home Calculators Women's diseases: when treatment is necessary. Carrying out and interpreting tank culture from the cervical canal

Women's diseases: when treatment is necessary. Carrying out and interpreting tank culture from the cervical canal

Due to the features anatomical structure representatives of the fairer sex have to undergo various gynecological examinations of their bodies.

If ultrasound, smear and standard manual examination are considered routine tests performed during the next visit to the doctor, then seeding from the cervical canal mucosa becomes a new procedure for many.

The collection of biological material is a painless procedure and does not take much time, but the diagnosis itself is not carried out urgently.

Bacteriological examination of the composition of the microflora of the cervical canal is carried out within 3-5 days. Diagnostics does not apply to tests performed by cito (urgent analysis), and also requires certain laboratory conditions for the cultivation and subsequent study of microorganisms that make up the mucus.

What is bacteriological culture?

Sowing from the cervical canal in women for flora is a procedure that involves collecting secretions lining the mucous membrane of the inside of the cervix. The cervical canal is a passage connecting the uterine cavity and vagina. The main function of this segment is the transport and secretion of mucus.

When performing bacteriological culture, the contents of the cervix are collected with a sterile spatula. In the future, this material is sent for research.

For several days, the microflora is kept in conditions favorable for bacterial growth. After a few days, the quantitative content and type of microorganisms obtained are assessed.

When unnatural flora is detected, sensitivity to antibiotics is established. Manipulation allows you to select effective treatments medicines.

Indications and purposes of the procedure

Bacterial culture of microflora from the cervical canal is carried out when planning any interventions in the uterine cavity or for the purpose of prevention. Indications for its implementation are:

Pregnancy or planning for it;
Preparing for childbirth;
Preparation for hysteroscopy;
Gynecological curettage (therapeutic or diagnostic);
Infectious and inflammatory processes in the vaginal cavity (when the number of leukocytes in the cervical area exceeds the norm);
Recurrent infectious or inflammatory diseases pelvic organs.

The main goal of diagnosis is to identify pathogenic microorganisms inhabiting the cervical cavity and eliminate them by effective treatment. The study allows you to stop the infectious-inflammatory process and prevent it from spreading to the uterine cavity and appendages.

In the process of studying mature microorganisms, pathogenic or conditionally pathogenic microorganisms, as well as mucous impurities, can be detected.

Not all pathogenic microorganism can be determined by bacteriological examination. Some subtypes require polymerase chain reaction. Therefore, if there is inflammation in the vagina, but there are no bacteria in the cervical canal, pathology cannot be ruled out.

Bacteriological culture during pregnancy: why is it done?

Every pregnant woman will have to take a microflora test, and some more than once. Diagnostics must be carried out upon registration in the first 12 weeks. It helps to determine the condition of the cervical canal mucosa, and if pathologies are detected, carry out treatment.

The main danger of the presence of infections in the cervix is infection of the membranes. Inflammation can also cause cervical insufficiency and other complications during pregnancy.

Before childbirth, manipulation is prescribed to those patients whose smear shows elevated white blood cells, and there are also cells atypical for this area.

Often, pregnant women are afraid to undergo a smear test, worrying that the intervention could harm the pregnancy. This myth should be dispelled, because refusal to perform diagnostics can lead to serious consequences. more harm new state.

The procedure for collecting biological fluid from the cervix is carried out with a thin spatula, which is inserted to a depth of no more than 5-15 mm. The tool does not even reach the middle of the canal to cause any disturbance. Therefore, tank culture from the cervical canal can and should be done during pregnancy.

Preparing for diagnosis

The patient should prepare for the test. To do this, you must follow the rules within 24 hours:

Do not douche;
Avoid sexual intercourse, especially without a condom;
Do not use vaginal suppositories, including contraceptives;
Avoid tampons and other hygiene products inserted into the vagina.

If the woman was previously given a smear, then a smear is taken no earlier than 2 days later.

Why can’t you use drugs that affect the vaginal microflora before the examination?

It is recommended to avoid the use of antibiotics several days before the procedure. hormonal drugs And antifungal drugs. They can influence the quantitative composition of the microflora of the cervical canal and vagina. In this case, the results obtained will be unreliable.

If a woman is treated with antibiotics or other agents that affect the microflora, then it is necessary to reschedule the day of bacteriological culture. It should be remembered that antimicrobial drugs cannot be stopped prematurely, otherwise they will be ineffective.

