Flora smear in women - leukocytes are elevated: causes, signs and treatment. Leukocytes in a smear of virgins. Local treatment consists of douching

Leukocytes (white immune blood cells) are blood elements immune system. Their main task is to provide protection to the body and fight against all kinds of harmful microorganisms, bacteria, microbes and viruses.

They form in space bone marrow And lymph nodes, but can move freely through the walls of blood vessels and move to places where potential danger appears. They exhibit antitoxic and antimicrobial effects.

So why can women have a lot of leukocytes in a gynecological smear? We’ll tell you the main reasons and treatment features in our article!

The role of cells in the body

The process of destruction of foreign and dangerous elements by leukocytes is called phagocytosis. They capture and absorb “enemies”, after which they themselves die.

What are leukocytes in a smear in women? Their main functions are:

Development of antibodies to fight external and internal “enemies”.
Normalization metabolic processes and supplying tissues with necessary enzymes and substances.
Cleansing the body - elimination pathogens and dead leukocyte cells.

Normal, why indicators may be increased

An increase in leukocytes in a smear in women is a sign of the presence of an inflammatory process in the body.

You can find out their level by taking tests:

Flora smear;
Blood analysis;
Analysis of urine.

Women are most often prescribed a smear test for flora.

This study allows you to identify diseases of the urinary canal, kidneys or bladder; makes it possible to recognize the presence of an inflammatory process in the urogenital area.

Material for research is taken:

From the vaginal wall;
From the mucous surface of the cervix;
With mucous membrane urethra.

Normal indicators of the level of immune cells in a smear are:

From the vagina - no more than 10.
From the urethra – no more than 5.
From the uterine cervix - no more than 15.

During the study, it is necessary to take into account some features:

The number of white blood cells (leukocytes) increases after sexual intercourse; increased performance last for 24 hours after the act.
An increased level is also observed during the installation of an intrauterine contraceptive device.
Microtraumas of the vaginal walls also contribute to an increase in indicators.

The main reasons for an increase in the number of leukocytes in a smear in women are:

Sexual infections transmitted directly during sexual intercourse (STIs):
Bacterial vaginosis. This disease is better known as vaginal dysbiosis. Occurs when the number of pathogenic microorganisms in the vaginal flora increases. Prerequisites for the development of the disease may be hormonal disorders, reduction local immunity or using vaginal suppositories.
Allergic reaction to gels and lubricants intimate hygiene or douching products.
Oncological diseases reproductive system.

Increased white immune cells in the smear indicates the presence of the following diseases:

Note: The cause of an increased level of leukocytes in a smear in women may be prolonged stressful situations or depression.

Symptoms of increase

Signs indicating an increase in white blood cell levels and the development of the inflammatory process of the urinary system are:

painful urination;
appearance false urges to urination;
discharge of an unusual nature;
Strong smell discharge from the genitals;
burning and itching sensation inside the genitals;
failure of the menstrual cycle;
problems conceiving a baby;
discomfort during sexual intercourse.

The manifestation of such symptoms is a reason to take a smear on the flora and check the condition of the body.

The inflammatory process can occur without pronounced symptoms, so it is important to listen to the slightest deviations.

What to do if a woman's platelet count is below normal? We will tell you about the functions of these cells in our body and the features of treating deviations.

A large number in pregnant women

During pregnancy, a smear test for flora is given to mandatory , both during registration and before childbirth.

Indicators within the acceptable norm are: 10 – 20 units in the observation field. A increased amount indicates the development of inflammation.

Many diseases often worsen during pregnancy., which did not show their presence in any way before conception.

A change is taking place hormonal levels , immune defense decreases and often pregnant women develop thrush or candidiasis. If an elevated level of white blood cells is detected, further testing is necessary to determine the exact cause of the inflammatory or infectious process.

Reasons elevated white blood cells In women, a smear may contain:

Sexually transmitted diseases (ureaplasmosis, syphilis, gonorrhea and others).
Thrush.
Vaginosis.
Colpitis.

Any inflammatory or infectious process poses a serious danger during pregnancy, so treatment is mandatory.

Doctors often prescribe the drug to strengthen local immunity:

Echinocea
Immunal
Eleutherococcus
Ginseng.

For the treatment of vaginosis the following is prescribed:

Bifidumbacterin
Lactovit
Lactofiltrum.

Leukocytes instantly react to the slightest deviations or changes in the functioning of the body. Therefore, their level often increases according to physiological reasons. These include the postpartum period.

During childbirth, a woman loses a lot of blood.

To prevent complications, immune white cells prepare in advance for such a situation and accumulate in large numbers in the uterine area.

This is precisely what is associated with the increase in the number of their indicators in a smear after childbirth.

Their number increases during the onset of labor and in recovery period. The indicators return to normal 4-5 days after birth.

If the elevated level of immune cells lasts more than 5 days and has serious deviations from the norm, this indicates the development of complications after childbirth and the presence of inflammation in the uterine cavity, kidneys or urinary system.

In such cases, you should immediately consult a doctor.

Possible danger of exceeding

Chronic and frequent increase in the level of white blood cells in the body can lead to serious complications. Possible risks include:

The onset of infertility.
Ectopic pregnancy.
The appearance of erosion.
Manifestation of mastopathy.
Abnormalities in the functioning of the bladder or kidneys.
Ovarian dysfunction.
Formation of adhesions and fibroids.

Diagnostics and assistance from a qualified specialist

If you detect an increased level of leukocytes in a smear, you must consult a qualified doctor:

Gynecologist
Dermatovenerologist
Infectious disease specialist.

The doctor chooses the treatment method based on laboratory tests. To establish accurate diagnosis additional diagnostics are prescribed.

The most commonly prescribed types are: diagnostic procedures:

Sowing on flora
Flora smear
ELISA (enzyme-linked immunosorbent assay)
Blood antibody test
Biopsy
PCR (polymerase chain reaction)
UAC ( general analysis blood)
UAM (general urine analysis)
Ultrasound of the abdominal cavity.

Drug treatment

As already noted, an increase in the number of white immune cells can occur due to inflammatory or infectious disease. Treatment for inflammation or infection is varied.

