value should not be more than 10 in the field of vision.
• Gram-positive bacteria - the main part (approximately 90%) consists of lactobacilli.
• Gram-negative bacteria - a pathogenic microflora is normally completely absent.
• Slime-smears during pregnancy allow absence or a moderate amount of mucus in the vagina and cervix of the uterus.
• Fungi of the genus Candida - an acceptable small amount in the vagina, but in the urethra and cervical canal they are normally completely absent.
• Kokki - Normally there may be streptococci, staphylococci and enterococci in small amounts. The presence of gonococci indicates the development of gonorrhea.
• Trichomonases - in a good smear they are absent.

White blood cells in the smear

Leukocytes are white blood cells that are part of the immune system. During pregnancy, it is especially important to monitor their quantity in the smear on the microflora, because even a slight change can indicate the development of the inflammatory process. The main purpose of leukocytes is to protect the body and fight against pathogenic bacteria. Therefore, to survive because of the detection of a small number of protective cells in the test results is not worth it. For women in the norm of leukocytes, the smear is within 15-20 in the field of vision.

Increased number of leukocytes smear

Smears during pregnancy are an important method of diagnosis, allowing you to determine the slightest deviation from normal performance. A slight increase in the number of white blood cells during the period of gestation is entirely acceptable. If the value exceeds 20 units in the field of vision, additional diagnostics should be carried out and the cause of the pathogenic condition should be established. An increased number of white blood cells indicates the presence of an inflammatory process in the body of a future mother.

Bad smears during pregnancy can adversely 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. Candidiasis (thrush), vaginosis, inflammation of the mucous surface of the vagina, infectious diseases (mycoplasmosis, gonorrhea, ureplasmosis) are common causes of leukocyte swelling in pregnant women.

"Degree of purity"

When conducting a study in the laboratory, assess indicators such as odor and viscosity of the material being diagnosed. Depending on the parameters of pathogenic microflora, which may contain smears during pregnancy, the expert assesses the degree of purity. In total there are four such degrees:

• The first degree speaks about the ideal smear on the microflora. The number of lactobacilli reaches 95%, which indicates a correct acid-base balance and good protection from the development of pathology.
• The second degree is put in the event that a small amount of opportunistic microflora was detected in the smear, but these values are within the normal range. The number of lactobacilli, as in the first degree, should prevail over the rest and be at the level of 90%.
• The third degree speaks about the development of dysbiosis (bacterial vaginosis). Doderlein's sticks in such a smear are smaller than necessary for the normal state of the flora. The number of gram-negative bacteria increases.
• The fourth degree is characteristic of vaginitis. In such a smear, an alkaline medium predominates, an increased number of leukocytes and epithelium are observed. Bad smears during pregnancy are grounds for re-examination.

How to prepare for the analysis?

To obtain accurate results of the study of the microflora of the vagina should be properly prepared before taking the test. First of all, it is necessary to give up sexual contacts 2-3 days before the material is taken. Also, the use of vaginal suppositories, creams and ointments should be avoided. The results can affect syringing with medicinal herbs, soda. Therefore, similar manipulations are not allowed before the examination.

For hygienic procedures should be used special means: intimate soap or gel. Their composition is specially developed taking into account the features of the acid-base balance of the female reproductive system. The use of ordinary cosmetic soap distorts the true state of the microflora of the vagina and adversely affects the condition of the external genital organs, causing burning and itching.

How to treat?

Bad smears in early pregnancy can lead to fading embryo development or miscarriage. Therefore, it is so important to apply to the women's clinic for registration and analysis. Treatment will depend on the type of pathogen and the duration of pregnancy. The scheme of therapy should be selected only by a specialist, having previously determined the sensitivity of pathogenic microorganisms to medicinal preparations. Late-term treatment is also necessary, because a neglected disease can damage the fetal membrane and infect an unborn baby.