In order for the diagnosis to be reliable and the treatment to be completed completely, it is necessary to individually agree with the gynecologist on the time of the manipulation.

Interpretation of results

The culture results are given to the patient in 3-5 days. The data received is deciphered by a doctor. You should not try to interpret the quantitative values of various microorganisms on your own. Some of them can normally inhabit the mucous membrane of the cervical canal, which does not require treatment.

In healthy patients, beneficial flora predominates in the smear, which consists of lactobacilli in quantities no less 107 . Escherichia coli and enterococci may also be present, but they do not have active growth and are determined by the quantity 102 .

An unfavorable diagnostic result is indicated by the detection of the following microorganisms in a smear:

Particular attention is paid to patients whose smear contains diphtheroids. They indicate vaginal dysbiosis and require immediate treatment. Effective drugs are selected for each type of microorganism colony individually.

When two cherished stripes finally appear on the test, it seems that there is now no reason to worry. You can relax and enjoy the happy period of waiting for the baby. However, you need to constantly keep your finger on the pulse, especially for expectant mothers who become pregnant after long-term treatment.

In order for the picture to be complete and clear, it is necessary to regularly take tests and conduct studies prescribed by your doctor. One of the most important studies throughout pregnancy is bacterial culture from the cervical canal. The condition of the cervical canal determines how successful the outcome of the pregnancy will be. That's where it accumulates a large number of pathogenic dangerous microorganisms from Klebsiella to coli. Their early detection and subsequent treatment guarantee the birth of a healthy baby.

The meaning of the cervical canal

The cervical canal is a kind of bridge from the cervix to the vagina. Doctors call it the pharynx. During menstruation, they come out through it blood clots, through which the sperm moves to the egg. The average channel width is 7-8 mm. These values may vary from age-related changes, presence of infections urinary tract, states hormonal levels women. Pregnancy adds its own adjustments to the usual life of the cervical canal.

U expectant mother the length of the cervical canal reaches 3.5 - 4 cm, provided that the length of the cervix is at least 2 cm. Both ends of the pharynx must be closed. Based on their condition and degree of openness, the doctor determines the approach of labor. It is in this area of the female reproductive system that a plug is formed, which throughout the entire 9 months separates the placenta and baby from the effects of harmful factors. external environment. A few weeks before giving birth, the plug comes off. From now on, mothers listen more carefully to their well-being. As soon as the baby begins to move along the birth canal, the pharynx expands to almost 10 cm.

If the period is still very short, the cervical canal acquires a bluish color, signaling that there is pregnancy.

Why is a bacterial culture test prescribed?

Culture from the cervical canal during pregnancy is one of the most effective and informative methods condition of the genital organs of a pregnant woman. It is this that shows the presence of pathogenic flora or the body’s reaction to taking antibiotics. Having received the results, the doctor will immediately be able to select individual treatment. Sowing is also carried out to study beneficial lacto- and bifidobacteria.

This type of analysis is not prescribed to everyone. When registering a future woman in labor, any gynecologist will take a general smear from her. Under conditions of increased leukocyte content, it is advisable to take a smear from the cervical canal. This is due to the fact that a high percentage of white blood cells indicates ongoing inflammation in the body of a pregnant woman. Only additional analysis will help identify the exact cause.

Controversy surrounding analysis

You can often hear concerns from expectant mothers about taking a smear from the cervical canal. This is due to the analysis procedure itself. Since the probe for taking biomaterial is inserted inside 0.1 -1.5 cm deep, the question involuntarily arises whether this will lead to a miscarriage or some other pathology on the part of the fetus. Absolutely any obstetrician-gynecologist will assure you of the safety of this test, but will not prescribe it for you without special reasons. Strictly according to indications!

The procedure for taking biomaterial takes less than a minute. Before taking a biosample, a Cusco speculum is inserted into the vagina, and then a brush is inserted into the cervical canal to a depth of 2 cm. The resulting sample is immersed in a sealed container with a gel-like liquid and sent to the laboratory for decoding. However, before the material is under the microscopic eye, it is provided with all favorable conditions for the growth of microorganisms in it.

Preparing for the study

To ensure that the analysis picture is transparent and does not raise questions for the doctor observing you, careful preparation is necessary. Distorted result is the way to improper treatment and unpleasant consequences.

It is better to start preparing for the analysis a few days in advance, and if possible, 1-2 weeks in advance.