Treatment of the inflammatory process is carried out according to the following scheme:

Use of antiseptics. The vagina is regularly washed with antiseptics “Miramistin”, “Chlorhexidine”, “Potassium permanganate”.
Antibacterial drugs are used. The most commonly prescribed drugs are Genferon, Pimafucin, Terzhinan, and Viferon.
Fluconazole and Flucostat are used to treat candidiasis.

Treatment of the infectious process is carried out according to the following scheme:

Intravenous use antibacterial agents: Ornidazole, Metronidazole and Tsiprinol.
Prescription of drugs for the prevention of vaginal dysbiosis: “Bifidumbacterin”, “Laktovit” and “Lactofiltrum”.

Note: It is strictly forbidden to self-medicate using antibacterial agents. They are prescribed only by a competent doctor, taking into account the severity of the disease and the condition of the patient’s body.

What not to do

During treatment of inflammatory process in the pelvic area caution must be exercised.

It is prohibited to use antibiotics without a doctor's prescription.
Antibacterial drugs should not be used during pregnancy.
It is impossible to treat the infectious process with anti-inflammatory drugs.
It is forbidden to wash yourself with cold water.
Tampons should be replaced with regular pads.
It is prohibited to use alcohol-based douches.
The body must not be overcooled.

Find out more about tests in gynecology: deciphering a smear for flora in women, the normal level of leukocytes and for what reasons their elevated levels are possible, a specialist will tell you in this video:

An increased level of leukocytes in a smear is a reason to seriously engage in treatment. This indicator is a sign of a malfunction internal organs and systems and indicates the development of infection or inflammation.

Self-medication is prohibited. If any abnormalities in the test results are detected, you should seek the help of an experienced doctor.

At each consultation with a gynecologist, you need to take a smear for flora; it is necessarily taken if the patient complains of bad feeling, with the help of a smear you can find out a lot and then prescribe effective treatment. The analysis is carried out only before examinations, colposcopy and other procedures. Remember that the result will depend on how the analysis was taken. Using a spatula, take the secretions and spread them on the glass. Then the analysis is sent to the laboratory for examination.

A very important indicator for this analysis is the number of leukocytes in the smear, they indicate inflammatory process. The norm is when the indicator is no higher than 15.

When a woman has received a test with , it is necessary to consult a doctor; it is best to do a repeat test. In cases of inflammation, there are not many rods, but there are many cocci. If there is an increase in leukocytes in the smear, it is very important that the doctor examines you, what the appearance of the vulva, cervix, vagina is and what discharge is observed from the genital tract. An experienced doctor can identify inflammation by sight and smell.

When do leukocytes appear in a woman’s smear?

Along with a smear on the flora, a cytology test is taken, with the help of which you can find out whether the cervix is inflamed. Using a flora analysis, you can identify the following pathogens: fungi, gonococci, trichomanas. White blood cells in a smear can indicate the following diseases:

2. Urethritis.

5. Oncology in the genital organs.

6. Dysbacteriosis of the intestines and vagina.

If the increase in leukocytes is persistent, further investigation is necessary. It is imperative to carry out a culture for microflora, an antibiogram. Using it, you can find out about the causative agents of infection - Escherichia coli, staphylococcus, streptococcus, you must determine what quantity they have, then select a drug to which these pathogens are sensitive.

Pathogenic microorganisms - chlamydia, gonococci and trichomanas can be identified using DNA diagnostics. It is used to detect herpes, HPV,. Mycoplasma and ureaplasma can be detected using culture with an antibiogram. Because they live in a woman’s body and may not cause inflammation. It is very difficult to prescribe treatment after leukocytes are detected in the blood. First you need to find out main reason what causes inflammation.

Leukocytes in a smear can show how the process is proceeding; the more leukocytes, the more dangerous the inflammation.

Rarely does the number of leukocytes reach 100. It happens that the tests show nothing, the tests are normal, but the leukocytes are still high, this indicates when the ratio of microorganisms is disturbed. IN in this case You cannot use antibiotics, this can only cause harm, because this is what leads to this disease. For this disease, suppositories are used that help restore the microflora of the vagina and intestines.

Leukocytes in a smear of a pregnant woman

A pregnant woman takes her first smear when she registers. The norm is a slight increase in leukocytes, the indicator ranges from 15 to 20. If leukocytes increase, this indicates inflammation and an infectious disease.

To determine the cause, it is necessary to undergo additional examination, take a culture test for bacteria, examine the immune system, etc.

It is not necessary that the woman contracted the infection; it could have been living in her body recently, and due to hormonal changes, the immune system began to manifest itself. That’s why it’s so important to monitor a woman’s health during pregnancy, because they can manifest themselves due to decreased immunity. Some diseases are sexually transmitted - gonorrhea, ureaplasmosis, mycoplasmosis, syphilis,.

White blood cells often increase due to thrush; pregnant women are more often affected by the disease; this disease manifests itself at later pregnancy.

It is difficult to treat this disease in pregnant women, because many antibiotics are contraindicated for them; remember that inflammation can infect the uterine cavity and become a threat to pregnancy.

That is why it is so important to carefully and closely monitor your health and the condition of your baby. Any disease affects the child.

How to reduce the level of leukocytes in a smear?

To do this, you need to restore the microflora in the vagina. You can use the following medicinal herbs - aloe leaves, St. John's wort, chamomile, oak bark, etc. Douching with chlorophyllipt solution helps a lot. Warm baths will help combat the inflammatory process. You may need special suppositories - pimafucin, terzhinan, etc.

So, leukocytes increase in the smear, if there is inflammation in the genitals, there are cases medical error or laboratory research To prescribe effective treatment you need to undergo additional research. If leukocytes increase, but the pathogen is not found, this indicates that there is dysbacteriosis in the intestines and vagina. In this case, it is imperative to take care of the microflora. Taking a gynecological smear for flora is very important and effective method research in order to timely diagnose the condition of the female reproductive system. It is recommended that all women undergo such an analysis regularly, regardless of whether there are no or no complaints about reproductive system. One of the important factors that helps to find out about gynecological pathology, are leukocytes, these blood cells are of no small importance because they perform a protective function, rid the woman’s body of pathogenic microorganisms and thereby prevent the pathological process from developing. When the pathogen is identified, a special course of drug treatment will be prescribed, which should take into account the pathogenic flora, sensitivity to the drug and whether the woman is pregnant. It is necessary to carry out antibiotic therapy, but it is very important to control the entire process; this should be done by a doctor.

