Pap Smear: MedlinePlus Medical Test

What is a Pap Smear?

A Pap smear is a test to help prevent cervical cancer or find it early. The cervix is the lower, narrow end of the uterus that opens into the vagina. During a Pap smear, a health care provider collects cells from the cervix and sends them to a lab.

At the lab, the cells are checked under a microscope for cancer or for signs that they may become cancer. Cells that may become cancer are called precancers. Finding and treating precancers can help prevent cervical cancer. The Pap smear is also a reliable way to find cancer early when it’s easier to treat.

Other names for a Pap smear: Pap test, cervical cytology, Papanicolaou test, Pap smear test, vaginal smear technique

What is it used for?

A Pap smear looks for abnormal changes in cervical cells before they become cancer. Sometimes the cells collected during a Pap smear are also checked for HPV, a virus that can cause cell changes that may lead to cancer.

Pap smears and HPV tests are cervical cancer screening tests that look for cancer before you have any symptoms. Research shows that cervical cancer screening can greatly reduce the number of new cervical cancer cases and deaths from the disease. Ask your provider which test is right for you or if you should have both a Pap smear and an HPV test.

How often do I need a Pap smear?

In general, if you’re between age 21 and 65, you should have regular Pap smears:

• If you’re between ages 21 and 29 and your last Pap test result was normal, your provider may say you can wait three years until your next test.
• If you’re between ages 30 and 65 and your last Pap smear result was normal:
  • Your provider may say you can wait three years until your next test.
  • If you also had a normal HPV test result, your provider may say that you can wait five years until your next test.
• If you’re over age 65, your provider may tell you that you don’t need Pap smears anymore if you:
  • Have had normal Pap smears for several years.
  • Have had surgery to remove your uterus and cervix because you had a condition that was not cancer, such as fibroids.

If you have a higher risk for developing cervical cancer, your provider may recommend screening more often or after age 65. You may have a higher risk if you:

• Had an abnormal Pap smear in the past
• Have HIV
• Have a weakened immune system
• Were exposed to a drug called DES (Diethylstilbestrol) before you were born. Between the years 1940–1971, DES was prescribed during pregnancy to prevent miscarriages. It was later linked to an increased risk of certain cancers in the female children exposed to it during the pregnancy.

If you’re under age 21, cervical cancer screening is not recommended. Your risk of cervical cancer is very low. Also, any changes in cervical cells are likely to go away on their own.

If you are unsure whether you need a Pap smear, talk with your provider.

What happens during a Pap smear?

During a Pap smear you will lie on an exam table. Your provider will use a plastic or metal instrument called a speculum to widen the vagina, so the cervix can be seen. Your provider will then use a small, soft brush or swab to collect cells from the cervix. The cell sample is sent to a lab for testing.

A Pap smear is often done as part of a pelvic exam. During a pelvic exam, your provider examines your uterus, ovaries, and genital area. But a pelvic exam doesn’t always include a Pap smear. So, when you have a pelvic exam, ask your provider whether you’ll have a Pap smear, too.

Will I need to do anything to prepare for the test?

You should not have a Pap smear while you are having your period. A good time to have the test is about five days after the last day of your period. For two to three days before your test, you should not:

• Use tampons
• Use birth control foam, jelly, or cream
• Use other creams or medicines in the vagina
• Douche (rinse the vagina with water or other fluid)
• Have vaginal sex

Are there any risks to the test?

You may feel some mild discomfort during a Pap smear. Afterwards, you may have some very light bleeding. But there are no known risks to having a Pap smear.

What do the results mean?

A Pap smear test has three possible results:

• Normal Pap smear or “negative” result. No abnormal changes were found in the cells of your cervix. Your provider may tell you that you can wait three years for your next test. If you also had a normal HPV test result, you may be able to wait five years for your next test, depending on your age and medical history.
• Unclear or unsatisfactory results. The lab sample may not have had enough cells, or the cells may have been clumped together or hidden by mucus. Your provider will usually ask you to come in for another test in 2 to 4 months.
• Abnormal Pap smear or “positive” result. Abnormal changes were found in your cervical cells. Most of the time, abnormal results do not mean you have cervical cancer. Minor changes in the cells usually go back to normal on their own. But your provider may recommend a follow-up test to check. More serious cell changes may turn into cancer if they are not removed. Finding and treating these cells early can help prevent cancer from developing.

