The analysis showed - elevated leukocytes in the smear. What does this mean? Large number in pregnant women

The delicate system of balance in the genital area of a woman can fail in the presence of an inflammatory process caused by exposure to various pathogens.

An increase in the level in the sample becomes an indicator of the presence of the disease. The detection of an excess of the number of white cells becomes the basis for an in-depth study in order to identify the source of the disease and prescribe targeted treatment.

A smear on the flora is an effective diagnosis for assessing the nature of inflammation of the urogenital canal

Usually, a smear is taken from a woman at every visit to the gynecologist, both during a routine examination and in case of complaints of incomprehensible discharge, dryness, burning, itching, irritation and pain during sexual intercourse.

In some cases, infections do not manifest themselves external manifestations and can only be detected by checking the smear.

An example of such a "hidden" disease is chlamydia, which is asymptomatic and often detected by accident.The basis for prescribing a smear, in addition to the presence of complaints, is the discovery, in another type of examination, of grounds for suspecting the presence of trouble in the female genital area, as well as pregnancy.A smear on the flora gives many indicators, it demonstrates not only the number of white cells, but also the possible infection with various microorganisms, and also indicates the state of the hormonal status of a woman.

The analysis consists in taking a smear from different places - the urethra, and, in some cases, from the rectum and oropharynx.

It is taken with a special disposable spatula, and the samples are individually applied to special glasses. Then the samples are marked in order to know exactly from which zone the material was taken for analysis.

The finished glasses are sent for microscopic examination, which is performed by an experienced laboratory assistant. It counts the amount, and also detects the possible presence of pathogenic microflora.

A smear is a fairly simple and quick test that can quite accurately determine the presence or absence of an inflammatory process and indicate the existing source of infection.

The analysis checks for the presence of the following indicators:

Leukocytes
squamous epithelium
Gonococci
Trichomonas etc.

If it is done, and the leukocytes are elevated, this means that the specialist counted more than 15 cells in the sample from the cervix in the field of view, 5 in the scraping from the urethra, and 10 from the vagina. This is usually evidence of an inflammatory process in the genitals of a woman, and the higher the test values, the more intense the inflammation.

Causes of an increase in the level of leukocytes

The main reason for the indicators, significantly exceeding the norm, is the presence of an inflammatory process in the area of the genitourinary organs.

There can be several diseases that cause such symptoms:

Dysbacteriosis of the vagina and / or intestines
Colpitis is an inflammatory process that develops in the mucous membrane of the vagina
Cevicitis - inflammation localized in the cervical canal
Endometritis - inflammation of the lining of the uterus
Adnexitis - inflammation of the ovaries, fallopian tubes
- process affecting the urethra
Oncological lesions of the urinary organs

If a smear on the flora shows that the leukocytes are elevated, and the numbers are very high, this is a reason to sound the alarm and immediately apply for an in-depth study and the appointment of the necessary treatment.

Useful video - Pap smear from the cervical canal in women.

In some cases, leukocytes are present in the sample, but the pathogen is not detected. This can be caused by the fact that the process has just begun, as well as by severe stress of a psychological or physiological nature. The most unpleasant option is an increase in indicators provoked by intestinal dysbacteriosis, since this condition is often extremely difficult to treat and the level of white cells in the smear does not decrease even with intensive drug exposure.

Sometimes the cause of a stable increase in the number of leukocytes can even be an intense sex life. In a fairly common number of reported cases, slightly above normal leukocytosis is detected as a variation of the woman's usual state and is not an indicator of the disease.

Signs of the disease

In most cases, inflammation of the urogenital area manifests itself quite rapidly. It is possible to note the presence of pains of varying degrees of intensity, scanty, abundant or foamy discharge, with an unpleasant odor, sharply different in color from the usual daily discharge.

Often inflammation is accompanied by itching, severe discomfort, swelling, redness. Such manifestations disturb a woman, make her nervous, interfere with a normal sexual life, affect behavior, affect the quality and duration of sleep.

It should be noted that all these signs indicate an infection, and not an increase in leukocytes - the appearance of these cells is one of the symptoms of the inflammatory process.In some diseases, no symptoms are noted. The woman feels healthy, outwardly everything is also in order - no pain, no itching or discharge.

Only a timely swab can reveal the presence of a lurking disease and allow you to start the right treatment, preventing the development of a dangerous disease.

When performed - leukocytes are increased, and according to other analysis data it is impossible to give an exact definition of the cause of the disease, the doctor must send the patient to an in-depth examination to finally determine the exact cause of the appearance of these cells in the sample.

Treatment Method

Since changes in the smear are associated with various reasons, the treatment itself is always specialized. This means that the appearance above the norm in a smear is just an indicator of trouble, and not the disease itself, so the main goal of treatment is to cope with the pathogens that caused inflammation. Since they can be different (bacteria, viruses, fungi, as well as various combinations of these pathogens), then specific treatment will be prescribed.

Most often, leukocytosis is caused by bacterial vaginosis, which is successfully treated with a course of appropriate antibiotics. Other diseases will require an accurate selection of drugs, and if several types of infection are combined at once, then the use of a whole range of drugs.