Gynecological women - most important aspect, affecting her health, course and labor practice in general. Unfortunately, there are many risk factors that destroy the sterility of the vaginal microflora, making it a breeding ground for infectious pathogens and inflammation. In the review we will find out what measures to take if the result shows a large number of in a smear for flora, what is the likelihood of infection in women, folk recipes and preventive measures.

What do leukocytes (Le) mean in a smear for microflora in women?

When examined by a gynecologist, patients often have to take a scraping. This is one of the main ways to find out about the patient’s sexual health. According to statistics, modern women today they increasingly have problems in the area reproductive health - bad ecology, early sexual activity and irregular intimate hygiene often have a bad effect on indicators. Leukocytes are necessary to fight pathogenic bacteria, cleanse the body as a whole, and normalize metabolic processes.

In a broad sense, a smear- This is a scraping that is taken from various places for subsequent bacteriological examination. For example, a scraping from the urethra is designated by the letter U, and from the vaginal canal - V. The diagnosis is carried out directly by a laboratory assistant, who also determines the number of bacteria. Leukocytes are small white blood cells that most important function- protection against the entry of infectious pathogens. Normal quantity leukocyte count (LE) should not be higher than 15 cells. If the indicator is higher, a diagnosis of leukocytosis is made.

Why is leukocytosis in a smear dangerous?

An increased content of leukocytes in a smear in women is associated with the phenomenon of an inflammatory process in the vaginal canal. The higher the index in the scraping, the longer and more complex the inflammation in the organs. The body begins to produce an excessive number of white blood cells to fight the infection. There is such a danger: if you visit the gynecologist irregularly, inflammation starts and, as a result, treatment is delayed, serious complications can arise in a woman’s gynecological health, up to the disruption or cessation of her labor.

Did you know? Inflammation in the uterus can occur not only in women, but also in girls who have not had sexual relations. Virgins can become infected with infectious diseases through everyday contact with infected objects or failure to maintain personal hygiene. Thus, in certain cases they exhibit leukocytosis. In this case, the smear is removed with soft thin probes that do not violate the integrity of the hymen. This procedure is painless.

Purpose of a smear for flora

A flora smear is so called because during diagnosis it becomes clear which flora (environment) currently predominates in the uterus - pathogenic or normal. Indicators for collecting analysis are a routine examination by a specialist, specific complaints of the patient: burning, painful sensations in the genitals, abdominal pain, poor urination. The study is also carried out when planning conception, after a course of treatment immediately after childbirth. The scraping is examined for flora at least 3 times, and if there are complications or complaints from the patient, even more often.

If a lot of leukocytes are detected in the smear, certain therapy will be prescribed. What does sampling mean, how to lower the level of leukocytes, how to treat this complication - let’s look at it in more detail.

Preparing for analysis

In order for the study to show the most truthful result, The following preparatory steps need to be taken:

don't join sexual intercourse 2 days before scraping;
do not use before 2 days;
try to refrain from urinating 3 hours before taking the test;
do not do it 2 days in advance;
in the evening before taking the test, wash off with water only, without using cosmetics(they affect the acidic environment of the genital tract).

Important! Scraping is not performed during menstruation - blood in the vagina, which is an antimicrobial agent, changes the composition of the scraping, and the diagnosis will show an incorrect result.

A smear is sometimes given involuntarily and without prior preparation - in case of emergency hospitalization. In this case, the analysis is taken, if possible, in the morning, before any gynecological procedures are performed.

Smear collection procedure

Note: in women aged 18 to 45 years, the leukocyte rate should not exceed 6-8 units. If the leukocytes in the smear are elevated, additional manipulations will be carried out to determine the reason for this.

A smear is taken using special sterile gynecological instruments. The analysis is taken from the urinary system with a special loop, and from the back wall of the vagina - with a clean swab. The scraping is directly applied to the glass and allowed to dry. In general, this operation is painless and short-lived.

The smear is then sent to laboratory technicians for review and diagnosis. The smears are colorless, so they are painted with special dyes - this makes them easier to study. Afterwards, leukocytes and other bacteria are counted, which for convenience are also painted in different colors. The readings are deciphered by a gynecologist. Note: during pregnancy, white blood cells can increase to 20, this is considered a normal indicator.

Often, a smear does not determine that the cause of the complication is an infectious disease. The fact is that this analysis by itself is not able to recognize infection due to the narrow limitations of the study of specific microbes. Therefore, the gynecologist will definitely prescribe special tests to determine the cause of the complication.

Symptoms of increase

It is possible to determine that a woman has a lot of leukocytes in a smear before taking the test. Symptoms will mostly relate to the gynecological spectrum:

painful urination;
vaginal disease, cervicitis;
presence of sexually transmitted infections;
in particular situations - intestinal dysbiosis and general inflammatory processes;
discomfort during sexual intercourse;
general weakness of the body, poor appetite;
Availability of used cosmetics.

Leukocytes may also be elevated in the cervical canal - it connects the internal and external gynecological organs of a woman. Since it is located directly in the uterus, it is through it that an infection can enter the vagina. Therefore, it is especially important to control the level of leukocytes in the microflora of the genital organs.

Did you know? The normal microflora of the uterus consists of 98% lactobacilli (milk bacteria). They are responsible for the acidic, oxygen-filled flora of the vagina.

Sometimes elevated white blood cells in a smear are detected in women after childbirth. The reasons for this are mainly the presence of infectious diseases or inflammation in the body and genital tract. Rarely, this occurs due to remaining pieces of the placenta in the uterus. Treatment will depend on the causative agent of the disease, on its root cause.

The mother's body can be severely weakened, so the immune system cannot cope with its protective function, as a result of which it risks being attacked by infections. Therefore, doctors carry out planned gynecological examinations and collection of tests after childbirth.