Talk with your health care provider to learn what your Pap smear results mean.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a Pap smear?

Thousands of women in the U.S. die from cervical cancer every year. A Pap smear, along with an HPV test, is one of the most effective ways to prevent cervical cancer.

References

1. American Cancer Society [Internet]. Atlanta: American Cancer Society Inc.; c2022. Can Cervical Cancer Be Prevented?; [updated 2020 Jul 30; cited 2022 Feb 11]; [about 3 screens]. Available from: https://www.cancer.org/cancer/cervical-cancer/causes-risks-prevention/prevention.html
2. American Cancer Society [Internet]. Atlanta: American Cancer Society Inc. ; c2022. The American Cancer Society Guidelines for the Prevention and Early Detection of Cervical Cancer; [revised 2021 April 22; cited 2022 Feb 111]; [about 2 screens]. Available from: https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/cervical-cancer-screening-guidelines.html
3. American Cancer Society [Internet]. Atlanta: American Cancer Society Inc.; c2022. The Pap (Papanicolaou) Test; [revised 2020 Jan 2; cited 2022 Feb 11]; [about 3 screens]. Available from: https://www.cancer.org/cancer/cervical-cancer/prevention-and-early-detection/pap-test.html
4. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Basic Information About Cervical Cancer; [reviewed 2021 Dec 14; cited 2022 Feb 11]; [about 3 screens]. Available from: https://www.cdc.gov/cancer/cervical/basic_info/index.htm
5. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; What Should I Know About Screening?; [reviewed 2021 Dec 14; cited 2022 Feb 11]; [about 3 screens]. Available from: https://www.cdc.gov/cancer/cervical/basic_info/screening.htm
6. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: cervix; [cited 2017 Feb 3]; [about 1 screens]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/cervix
7. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Diethylstilbestrol (DES) and Cancer; [reviewed 2021 Dec 20 cited 2022 Feb 11]; [about 11 screens]. Available from: https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/des-fact-sheet
8. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: Pap test; [cited 2017 Feb 3]; [about 1 screens]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/pap-test
9. National Cancer Institute [Internet]. Bethesda (MD): U. S. Department of Health and Human Services; HPV and Pap Testing; [reviewed 2019 Dec 20; cited 2022Feb 11]; [about 7 screens]. Available from: https://www.cancer.gov/types/cervical/pap-hpv-testing-fact-sheet
10. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: precancerous; [cited 2017 Feb 3]; [about 1 screens]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/precancerous
11. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Understanding Cervical Changes: A Health Guide ; 2021 Sept; [cited 2022 Sept]; [about 20 screens]. Available from: https://www.cancer.gov/types/cervical/understanding-abnormal-hpv-and-pap-test-results/understanding-cervical-changes.pdf
12. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2022. Health Encyclopedia: Pap; [cited 2022 Feb 11]; [about 4 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=pap

Pap Smear (Pap Test) – Testing.com

Test Quick Guide

A Pap smear, also called a Pap test, is a test used to detect abnormal cells on the cervix that are cancerous or may become cancerous. The cervix is the lower part of the uterus that connects to the vagina. A Pap smear is conducted by taking a sample of cells from the surface of the cervix during a pelvic exam using a swab or small brush.

A Pap smear is primarily used as a screening test for cervical cancer. Additional health conditions, including infections, inflammation, and other types of cancer may also be detected using this test.

About the Test

Purpose of the test

A Pap smear identifies abnormal changes in cervical cells. Pap smears have several uses in medical care, including:

• Screening: A Pap smear is most often used to screen for cervical cancer in people without symptoms. It is able to identify cervical cancer early, as well as changes in cervical cells that may become cancerous if not treated. When used as a screening test, a Pap smear may be used alone or along with a test for strains of human papillomavirus (HPV) that can cause cervical cancer.
• Diagnosis: A Pap smear can be used to help determine the underlying cause of vaginal symptoms, including abnormal vaginal bleeding or discharge.
• Monitoring: A Pap smear may be used as a follow-up test to monitor cervical cell abnormalities or other findings detected on an initial Pap smear.