Stop taking any antibacterial drugs.
Don't douche.
Eliminate the use of contraceptives vaginal suppositories and creams.
A day before the study, stop having sex.
If a colposcopy or other diagnostic procedures with the introduction of mirrors into the uterine cavity, it is better to postpone the study for a while.
Immediately before taking a smear, do not go to the toilet for minor needs and do not wash yourself.

Important! Pregnant women this procedure This can only be done by a gynecologist with sufficient experience.

The results are ready 4-5 days after taking the material.

What does the result say?

A normal culture in a pregnant woman should contain only beneficial bacteria- lacto and bifido. Doctors admit the presence of a small percentage of E. coli. It should not exceed 10^2. There shouldn't be any mushrooms.

We can talk about pathology if the following microorganisms are present in the smear:

E. coli beyond the normal range;
yeasts, especially mycelium and or Candida;
staphylococcus of all types;
gonococcus;
Trichomonas;
gardnerella;

Future mothers should know that ureaplase, chlamydia and mycoplase this type the research does not reveal it, because it simply “does not see” them.

Pathogenic bacteria grow at different rates, and this determines what diagnosis the woman will be given.

If the danger level is first or second, when bacteria grow slowly and weakly and are present only in a liquid medium, then this is a signal of a contaminated nutrient medium.

An active inflammatory process is indicated by bacteria that grow in excess of 100 colonies on a solid medium. This can be the result of anything: poor hygiene, hereditary diseases, weakened immunity. Such data helps the specialist take the right measures to “save” the patient.

Taking a culture sample from the cervical canal is an important step in diagnosing a pregnant woman. It helps to avoid irreparable problems in the future. Finding and neutralizing it at an early stage is much better than treating an advanced one. Sometimes this is impossible. Any girl or woman needs to think about a thorough examination at the stage of pregnancy planning, which will help give birth to a healthy toddler.

Medical tests and studies play a big role in diagnosis various diseases. Many diseases do not produce any symptoms, and only laboratory test cells under a microscope can reveal infection or the presence pathological changes in tissues. That is why all women aged 19 to 65 years old must be seen by a gynecologist for analysis.

How is a cervical smear taken?

One of the simplest, but no less important gynecological tests is a smear from the cervical canal. It is performed for every woman reproductive age, who came for a preventive appointment with a gynecologist during a routine examination on the chair. A smear is a scraping from the cervical canal, which is then sent for cytological examination to the laboratory. The latter is usually done using one of two methods: examining biological material under a microscope or do bacteriological culture. Cytology of a smear from the cervical canal makes it possible to judge the state of the microflora, and also helps to identify inflammatory processes and even oncological changes in the cervix.

A cytological smear from the cervical canal is not painful or scary at all. The doctor simply carefully takes the scraping with a special spatula, and then transfers it to a clean glass slide. This process takes literally a few seconds. Analysis is the basis for the prevention of many women's diseases, so you need to prepare for it: at least a day before going to the doctor, sexual intercourse, douching, the use of vaginal suppositories, pills, etc. are not recommended, otherwise the analysis will be uninformative. In addition, a cervical smear test should not be performed during menstruation.

Deciphering a smear from the cervical canal

In the table below you see the indicators by which the doctor interprets this analysis. This is the presence or absence of leukocytes, gonococci, trichomonas, yeast fungi and other norms in a smear from the cervical canal. Letters V, C and U stand for vagina, cervix and urethra respectively (those tissues where certain microorganisms were or were not found).

The following facts indicate a deviation from the norm:

a large number of leukocytes, mucus or epithelium (inflammation);
lack of epithelium (lack of estrogen hormone);
presence of gram-negative rods ();
gonococci();
trichomonas (trichomoniasis);
chlamydia (chlamydia);
yeast fungi (candidiasis);
key cells (vaginal candidiasis).

There is also a Papanicolaou reading option - it helps identify cervical pathologies, including precancerous conditions. There are 5 stages:

In more than 20% of cases, the results of this cytological examination are false. This happens when outdated methods are imperfect. Therefore, if you doubt the reliability of the result of a smear from the cervical canal, you can retake it or ask your doctor about colposcopy - a detailed examination of the cervix, which provides expanded information about possible pathologies, which are not noticeable during normal inspection.