Leukocytes in a smear in women may be elevated even after. If an overestimation of the norm occurs during the first week after birth, then this is accepted as normal indicator, because after childbirth, leukocytes are often elevated. However, if after 7 days the levels have not decreased, anti-inflammatory treatment will be prescribed.

Diseases associated with leukocyturia

Leukocyturia name various complications caused by a large concentrated presence of leukocytes in the urine. The norm of corpuscles in a single urination should be no higher than 6. Notable: Leukocyturia can be true or false. In the first case, the analysis shows the number of leukocytes contained directly in the urine. In the second case, bacteria enter the urine sample along with the uterus, which is a consequence of violation of the rules for taking the test.

Leukocyturia is a complication that does not appear “alone.” It is often accompanied by infectious and non-infectious illnesses.

Infectious STIs as causes of high white blood cells in a smear

Sexually transmitted infections (STIs) are one of the consequences of leukocytosis and leukocyturia. These include:

gonorrhea (Gonoccocus);
syphilis;
Trichomonas;
tuberculosis of the genital organs (in 20% of women with a chronic disease);
genital herpes;
actinomycetes.

If there are such concomitant diseases Urgent hospitalization and specific therapy are recommended, especially if infected during pregnancy - because the infection can be transmitted to the fetus.

Non-infectious causes of high white blood cells in a smear. Treatment

An increase in leukocytes in a smear in women does not always mean that the body is fighting an infectious disease. The reasons are the consequences:

suffered painful trauma to the genital organs (both internal and external);
tumor formation;
kidney disease (uremic intoxication);
changes in the shape of cells in the cytoplasm (due to any concomitant);
allergic intolerance to certain cosmetics used for intimate hygiene;
extragenital diseases ().

So, an increased content of leukocytes in a smear in women can be a consequence of many factors. Modern gynecology offers wide variability in how to treat the disease. If the causative agent of non-infectious diseases is not a virus, malignant bacteria or infection, this simplifies therapy and shortens the treatment time, bringing recovery closer.

In each specific case, treatment and therapy is prescribed only by a specialist, based on the patient’s condition, the nature of the disease, the level of protective function immune system and the number of elevated leukocytes in the analysis. Leukocytosis is often divided into several categories: severe, mild and moderate. With severe leukocytosis and leukocyturia, copious discharge pus, in this case hospitalization is required.

What examination can identify the cause of leukocyturia?

If leukocyturia is suspected, to clarify the diagnosis, additionally The following tests are prescribed:

two-glass test method. During a one-time collection of urine, it is divided into two containers - initial and final. Average urine is not collected. This method allows you to determine exactly where the infection is located. If the bodies are found in the first “portion,” this means that inflammation occurs in the urethra. In the second case, this is a consequence inflammatory complication V bladder or ureters;
three-glass test method. Urine is divided into 3 parts with a single, continuous urination. If most of the leukocytes are detected in the first container, this indicates complications in urinary canal. If their number predominates in the other two cases, this is a sign of bladder disease.

Drug treatment

To return the increased number of leukocytes in a smear to normal, it is first necessary to eliminate the main pathogen. If it is infectious, anti-inflammatory therapy will be indicated. treatment includes both internal, oral therapy and medication local significance. Traditional medicine offers such methods How to treat this complication:

douching with medications (for example, solution and chlorhexidine);
administration of suppositories with antifungal properties (for leukocyturia) - etc.;
introduction cotton swabs with probiotics into the vaginal canal (to normalize microflora). The course of such treatment is at least 3 weeks;
use of various antiseptics hygiene products(external use);
vitamin therapy to restore the protective properties of the immune system;
Additionally, medications may be prescribed to eliminate concomitant diseases.

Important! Only a specialist can identify the root cause of the disease and determine the correct and high-quality therapy! Self-medication without prior consultation with a doctor can negatively affect health and aggravate the pathology.

How to treat with folk remedies

Alternative medicine offers alternative treatment for illness. However, remember that for effective therapy traditional methods must be auxiliary, and not the main method of treatment.

Traditional methods:

douching with medicinal herbs and decoctions that have anti-inflammatory properties (sage, calendula,);
use for douching;
insertion into the vagina of a tampon lubricated with a mixture of aloe juice and honey (the mixture has antimicrobial properties). This course of treatment lasts up to 2 weeks;
sitz baths with tincture of chamomile and oak bark (the water should not be hot, otherwise the genitals may burn);
douching with water with garlic tincture diluted in it (5 cloves per 2 liters of water).

Be sure to notify your doctor about any folk remedies you use for self-medication, since some of them may be incompatible with certain medications.

What not to do

First of all, it is strictly not recommended to self-medicate without consulting a doctor. Also, during the period of illness, you should not engage in heavy activities or simply overexert yourself physically. At severe forms illness, it is preferable to take a sick leave or go to a hospital for treatment, since going to work often complicates the necessary procedures. It should also be excluded for some time, especially in the presence of infectious diseases. It would be useful to refuse bad habits, because drinking alcohol greatly destroys the protective properties of the immune system.

Decrease in leukocytes in a smear in women: prevention

To avoid leukocytosis, the following preventive actions can be taken:

choose your sexual partner carefully, do not neglect
carry out high-quality intimate hygiene procedures;
pass routine examinations at the gynecologist;
contact only qualified and trusted doctors. Examination of the vagina and internal genital organs is a very delicate procedure and should only be trusted by an experienced doctor with a good medical reputation;
stick to healthy eating required amount include in the diet large quantity fresh vegetables And .

In this article, we looked at the reasons why leukocytes in a woman’s smear are elevated, what symptoms in the field of gynecology can be used to distinguish the disease, what determines its occurrence and how to treat it. This disease can turn into serious complication, if it is not detected in time and treatment is not prescribed. Do not neglect medical recommendations, visit your gynecologist regularly, and then the risk of leukocytosis will be reduced to a minimum. Be healthy!

At every visit to the gynecologist during the examination, samples must be taken from the urogenital tract, regardless of whether the woman has complaints or not. The flora smear shows not only beneficial, opportunistic and pathogenic bacteria, but also leukocytes.