What does the test measure?

A Pap smear involves obtaining a sample of cells from the opening of the cervix and examining them under a microscope for signs of abnormalities. Pap smear results indicate whether cervical cells appear normal, abnormal, or if the test result is unclear. Abnormal Pap smear results are described according to the type of abnormality detected, as well as the type of cell in which the abnormality was found.

When should I get Pap smear?

Screening for cervical cancer with a Pap test is appropriate for anyone with a cervix, including women and transgender men who have a cervix. When a person with a cervix should get a Pap smear depends on a variety of factors, including age, health, and history of cervical cancer screening. A healthcare practitioner may also order a Pap smear when a patient is pregnant.

Cervical cancer screening may involve a Pap smear, an HPV test, or cotesting with both tests at the same time. The U.S. Preventive Services Task Force recommends regular cervical cancer screening between ages 21 and 65:

• Ages 21 to 29: Most people with a cervix between 21 and 29 years old should get screened for cervical cancer every three years with a Pap smear alone.
• Ages 30 to 65: For people with a cervix between 30 and 65 years old, there are several options for cervical cancer screening. Individuals in this age group may choose to be screened every three years with a Pap smear alone, every five years with an HPV test alone, or every five years with both a Pap smear and an HPV test.

Patients should have a discussion with their healthcare provider about the pros and cons of different screening strategies in order to decide which approach is best for their situation.

Patients may need to be screened for cervical cancer more often if they have one of the following risk factors:

• A history of abnormal Pap smears
• HIV
• A mother who was exposed to diethylstilbestrol (DES) while pregnant
• A weakened immune system

Other groups do not need regular cervical cancer screening. These groups include:

• Patients who are under 21 years of age
• Patients who are older than 65, have had adequate screening in the past, and are not at an increased risk of cervical cancer
• People who have had a hysterectomy and who do not have a history of abnormal Pap smears or cervical cancer

Finding a Pap Smear

How to get tested

A Pap smear is generally ordered by a doctor and conducted in a medical setting such as a doctor’s office or health clinic. Analysis of the sample of cervical cells is performed in a medical laboratory.

Can I take the test at home?

At-home Pap smears are not currently used in the United States. Patients who are interested in at-home screening tests for cervical cancer may find it helpful to discuss at-home HPV testing with their doctor.

How much does the test cost?

The cost of a Pap smear depends on where the test is taken and if you have insurance coverage. Costs of testing may include the office visit, the fee for the healthcare professional to conduct the Pap smear, and the actual laboratory analysis.

If your doctor recommends a Pap smear, these costs are typically covered by insurance, but, depending on your plan, you may be responsible for copays or a deductible. Your doctor and insurance plan can provide more specific information about your costs for a Pap smear. Local and federal health departments may offer financial assistance programs for Pap smears for people who don’t have insurance.

Taking the Pap Smear

A Pap smear requires a sample of cells from the opening of the cervix. These cells are obtained by gently scraping the cervix with a swab or small brush.

Before the test

Before a Pap smear, it’s important to tell your doctor about any medications you are taking, if you’ve had an abnormal Pap smear in the past, or if you might be pregnant. You should not have a Pap smear while you are menstruating, so it’s best to schedule this test around five days after the last day of your period.

Additional pre-test precautions include avoiding the following activities within two to three days before a Pap smear:

• Using tampons
• Having sex
• Douching
• Using vaginal creams or birth control foams

You may feel more comfortable if you empty your bladder right before a Pap smear.

During the test

A Pap smear may be conducted during a pelvic examination. A pelvic examination involves lying on an exam table with your feet in stirrups while a health care provider examines your vulva, vagina, cervix, rectum, and pelvis.

During the Pap smear, an instrument called a speculum is gently inserted into your vagina, allowing the health care provider to see the cervix. Once the provider can see the cervix, they obtain a small sample of cells by gently scraping the cervix with a brush, spatula, or scraper. This portion of the Pap smear only takes a few seconds.

Most patients experience little to no pain or discomfort during a Pap smear. Some may experience a feeling of pressure or temporary cramping similar to menstrual cramps.