A smear from the cervical canal, what kind of test is it, how is it carried out, does it require pain relief, and is it always possible to get a reliable result? These questions are important, since it is taking a smear analysis from the cervical canal (Pap test) and from the cervix that allows for the most early stages diagnose cervical cancer or its underlying diseases, thus getting a chance to prevent the oncological process.

As a rule, when visiting a gynecologist, a woman is always examined in a chair and a vaginal smear is always taken, but it can be examined in different ways. The most common study is on the “degree of purity”, the composition of the microflora (seeding). But their results do not make it possible to judge the likelihood of oncological processes. But cervical cancer is asymptomatic and can be detected in the early stages by examining a smear from the cervical canal.

What you need to know

1. You need to undergo this examination in the middle of the menstrual cycle. Approximately 5-7 days after the end of menstruation.

2. 2-3 days before this event, you cannot have sex, use vaginal treatments, contraceptives, or douche. Also, during this time, you should not visit a gynecologist or do a colposcopy. Only then will the cytology of a smear from the cervical canal be reliable.

3. It is better to take the test if your microflora is absolutely healthy. if you have pathological discharge, bad smell from the vagina, itching, rashes - you must first be cured and achieve, preferably, the first degree of cleanliness of the vagina. Then there is a high probability that there will be no inflammatory process on the cervix, because it makes the result uninformative. It is advisable to first take a smear for flora from the cervical canal; according to its results, there should be no more than 30 leukocytes in the field of view.

4. You need to get tested once a year. It is especially important to do this for those who have an active sex life, often change sexual partners, and have HPV (human papillomavirus) 16, 18 and other oncogenic types.

5. A doctor should take a smear using special brushes - spatulas. Pay attention to this. They are not always available in antenatal clinics, and doctors can take discharge for analysis directly from a gynecological speculum that touched the cervix. But such an analysis will not be reliable!

6. If there is ectopia, leukoplakia and other changes on the cervix, the material should be taken from them, since these are background diseases for cervical cancer.

7. It doesn’t hurt at all to pass it. This misconception arose due to confusion this study with aspiration of the endometrium - this is completely different; the instruments will not penetrate into the uterus. After taking a Pap test, there may be slight spotting (brown) - this is not dangerous and is normal.

8. When a cervical smear is taken, the norm during pregnancy is the same as outside of it. Another thing is that this examination is not mandatory during pregnancy, unlike microscopic examination smear, which is carried out twice.

Reading the result

Deciphering a smear from the cervical canal is the job of a gynecologist. But you should know that attention is removed by the presence of collected material atypical cells. In moderate quantities they can be inflammatory processes. That is why we previously wrote that you need to take cytology only when the number of leukocytes does not exceed acceptable limits.

A smear from the cervical canal is normal - this is when atypical (with an altered nucleus) cells are absent. If there are altered cells, a diagnosis of “dysplasia” (neoplasia) of 1, 2, 3 degrees is made, or cancer - if a typical type of malignant cells is detected.

If grade 1 dysplasia is detected, in the absence of underlying diseases on the cervix, the woman is recommended to be observed. In grades 2 and 3, colposcopy, biopsy, and often conization are required (when the affected area of the cervix is removed with a scalpel or radio knife). The fact is that grade 3 dysplasia often turns out to be cancer in situ. And then the treatment is carried out by a gynecological oncologist at an oncology clinic.

Tank culture from the cervical canal- it's simple and available method determination of microorganisms living in the cervical canal. It is prescribed only when a vaginal smear shows a poor result and there is increased amount leukocytes.

It is especially important for pregnant women to take the test, because they are responsible for the health of the fetus developing in their body.

This analysis helps to recognize the causative agents of dangerous diseases, count their number and decide on an antibiotic that can be used to cope with the disease.

What is the cervical canal and what is its significance?

The external one is usually examined by a gynecologist using medical instruments. nulliparous women have a dotted pharynx. And those who gave birth have a slit-like pharynx.

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Smooth channel pale pink typical for young people healthy women. And during menopause, the mucous membrane is very pale, and almost no secretion is produced.

IN female vagina There is a huge variety of microorganisms and fungi. And the uterus somehow remains sterile. A similar situation is possible thanks to the cervical canal. After all, in its walls there are many cells responsible for the production of special protective mucus.

At the very beginning and after the end of the menstrual cycle, mucus from the cervical canal has an acidic environment. The mucus from the cervical canal is very viscous and blocks the passage like a plug.