Often, elevated white blood cells in a smear in women indicate some kind of problem in the body, which requires finding out the cause of this condition, and, of course, treatment. It is important to remember that no amount of self-medication will help cope with the problem, and sometimes can lead to negative consequences.

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 to protect the body, as specific, for example, from certain type microorganisms, both nonspecific and general.

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

Flora smear

A smear on the flora, as already indicated, is taken from the woman at each visit antenatal clinic, that is, every six months, if the patient has complaints, as well as after a long course of antibiotics, when planning pregnancy, during gestation and after childbirth. During pregnancy, a smear for microflora (in the absence of complaints) is examined three times: upon registration, before maternity leave (30 weeks) and at 36 weeks.

Preparing for the test

In order for the results of a smear on the flora to be reliable, it is necessary to prepare in advance for the test:

exclude sexual intercourse for 1 – 2 days;
Douching is not allowed 2 days before a visit to the doctor;
the use of suppositories, tablets and creams is prohibited for at least 24 hours;
a smear is not taken during menstruation, since menstruation changes the composition of the smear;
2 – 3 hours before visiting the gynecologist, refrain from urinating;
You should wash yourself the day before your appointment, warm water no soap.

If a woman is preparing for a preventive examination, then it is advisable to schedule a visit to the gynecologist in the first days after her period or before it begins.

Procedure for collecting and examining material

In a gynecological smear, the composition of the microflora of the contents of the urethra, vagina and cervix is determined.

The material is collected using sterile disposable instruments. A smear is taken from the urethra using a bacteriological loop or a Volkmann spoon, from the vagina ( posterior arch) with a sterile gauze swab, and from the cervix with an Eyre spatula.

The following symbols are indicated on the slides:

U – smear taken from the urethra;
C – cervical smear;
V – vaginal smear.

After the glasses are dry, they are sent to the laboratory for testing. Laboratory assistants stain smears with special dyes (Gram stains), then examine them under a microscope. During the analysis, leukocytes and various opportunistic and pathogenic bacteria are counted, which are painted in different colors.

Explanation of smear analysis

Data indicated in the smear analysis:

Leukocytes

The leukocyte rate depends on the location from which the smear was taken. Their content is normally small. In the urethra, the number of leukocytes is 0 – 5 – 10, in the vagina their concentration corresponds to 0 – 10 – 15, and in the cervical canal from 0 to 30.

During pregnancy, the content of leukocytes increases slightly and can range from 15 to 20 (in the vagina) in the field of view.

Flat epithelium

Flat epithelium lines the vagina, urethra and cervical canal. IN normal smears quantity epithelial cells ranges from 5 to 10. When the epithelium disappears (0 cells in the field of view), they speak of atrophy of the mucous membrane, and in the case of an increase in epithelial cells, they speak of inflammation.

Slime

Lactobacilli or Doderlein bacilli

It is typical for normal smears great content they are in the vagina, while they are absent in the cervix and urethra. When the number of lactic acid bacteria decreases, they speak of.

Yeast

Fungi of the genus Candida are normally absent at all three points of smear collection, but their occasional presence in the vagina is allowed. Increase yeast-like fungi talks about thrush.

"Key" cells

They are conglomerates of squamous epithelial cells and bacteria - gardnerella. Normally absent, the presence of such cells is a sign of gardnerellosis or bacterial vaginosis.

Leptothrix

Refers to anaerobic (living without air) gram-negative bacteria, often found in mixed infections, for example, thrush and bacterial vaginosis or trichomoniasis and chlamydia. If these bacteria are detected in a smear, an advanced analysis for sexually transmitted infections is indicated.

Others

Mobiluncus - also refers to anaerobic microorganisms and is present in candidiasis or bacterial vaginosis.
Trichomonas is a protozoan; normally they are absent from the smear.
Gonococci - cause a sexually transmitted disease - gonorrhea, respectively, are normally absent.
Escherichia coli— normally observed in single numbers in a vaginal smear. As the concentration of bacteria increases, bacterial vaginosis and neglect of personal hygiene are possible.
Cocci - in gynecological smears are divided into gram-positive - colored blue and gram-negative - do not stain and remain pink. Gram-positive cocci include opportunistic bacteria: streptococci, staphylococci and enterococci, which are normally found in smears in single quantities. When their concentration increases, they speak of nonspecific vaginitis (colpitis).

Degrees of vaginal smear purity

When we talk about gynecological smears, we mean not only smears taken from the cervical canal, urethra and vagina, but also separate species a smear that determines the degree of cleanliness of the vagina. The material is collected from the walls of the vagina and dried on a separate glass. There are 4 degrees of purity, but only degrees 1 and 2 are considered normal:

1st degree - leukocytes 0 - 5

It is considered an ideal option. The number of leukocytes is small, the microflora is mainly (up to 95%) represented by lactic acid bacteria, and there are only a few epithelial cells.

2nd degree - leukocytes 5 - 10

Also refers to the norm, but in a smear it is determined in a small amount, conditionally pathogenic microorganisms(cocci or single yeast mushrooms). Lactobacilli predominate, leukocytes and mucus are moderate, epithelial cells are normal.

3rd degree - more than 10 (up to 50)

The content of leukocytes increases, a lot of mucus and epithelium are detected. The concentration of Doderlein rods decreases due to an increase in conditional pathogenic flora.

4th degree - leukocytes completely (cannot be counted)

Against the background of a huge number of leukocytes (the term “entirely” is indicated in the description of the smear), pathogenic microorganisms (gonococci, trichomonas) are determined. Doderlein's rods are not detectable, there is a lot of mucus and epithelial cells (a consequence of the inflammatory process).

If grade 3 and 4 purity of the vaginal smear is detected, it is necessary to establish the cause of inflammation and carry out treatment.