After the test

While you may experience vaginal bleeding for a short time after a Pap smear, there are no restrictions on activities after a Pap smear is complete.

Pap Smear Results

Receiving test results

The results of a Pap smear are most often available within one to three weeks. Results may be sent to the patient electronically or by mail. A doctor’s office may also contact the patient to discuss Pap smear results or to arrange a follow-up appointment.

Interpreting test results

Pap smear results are reported as normal, abnormal, or unsatisfactory for evaluation. A normal, also called negative, Pap smear result indicates that no evidence of abnormal cells were found in the sample. An abnormal, or positive, result on a Pap smear indicates that abnormal cells were detected in the sample and additional treatment or testing may be necessary. Treatment of abnormal cervical cells prevents the development of cervical cancer.

Cell types commonly described in Pap smear results include squamous and glandular cells. Squamous cells are a type of cell that lines the outer portion of the cervix. Abnormal changes in squamous cells are divided into several categories:

• Atypical squamous cells (ASC): Atypical squamous cells are the most common abnormal finding on a Pap smear. Atypical squamous cells may be reported as atypical squamous cells of undetermined significance (ASC-US) or atypical squamous cells, cannot exclude a high-grade squamous intraepithelial lesion (ASC-H). Both results indicate that cervical cells appear abnormal under the microscope, but the meaning of the cell changes is unclear. A result of ASC-H indicates that cells may be at a higher risk of becoming cancerous than a result of ASC-US.
• Low-grade squamous intraepithelial lesions (LSIL): Sometimes called mild dysplasia, a result of LSIL indicates that the Pap smear detected mild cell changes. A result of LSIL may not require treatment, as these changes are often resolved by the immune system, especially in younger people.
• High-grade squamous intraepithelial lesions (HSIL): Sometimes called moderate or severe dysplasia, an HSIL finding indicates that somewhat to very abnormal cell changes were detected. These changes are more likely than LSILs to progress into cancer if left untreated.
• Carcinoma in situ (CIS): A result of CIS indicates that more severe cell changes were found during the Pap smear. These changes appear similar to cervical cancer, but have not yet spread beyond the surface of the cervix. CIS is likely to progress into cancer if left untreated.
• Squamous cell carcinoma: Squamous cell carcinoma is a type of cervical cancer. Finding squamous cell carcinoma on a Pap smear is very rare for patients who receive regular cervical cancer screening. This result indicates that abnormal squamous cells have spread more deeply into the cervix or to other parts of the body.

Glandular cells are found in the tissue that lines the inner portion of the cervix. Abnormal cell changes in glandular cells are divided into the following categories:

• Atypical glandular cells (AGC): A result of AGC indicates that abnormal glandular cells were seen under the microscope, but the meaning of these cell changes is unclear.
• Endocervical adenocarcinoma in situ (AIS): This result means that more severe cell changes were found but have not yet spread beyond the glandular tissue of the cervix.
• Adenocarcinoma: Adenocarcinoma is a type of cervical cancer that begins in glandular cells. While very rarely found on Pap tests in people who are regularly screened for cervical cancer, a result of adenocarcinoma indicates that abnormal glandular cells have spread more deeply into the cervix or to other parts of the body.

In addition to detecting the presence of cell changes in squamous and glandular tissue, a Pap smear may also detect several other kinds of abnormalities:

• Endometrial cells: A Pap smear may detect endometrial cells, which are cells from the lining of the uterus. While these cells may be present in healthy individuals during menstruation, they should not be present in a cervical sample after menopause. Because this finding may be normal in young patients, endometrial cells are only reported in Pap smear results for patients 45 and older.
• Other types of cancer: Although not the primary goal of a Pap smear, this test can sometimes detect cancerous cells not related to cervical cancer. A Pap smear may detect cancerous cells from the fallopian tubes, ovaries, endometrium, peritoneum, vulva, or vagina.
• Infection or inflammation: A Pap test may detect evidence of infections and inflammation of the cervix.

Unsatisfactory results on a Pap smear indicate that the sample of cervical cells obtained for the test either didn’t have enough cells on the slide to be examined or the quality of the slide wasn’t satisfactory. Unsatisfactory results may be followed up by a repeat Pap smear.