Harmful microorganisms die in this acidic environment. And spermatozoa in such an environment become incapable of fertilization. can be determined by stretching the mucus; the longer the thread, the more hormones in the body.

Already in the middle monthly cycle The estrogen level increases significantly, and the mucus becomes thin and alkaline. And sperm gain access to the eggs of the uterus.

My personal story

With premenstrual pain and unpleasant discharge, it's over!

Our reader Egorova M.A. shared her experience:

It's scary when women don't know the real reason their illnesses, because problems with menstrual cycle may be harbingers of serious gynecological diseases!

The norm is a cycle lasting 21-35 days (usually 28 days), accompanied by menstruation lasting 3-7 days with moderate blood loss without clots. Alas, the state of the gynecological health of our women is simply catastrophic; every second woman has some kind of problem.

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Controversy surrounding analysis

Expectant mothers are wary of bacterial analysis. After all, the brush is inserted deep into the vagina and a smear is taken from the cervical canal. But taking a smear test cannot lead to a miscarriage.

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The study is completely safe, but it is prescribed only when absolutely necessary. When assessing the state of the vaginal microflora, gynecologists use a special concept - the degree of purity.

There are 4 degrees of vaginal smear purity:

If a vaginal smear indicates problems, and the degree of purity is 3 or 4, then pregnant women are additionally prescribed a culture test from the cervical canal.

In a normal culture of a pregnant woman there should only be beneficial microorganisms: lacto and bifido. A small amount of E. coli is allowed. There should be no yeast or bacteria present.

If detected increased content dangerous microorganisms, treatment is necessary. Good result gives therapy for early stages pregnancy.

Indicators are normal

The canal is populated by various microorganisms; it cannot be completely sterile. Lysozyme contained in the secretion of the canal has an antimicrobial effect.

Beneficial bacteria must be present in the cervix. But just one harmful bacteria, for example, staphylococcus indicates an infection and the need for treatment.

The composition of the microflora depends on:

on the age of the woman;
presence of infection;
hormonal levels;
taking antibiotics;
various pathologies.

The analysis provides data on the microorganisms inhabiting the cervix. Normal indicator must not contain any fungi or bacteria.

However, there must be beneficial bifidobacteria and lactobacilli, but not less than 10.7. Indicators of E. coli – 10.2 enterococci. Leukocytes are normal up to 30. Flat epithelium – 5-10. There should be a moderate amount of mucus.

Pathological is a condition in which a large number of E. coli, gonococci, yeast fungi, staphylococci, and trichomonas are found. This analysis is not able to detect chlamydia and ureaplasma.

Decoding the results

The gynecologist interprets the results obtained from the laboratory. The analysis shows the name of the microorganisms inhabiting the cervix, as well as one of the 4 levels of cleanliness of the canal.

There are 4 levels of channel purity:

The first two degrees indicate contamination of the canal, and the third and fourth degrees indicate inflammatory processes.

And the reasons increased number bacteria in the cervix are decreased immunity, hormonal imbalances, taking antibiotics, hereditary diseases, poor hygiene, infection during sexual intercourse, infection due to medical procedures.

Tank culture for the presence of bacteria can also determine sensitivity to various antibiotics. Bacteria whose sensitivity needs to be determined are placed in a dish with a nutrient medium. Discs soaked in antibiotics are placed on the surface of the medium.

This antibiotic penetrates the environment and affects the growth of microorganisms. The bowl should stand for some time at room temperature, and then it is placed in a thermostat for several hours.

After the required amount of time has passed, the diameter of the growth inhibition zone is measured and the suppression of bacterial growth is assessed:

no stunting indicates bacterial resistance to the drug;
zone diameter up to 1.5 cm– weak reaction, low effectiveness of the product;
zone diameter from 1.5 to 2.5 cm– moderate sensitivity;
diameter greater than 2.5 cm– hypersensitivity to antibiotics.

It is important to determine sensitivity to antibiotics, because different women Bacteria react differently to certain medications. Cannot be prescribed medications, based only on textbook recommendations. It is necessary to find out which antibiotic can cope with the disease.

Is there a difference between tank culture and smear cytology?

- This is a scraping from the cervical canal for microflora. It can only detect fungi and bacteria.

Tank culture analysis is important method diagnosis of various diseases. The study is recommended for all women who have been diagnosed with vaginal discharge that is uncharacteristic of healthy flora. The method is completely safe during pregnancy, but the collection of biomaterial should be done very carefully.

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