Reasons for an increase in the content of leukocytes in a smear

If leukocytes in a smear in women are elevated, then the causes may be either diseases of the reproductive sphere or malfunctions of other internal organs and systems. Inflammation comes first among the causes of an increase in leukocytes in urogenital smears:

inflammatory process in the cervical canal or;
development of inflammation in the appendages (tubes and ovaries) or salpingoophoritis;
inflammation of the uterine mucosa – endometritis;
inflammatory process in the vagina - colpitis or vaginitis;
development of inflammation in the urethra – urethritis;
malignant tumors of the genital organs (destruction of healthy tissue is accompanied by inflammation);
intestinal and/or vaginal dysbiosis;
infections that are sexually transmitted (both sexually transmitted diseases and hidden sexually transmitted infections).

Pathogenic microorganisms are the culprits of inflammation

Why do leukocytes increase in a smear? Pathogenic microorganisms that are difficult to detect participate in the development of the inflammatory process in the usual way– examination of a urogenital smear, or activated representatives of opportunistic flora. To detect pathogens of latent sexually transmitted infections, they resort to a more complex examination - PCR method(examination of blood, urine, genital discharge).

A detailed study may reveal the following in smears or blood:

mycoplasma and ureaplasma;
gonococci (see);
Koch's bacillus (the causative agent of tuberculosis);
treponema pallidum (causative agent);
Donovan bodies (causative agents of granuloma inguinale);
Trichomonas (see);
amoeba;
human papillomavirus (cause);
immunodeficiency virus;
viruses;
mushrooms of the genus Candida ();
actinomycetes fungi.

Other causes of increased white blood cell counts

Bacterial vaginosis or vaginal dysbiosis

Under certain conditions, opportunistic flora is activated and the growth of lactic acid bacteria is suppressed:

disruptions in hormonal status ( puberty or decline in reproductive function - pre- and menopause, pregnancy and spontaneous abortion, endocrine diseases);
weakening of local and general immunity(hypothermia, antibiotic therapy);
severe stress and overwork;
microtrauma of the vagina due to intense sex;
radiation treatment, chemotherapy;
use of spermicides in the form of ointments and suppositories;
oral sex;
a large number of sexual partners;
excessive adherence to the rules of intimate hygiene, passion for douching;
entrance to the vagina deformed by scars (anatomical features, pathological birth, surgical interventions);
imbalance of intestinal microflora (dysbacteriosis);
foreign bodies in the vagina (tampons).

Allergy

allergy to medications and herbs;
intolerance to lubricants (gels, ointments);
intolerance to partner's sperm.

Irritation of the vulva and vagina

neglect of intimate hygiene;
temperature changes (hypothermia and overheating);
mechanical injury (tight, synthetic underwear, thongs, rough sex, etc.);
chemical burns (douching with acids and other drugs);
general diseases (diabetes mellitus, pathology urinary system and others).

In addition, elevated white blood cells in urogenital smears can be observed within 24 hours after coitus or for 7 to 10 days after insertion of the intrauterine device. If the reason for the increase in the content of leukocytes in smears cannot be established, a more thorough and detailed examination should be carried out, including to identify malignant tumors reproductive system.

Causes of increased leukocytes in pregnant women

A slight increase in the level of leukocytes in a smear during pregnancy is considered normal. Normal content white blood cells in vaginal smears correspond to 15–20 per field of view.

Elevated leukocytes in pregnant women in a smear are explained by physiological factors:

Firstly, during the period of gestation, restructuring occurs hormonal balance, progesterone and estrogens are produced in large quantities. Under the influence of estrogens, Doderlein bacilli begin to actively multiply, which create an acidic environment in the vagina and prevent the proliferation of opportunistic and pathogenic flora, but contribute to the accumulation of leukocytes.
Secondly, expectant mothers have a decreased immune system, which prevents the embryo from being rejected as a foreign body. Due to weakened immunity, the vagina is easily penetrated by pathogenic bacteria or is activated hidden infection, which explains the increase in leukocytes in gynecological smears (a protective reaction during inflammation).

Often a very high concentration of white blood cells is detected in smears (50 - 100 or leukocytes completely in the field of view), which is usually noted with thrush (urogenital candidiasis). IN similar cases in the smear except large number leukocytes, fungi of the genus Candida and mycelium in the form of white threads are detected.

An excess of leukocytes in expectant mothers requires careful examination and appropriate treatment. An infectious process from the vagina can spread to the cervix and cervical canal, penetrate into the uterine cavity, which will lead to infection of the amniotic fluid and fetus and result in miscarriage or premature birth.

Clinical manifestations

An increased level of leukocytes in secretions from the cervical and urethral canal and vagina often accompanies diseases of the female urinary and reproductive system:

frequent and painful urination is a sign or;
false urge to defecate indicates intestinal dysbiosis;
discharge from unpleasant smell accompanied by itching and burning may indicate vaginitis, cervicitis or inflammation of the uterus and;
purulent, foamy discharge or cheesy discharge is observed with vaginitis of a specific etiology (thrush, gonorrhea, trichomoniasis);
possible with pathology of the cervix, uterus or appendages;
in combination with an increase in leukocytes makes one think about inflammation of the appendages.

Diagnostics that determine the direction of treatment

Before you start fighting increased level white blood cells in smears, the cause must be determined this phenomenon. It often happens that the content of leukocytes in a gynecological smear is high, although there is no activation and growth of opportunistic flora and, especially, specific pathogens. What to do in such a case?

The gynecologist will recommend taking smears again, choosing the most successful day menstrual cycle and recommending that you properly prepare for testing (exclude sexual intercourse, taking medications, douching). If, when taking smears again, the leukocytes again have high rate, an extensive examination is carried out:

A smear from the cervical canal and vagina onto the tank. sowing

When vaginal and cervical secretions are sown on nutrient media, colonies of pathogenic and opportunistic microorganisms often grow. The pathogen is identified and its sensitivity to certain antibiotics is determined, which is necessary for further treatment.

PCR for latent sexually transmitted infections

The method is highly accurate and almost 100% detects hidden sexually transmitted infections, which may not manifest themselves clinically, but lead to irreversible consequences (infertility).

Ultrasound of the pelvic organs

In this case, preference is given to ultrasound performed with a transvaginal sensor. Possible reason elevated leukocytes in tests, in addition to inflammation of the uterus and appendages, there may be various tumor-like formations (ovarian cysts, uterine fibroids or sarcoma, uterine polyps, etc.).