Are test results accurate?

A Pap smear is not 100% accurate. Abnormal cells may be missed in some individuals. Fortunately, cervical cancer typically develops slowly and it can take years, or even decades, for abnormal cells to develop into cervical cancer. Because cell changes progress slowly, regular Pap smears can usually detect cell changes before they progress into cervical cancer.

Do I need follow-up tests?

Follow-up testing after a Pap smear will depend on the test results and a patient’s reason for being tested. For individuals undergoing screening for cervical cancer who have a normal Pap smear result, it’s important to continue cancer screening at regular intervals.

People who receive abnormal Pap smear results require follow-up tests and/or treatment in order to further assess the cervix for signs of disease. For minor abnormalities such as ASC-US, a doctor may recommend a human papillomavirus (HPV) test and/or having another Pap smear in a year to see if the abnormality resolves without treatment.

For a result of LSIL, a doctor may recommend additional testing to look for more serious abnormalities on another portion of the cervix.

If a patient has more severe abnormalities, including ASC-H or HSIL a doctor may recommend a colposcopy. A colposcopy is a procedure that involves the use of an instrument called a colposcope to more closely examine the cervix. Doctors may perform a biopsy during a colposcopy to remove additional tissue for examination.

Questions for your doctor about test results

Your doctor can address detailed and specific questions about your Pap smear results. Some questions that you might review with your doctor include:

• Was any part of my Pap smear result abnormal?
• If there was an abnormal Pap smear result, can you explain what was found and what it may mean?
• If Pap smear results were normal, when should I have this testing again in the future?
• Are there any follow-up tests that may be beneficial given my test result?

How is a Pap smear different from an HPV test?

The human papillomavirus (HPV) test is used to detect infections with high-risk types of HPV that can cause abnormal changes in cervical cells. An HPV test may be used to screen for cervical cancer alone, in combination with a Pap smear, or to follow up on an abnormal Pap smear result.

• HPV Testing
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• STD Testing
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• CDC: Cervical Cancer
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• National Cancer Institute: Cervical Cancer Screening
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• National Cancer Institute: Understanding HPV and Pap Test Results
  Learn More

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Vaginal swab: analysis, data, indications

• What can a vaginal smear show?
• Vaginal flora smear
• What does this test show?

Many sexually transmitted infections may go unnoticed for years and be hidden. But even if a woman is not worried about anything, she should regularly take gynecological tests. A vaginal smear is a study aimed at studying the microflora in the urethra, vagina, and cervix. This procedure is recommended for every woman twice a year. The analysis is quick and almost painless.

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What can a vaginal smear show?

The gynecologist applies the obtained material to the glass, which is colored with a special substance, which makes it possible to identify pathogenic bacteria under a microscope. The following data are obtained:

• The content of leukocytes and erythrocytes.
• Flora indicators.
• The presence of dangerous infections: fungus, Trichomonas, gonococci.
• The presence of lactobacilli in the body.

Indications for this test

• Pain in the bladder and vagina, discharge with a putrid odor.
• Scheduled preventive check-ups at the gynecologist.
• Pregnancy and its planning.

Rules for preparing for a laboratory test.

• Take a shower
• Avoid sexual intercourse for a few days.
• Do not use vaginal suppositories, gels, creams two days before visiting a doctor.
• Drink plenty of water and do not urinate 2-3 hours before your appointment.
• A smear should be taken 5-6 days after the end of menstruation.
• Two days before the procedure, do not drink alcohol, eat spicy food.

Vaginal smear for flora

The above analysis is performed in the following way: a scraping is made from the surface of the mucous membrane of the cervix, vagina, urethra. The biological material is dried, then examined using a microscope, which allows us to draw conclusions about the state of the microflora. In the female body, as a rule, lactobacilli are present, which maintain a special environment that does not allow microbes to multiply. These are kind of helpers of the body, and if their number decreases, then various diseases begin, such as vaginosis, candidiasis. A smear helps to identify sexually transmitted diseases. As a rule, the results of the study are ready in one day. During the procedure, the woman practically does not feel pain, there may be discomfort from touching the medical spatula to the cervix, especially when inflammation is present. In some cases, after taking a smear, there may be slight bleeding. The procedure has no contraindications and is completely harmless to health. After passing the analysis, it is advisable to refuse sexual intercourse for one day.

What does this analysis show?

• A large amount of squamous epithelium and leukocytes indicates inflammatory processes in the body.
• Reduced levels of lactobacilli Doderlein and mucus indicate reduced immunity
• In addition, the smear reveals dangerous infectious diseases that can be obtained during sexual intercourse.

But the smear is considered a preliminary study, after which women are often sent for bacterial culture. There may be so-called latent infections in the body that cannot be determined using a smear on the flora. Among them are mycoplasmas, chlamydia, ureaplasmas. Their size is so small that they cannot be seen with a microscope. Therefore, if the smear did not show anything dangerous, and the patient continues to feel unwell, then she is prescribed an additional series of tests. A smear can be done in the state

Flora smear during pregnancy – when and why to take it

1. When to take a flora test
2. What a flora smear shows
3. Flora smear preparation rules

Flora smear is the most common test prescribed by an obstetrician-gynecologist. To conduct this study, the doctor, while examining a woman in a gynecological chair, takes the contents of the vagina from the posterior fornix (this is the space that is located between the back wall of the vagina and the cervix), the cervical canal and the discharged urethra, applies the material to the glass slide and directs him to the lab.

Smear examination for flora in the laboratory is carried out by a doctor of laboratory diagnostics under a microscope. This study allows you to determine the nature of the microflora (types of microorganisms) of the vagina, cervical canal and urethra, to identify the inflammatory process in the genitals of a woman, in some cases it also allows you to determine the causative agent of this inflammatory process (for example, gonococcus, Trichomonas).

When to take a smear for flora

It is mandatory for all pregnant women to take a swab twice – at registration and at 30 weeks of pregnancy, often another swab for flora is taken at 36-37 weeks to assess the state of the vaginal microflora before childbirth. During these periods, the analysis is given even in cases where the patient is not bothered by anything. This is carried out in order to identify a hidden inflammatory process that can lead to serious complications during pregnancy. During pregnancy, due to changes in hormonal levels and a decrease in immunity, exacerbation of chronic infections, as well as candidiasis (thrush), is much more likely. Any inflammatory process in the vagina during pregnancy can lead to serious complications of pregnancy – premature rupture of amniotic fluid, premature birth, oligohydramnios or polyhydramnios, intrauterine growth retardation and others.

If a pregnant woman has complaints – the appearance of copious discharge from the genital tract, itching, burning or discomfort in the genital area, a smear for flora is also taken. In some pathological conditions, for example, in the presence of past miscarriages associated with infectious complications of pregnancy, cervical incompetence, a smear for flora is taken once a month, and after 30 weeks once every two weeks. Smear sampling is an absolutely safe procedure and does not lead to any complications, therefore it can be performed at any stage of pregnancy.

Find out more about the services:

• Tests for pregnant women

What a flora smear shows

A flora smear is evaluated according to the following indicators:

Epithelium

Squamous epithelium is the cells of the surface layer of the mucous membrane of the vagina and cervix. The presence of a large amount of squamous epithelium in a smear may indicate an inflammatory process. The absence of epithelium in the smear indicates a violation of the hormonal background.

Leukocytes

These are blood cells involved in the destruction of pathogenic bacteria. Leukocytes are able to actively penetrate through the wall of blood vessels into the tissues of the body and participate in the fight against infectious agents. Normally, no more than 10 leukocytes are present in a smear for flora from the vagina, no more than 15 leukocytes per field of view from the cervical canal, and up to 2 leukocytes per field of view from the urethra. An increase in the content of leukocytes in a smear is a sign of inflammation, while the higher the content of leukocytes in a smear, the more pronounced the inflammatory process.

Red blood cells

These are red blood cells. Normally, single erythrocytes (1-2 in the field of view) can be found in a flora smear. An increase in the number of red blood cells indicates the presence of a chronic inflammatory process, and in addition, be a sign of trauma or occult bleeding, for example, in the presence of cervical ectopia (the so-called erosion, when the vaginal part of the cervix is ​​​​covered with a cylindrical epithelium normally lining the inside of the cervix).