Colposcopy

Examination of the cervix under multiple magnification helps diagnose diseases that are not visible to the naked eye, but are the cause of elevated white blood cells in tests (leukoplakia, cervical dysplasia or early stage cancer).

Consultations of related specialists

Appointed after the above examination. For example, consulting an endocrinologist and prescribing appropriate therapy will help normalize the level of leukocytes when diabetes mellitus, pathology thyroid gland or when overweight. A nephrologist will identify a disease of the urinary system (pyelonephritis, cystitis) and prescribe anti-inflammatory therapy (antibiotics, nitrofurans). The allergist will advise you to exclude irritating factors (synthetic underwear, the use of intimate sprays, deodorants and various lubricants). Neurologist appoint sedative fees and drugs to eliminate neurosis, which can also cause an increase in leukocytes.

Anti-inflammatory treatment

Anti-inflammatory treatment is prescribed only if an infection is detected. The doctor decides what to treat, depending on the test results. Anti-inflammatory therapy includes:

local treatment;
general treatment;
restoration of normal vaginal microflora.

Local treatment consists of douching:

the course is short and lasts no more than 4 – 5 days
medications (solutions of potassium permanganate, chlorhexidine, miramistin)
herbs (chamomile, sage, coltsfoot, calendula, St. John's wort). Cm. .

Candles:

at the same time, suppositories with an anti-inflammatory effect are prescribed locally (hexicon, polygynax, betadine and others, see).
if a diagnosis of urogenital candidiasis is made, it is recommended to use suppositories with an antifungal effect (clotrimazole, pimafucin, livarol, see). Suppositories are administered once or twice a day for 10 to 14 days.
when the inflammatory process is not started, treatment is limited to this.

Treatment of hidden sexually transmitted infections

If detected viral infection, venereal diseases or latent genital infections, systemic antibiotic therapy or antiviral drugs are prescribed. Choice medicine depends on the etiology of colpitis and/or cervicitis.

Restoration of the world flora

The final stage of therapy is the restoration of normal vaginal microflora (increasing the content of lactic acid bacteria). For this purpose the following are appointed:

vaginal suppositories or tampons with probiotics (lactobacterin, bifidobacterin, acylact, colibacterin and others).
A high content of white blood cells in smears during pregnancy is dangerous due to premature termination of pregnancy (miscarriage or premature birth), intrauterine infection of the fetus, the development of chorioamnionitis (inflammation of the waters and placenta), rupture of the birth canal during childbirth and the development of purulent-septic diseases in the postpartum period. Therefore, expectant mothers should follow the doctor’s recommendations with special care and carry out the prescribed or treatment if the leukocyte count in the tests increases.

Question:
Is it possible to have sexual activity with elevated leukocytes in smear tests?

If a specific infection has not been identified (gonorrhea, chlamydia, genital herpes and other diseases), then having sex is not contraindicated.

Question:
Can I get pregnant if my smears show elevated white blood cells?

Yes, it is quite possible to become pregnant, but it is advisable to undergo preliminary treatment, since often a high level of leukocytes in tests indicates an inflammatory process in the genital organs.

Question:
Is it possible to reduce the content of leukocytes in tests using only traditional methods treatment?

You should not self-medicate, including treatment only with traditional medicine, if you have a “bad” smear test result. Only a doctor can identify the cause of “bad smears” and prescribe appropriate treatment. Reduce white blood cells in tests only with the help of traditional medicine is not possible, since treatment with antibiotics or antiviral drugs or therapy for concomitant diseases is often necessary.

With the onset of gestation, the expectant mother strives to be more careful and attentive to her health.

Numerous tests and examinations that a woman undergoes during pregnancy are designed to promptly identify problems and correctly eliminate them. One of these tests is a gynecological smear for flora. The study of material from the urogenital tract allows us to determine many pathological conditions already at their initial stage, as it reveals the presence of both beneficial microorganisms and pathogenic and opportunistic forms of bacteria, as well as leukocytes. Early diagnosis allows, if necessary, to begin treatment in a timely manner and prevent negative consequences. Determining the level of leukocytes in a smear during pregnancy is an important diagnostic test.

Leukocytes in a smear during pregnancy: getting to know important helpers

Leukocytes in a smear during pregnancy. Preparation for collecting vaginal material for examination

In order for the analysis results to be reliable and reflect the true picture, it is necessary to follow the rules for preparing for a smear test:

Eliminate intimacy, as well as douching 1-2 days before the analysis.
Do not use vaginal suppositories, tablets or cream a day before taking a smear.
It is advisable to refrain from urinating 2-3 hours before visiting the doctor.
Daily hygiene procedures should be done without using soap (on the eve of visiting the doctor).

Leukocytes in a smear during pregnancy

Pregnant women do not take a smear test for flora at every visit to a gynecologist, but urogenital material is still collected several times. The first time a woman undergoes a gynecological examination is most often when registering in connection with her interesting situation. This analysis is one of an extensive list of studies that are designed to establish an overall picture of the state of health expectant mother. If a woman does not make specific complaints, then during the remaining weeks of waiting for the baby she will be asked to take this test again at about 30 weeks. If there are indications or complaints from the pregnant woman, a smear may be scheduled earlier.

What number of leukocytes can normally be detected in a woman’s smear during pregnancy?

The changes that occur in the body of the expectant mother affect the activity of absolutely all organs and systems. In some cases, this process occurs easily and gently, and in some women, such changes exacerbate chronic processes that have been “dormant” in the body for many months or even years. So, the material has been collected and now the results of the analysis are in the hands of the doctor. How to find out whether the obtained indicators are normal leukocytes in a smear during pregnancy or indicate the presence of a pathological process? Of course, only a doctor can competently comment on a specific situation based not only on the number of blood cells, but also on other data (both a smear and other tests), but knowledge of the reference values will also help to draw conclusions. Depending on the detected number of leukocytes, there are 4 degrees of purity of the vaginal smear:

1st degree – leukocyte content 0-5. This type The smear can be called ideal, since lactic acid bacteria and a minimum of leukocytes are present.
2nd degree – leukocyte content 5-10. Such meanings also fit the term “norm”. There may be a small number of opportunistic microorganisms, but the number of lactobacilli still prevails.
3rd degree – leukocyte count 10-50.
4th degree – the content of leukocytes is completely. In this case, a lot of leukocytes are detected in the smear, which poses a particular danger during pregnancy.

Smears of 3 and 4 degrees of purity indicate the activation of opportunistic forms that violate normal microflora vaginal mucosa. It is worth noting that the norm of the number of leukocytes in women in this position is higher than that of other representatives of the fair sex. This feature associated with additional activation protective forces body, which was caused by the pregnancy itself. Although significant deviations require additional examination of the expectant mother. The acceptable number of leukocytes in a gynecological smear of a pregnant woman is no more than 10-15 units. in the PZR (in the field of view). The maximum number of leukocytes in a smear in a woman should not exceed 20 units. in pzr. If the obtained values exceed these values, the woman is recommended to undergo additional tests to determine the exact cause of the deviations.

Increased number of blood cells in a smear during pregnancy

If there is an increased number of leukocytes in a smear during pregnancy, then we can safely talk about the presence of an infectious process. Moreover, the higher the titers of white blood cells, the stronger the ongoing infectious process. This factor cannot be ignored, since the spread of infection threatens not only the woman, but also the baby who lives in her womb. The baby can “get” an intrauterine infection, and the pregnancy can be terminated before nature’s due date.

Elevated leukocytes in a smear during pregnancy: reasons for a “bad” smear

Having received bad analysis results, it is important to find out the factors that led to such indicators.

Diseases of the genitourinary system

An increase in the number of white blood cells in most cases causes pathologies inflammatory in nature that affect the organs of the genitourinary system. The location of the source of the disease also determines the type of disease:

Cervicitis - if inflammation has invaded the cervical canal.
Colpitis - in case of damage to the vaginal mucosa.
Endometritis is inflammation of the lining of the uterus.
Urethritis – pathological process flows in the urethra.
Inflammation in the area of the ovaries, fallopian tubes.

In addition, an excessive increase in leukocyte titers can be observed with infections such as:

Genital herpes.
Gonorrhea.
Microplasmosis.
Ureaplasmosis.

What other ailments lead to an increase in the number of leukocytes in a smear during pregnancy, which is the cause bad tests? Banal thrush (candidiasis), as well as vaginal dysbiosis (vaginosis) also lead to leukocytosis. A “bad” smear may be present in pathologies unrelated genitourinary system women, for example, with intestinal dysbiosis.

Other factors

If the results of the analysis reveal an increase in leukocytes, you should not immediately look for the reasons for the presence of “terrible” diseases. A similar picture can also occur in conditions such as:

Allergic reaction to herbs, medications, lubricants.
Insufficient hygiene of the genital organs, or vice versa – passion for douching, excessive hygiene.
Mechanical damage - tight or synthetic underwear, rough manipulations during sex.
Stress, overwork.

Additional tests and examinations if there is an increase in leukocytes in a smear during pregnancy

If the results of the smear raise questions about the woman’s condition, he may order additional examinations.

Sowing for microflora

If leukocytes are detected in the smear, it would be advisable to culture the flora during pregnancy. Inoculation of secretions on special media in some cases leads to the growth of colonies of pathogenic as well as opportunistic organisms. If this happens, it is necessary to identify the “enemy” and also find out its susceptibility to the active components of antibacterial drugs.

PCR diagnostics

An additional study, if leukocytes in the smear are elevated during pregnancy, can be PCR diagnostics. This research method is highly accurate and with almost 100% probability will help determine the presence or absence of hidden sexually transmitted infections. Such illnesses can for a long time not to make itself felt and appear at the most undesirable moment. To carry out diagnostics, biomaterial is taken from a pregnant woman and examined.

Ultrasound

A careful ultrasound examination with a transvaginal probe will help determine the presence of inflammatory diseases uterus, appendages, presence of neoplasms.

How to reduce leukocytes in a smear during pregnancy: treatment

Normalizing the level of leukocytes is directly related to eliminating the problem that caused this condition. Based on the results of symptom assessment, as well as the data obtained additional examinations, the doctor determines the cause of the increased number of leukocytes in the smear during pregnancy and the necessary therapy regimen. It is important to remember that self-prescription of drugs is strictly unacceptable.

Drug treatment of leukocytes in a smear during pregnancy

If a disease is detected, then herbal treatment alone will not be enough. An integrated approach to eliminating the disease includes both local and general therapy.

Antibacterial therapy is prescribed, but only if there are absolute indications. For example, when gonorrhea, ureaplasma or syphilis are detected, Ceftriaxone, Azithromycin, and Erythromycin often become the drugs of choice.
Treatment for genital herpes is not always prescribed. But in cases where the doctor sees the feasibility of therapy, Zovirax ointment can be used.
In cases of candidiasis, treatment with drugs such as Pimafucin, Polygynax, Livarol, Clotrimazole, Terzhinan is possible (the last 3 drugs are prohibited for use in the first trimester of expecting a baby)
Solutions of potassium permanganate, miramistin, chlorhexidine, and chlorophyllipt can also be used to treat the genitals.

Methods of traditional therapy for leukocytes during pregnancy

If no serious abnormalities are found, the woman can turn to traditional medicine. But even in this case, a preliminary consultation with a doctor is necessary.

Herbal decoctions will help normalize vaginal microflora. St. John's wort leaves, chamomile, aloe, oak bark or red root are suitable for these purposes. To carry out the procedure, you must prepare a warm sitz bath with healing decoction. Good effect also possess sage, coltsfoot, calendula.
Candles with sea buckthorn oil. Mix 10 g butter with beeswax. Melt the resulting composition in a water bath, simultaneously stirring in 3 g pine resin Pour the resulting mass into molds (for future suppositories) and cool. Insert 1 suppository vaginally before bedtime.
It is necessary to improve nutrition by saturating the diet with fermented milk and protein products.
Until complete healing, abstinence from intimate relationships is recommended.

Do not worry too much if, after the analysis, a large number of leukocytes are found in a smear during pregnancy. Additional tests and examinations will help determine the exact cause of the violations and effectively deal with them.