Slime

Normally, there is no mucus in the urethra, a moderate amount of mucus is detected in the vagina, and there may be a large amount of mucus in the cervix. An increase in the amount of mucus may be a sign of an inflammatory process, but this criterion does not have great diagnostic value, and doctors rarely rely on it when making a diagnosis.

Bacteria

Normally, flora should not be detected in the urethra, rod flora is detected in a moderate amount in the vagina and cervix. Rod flora is most often lactobacilli, which are 95% are normal vaginal biocenosis. Lactobacilli actively colonize the vagina and create an acidic environment in it, thereby preventing the growth and reproduction of pathogenic bacteria.
In addition to lactobacilli, other rod bacteria, such as E. coli, bacteroids, and various cocci, may also be present in the vagina. These are bacteria that, under microscopy, have the shape of balls. This group of bacteria includes streptococci, staphylococci, enterococci. In a small amount, they are normally present in the vagina. If their number increases sharply against the background of the death of normal lactobacilli, this can lead to the development of an inflammatory process. Unfortunately, according to the results of a routine smear on the flora, it is impossible to determine which specific bacteria and in what quantity are present in the vagina. Therefore, with a pronounced inflammatory process, as well as when a large amount of coccal flora is found in a smear on the flora, the doctor prescribes an additional analysis to make the correct diagnosis – sowing on the flora with the determination of sensitivity to antibiotics.

Opportunistic flora

These are micro-organisms that live in the human body in small numbers without causing harm, but under certain conditions can lead to an inflammatory process. Such microorganisms found in a smear on the flora include fungi of the genus Candida and gardnerella.

Gardnerella (“key cells”)

Gardnerella and other bacteria living in anoxic conditions (so-called anaerobic bacteria) normally live in the vagina in small numbers, without causing symptoms of an inflammatory process. With a decrease in local immunity, which is quite common during pregnancy, there is an increase in the proportion of these bacteria in the vaginal microflora, a disease occurs – bacterial vaginosis (vaginal dysbiosis). At the same time, “key” cells are found in a smear on the flora – these are cells of the vaginal mucosa, covered with gardnerella and other anaerobic bacteria. The gardnerella themselves are not visible in a normal unstained smear. They can only be detected by staining smears with special dyes.

Mushrooms

Microorganisms of the genus Candida are part of the normal microflora of the mouth, vagina and colon of most healthy people. Normally, the number of these microorganisms is small and they do not cause an inflammatory process. Normally, in some women, a small amount of spores of the fungus may be detected in a vaginal smear. In the absence of an inflammatory reaction and complaints of the patient, the treatment of this condition is not carried out. The detection of a large number of spores or mycelium of a yeast-like fungus of the genus Candida in a smear on the flora makes it possible to diagnose candidiasis (or thrush)

Pathogenic flora

There are microorganisms that should not normally be present in the vagina of a healthy woman and the detection of which in a smear for flora indicates the presence of a serious sexually transmitted disease. Of these infections in the smear, Trichomonas and gonococci are most often detected.

Trichomonas

These are the simplest microorganisms that have a flagellum and are capable of movement. Detection in a smear on the flora of Trichomonas indicates the presence of a sexually transmitted disease – trichomoniasis. Trichomoniasis in a pregnant woman increases the risk of preterm birth, premature rupture of amniotic fluid, intrauterine growth retardation. In addition, there is a risk of infection of the baby when passing through the birth canal, therefore, if Trichomonas is found in a smear, antibacterial treatment is mandatory during pregnancy.

Gonococci

These are bacteria that look like double bean-shaped balls in the smear, adjacent to each other with a concave side. Detection of gonococci in a smear allows the doctor to make a diagnosis – gonorrhea. This is a sexually transmitted disease, which must also be cured during pregnancy. The inflammatory process caused by gonococcus significantly complicates the course of pregnancy, can lead to miscarriage, premature birth, premature rupture of amniotic fluid, infection of the placenta and membranes, and in addition, when the baby passes through the birth canal, the eyes of the newborn are affected by gonococcus.