With candidiasis, it is necessary to fight a fungal infection, and chlamydia, gardnerellosis and many other diseases are caused by protozoa. They are also treated with specific drugs. The large number of pathogens that can cause changes in smear indicators suggests that there is simply no single universal medicine to combat them, each reason requires a “personal” drug.

It is extremely important to complete the entire course of treatment prescribed by the doctor, without skipping medication or arbitrarily reducing the dose and duration of therapy.

If you stop treatment after the symptoms disappear, the infection can simply be "healed". It will not go anywhere, it will “doze off” in the body until the next convenient opportunity. As soon as something happens and the immune system decreases and cannot resist the onslaught of infection, the disease will return at the most inopportune moment.

It is especially risky if it turns out to be this inopportune moment. Some infectious diseases, especially, can extremely negatively affect the development or even cause involuntary termination of pregnancy. Treatment of such infections in a pregnant woman is very difficult, since drugs can also have a detrimental effect on the fetus and the gestation process.It is much wiser to diligently complete the treatment and rid yourself of the risk of a recurrence of the disease.

Leukocytes in a smear - the norm is up to 15-20 (in the urethra up to 5, in the vagina up to 10 and in the cervix up to 20 units). The number of leukocytes in a smear increases sharply with inflammation of the vagina (colpitis, vaginitis).

The more of them in the smear, the more acute the disease. In acute inflammation, the value of gynecological smear leukocytes will be quite high - "up to 50-100 in the field of view" or "leukocytes cover the entire field of view."

Assessment of leukocyte reaction in smear microscopy:

Leukocytes are absent, units. in p / sp .;
. up to 10 in p / sp. - a small amount of;
. 10 - 15 in p / sp. - a moderate amount;
. 30 - 50 in p / sp. and more - a large number;
. 100 or more - leukocytes in a smear completely cover the field of view.

Moderate, large amount and continuous coverage are evaluated as signs of an inflammatory reaction of varying severity.

CAUSES OF INCREASED LEUKOCITES IN SMARS

An increased number of leukocytes in a smear, as mentioned above, in women is usually associated with an inflammatory process in the urogenital zone. Under what pathological conditions in gynecology does such an analysis result occur? Most often they are increased in diseases such as:

* Colpitis - inflammation of the vaginal mucosa,
* Cervicitis - inflammation of the cervical canal,
* Urethritis - inflammation of the urethra,
* Endometritis - inflammation of the uterine lining,
* Adnexitis - inflammation of the uterine appendages,
* Oncological diseases of the genital organs,
* Sexually transmitted infections
* Dysbacteriosis of the vagina and intestines.

Leukocytes in a smear in virgins

Inflammatory processes in the genital tract are not only among girls and women who are sexually active. Various diseases, including those of an infectious nature, can be transmitted not only through sexual contact, but also through contact and household (common items of use, violations of intimate hygiene, etc.). Therefore, leukocytosis in a smear can be in children, adolescent girls and virgins who have not had traditional sexual relations. To find out its causes, tests are also given.

Taking for the diagnosis of a smear, PCR and seeding in a virgin is carried out in the same way as in women who are sexually active. However, the gynecological mirror is not used, the material is taken from the vagina through the hole in the hymen with special thin soft probes. According to indications and at will, material is taken for examination from the urethra and other localizations. The sampling procedure carried out by our gynecologists is absolutely painless, damage to the hymen is excluded!

THE LEUKOCITES IN THE STROKE ARE INCREASED, BUT THERE IS NO INFECTION?

A very common situation! You need to clearly know - if there are a lot of leukocytes in a smear, the reason is an infection. Just a smear does not allow it to be detected - its diagnostic value is limited by a narrow spectrum of the studied microbes. A significant list of possible infections, in which the causes of elevated leukocytes in a smear lie, can only be detected by other methods of diagnosing vaginal discharge (PCR, culture, and an ELISA blood test). Your gynecologist should tell you about this and send you for an appropriate examination!

With the onset of the period of bearing a little one, the expectant mother seeks to be more careful and attentive to her health.

Numerous tests and examinations that a woman passes and undergoes during the period of bearing crumbs are designed to identify problems in a timely manner and competently eliminate them. One of these tests is a gynecological smear on the flora. The study of material from the urogenital tract allows you 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 start treatment in a timely manner and prevent negative consequences. Determination of the level of leukocytes in a smear during pregnancy is an important diagnostic study.

Leukocytes in a smear during pregnancy: an introduction to important helpers

Leukocytes in a smear during pregnancy. Preparation for the collection of vaginal material for research

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

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

White blood cells in a smear during pregnancy

A woman in position does not take a swab for the flora at each visit to the gynecologist, but several times the urogenital material is still taken. The first time a gynecological examination is most often performed by a woman during registration due to her interesting position. This analysis is one of an extensive list of studies that are designed to establish a general picture of the health of the expectant mother. If a woman does not make specific complaints, then during the remaining weeks of waiting for a toddler, she will be asked to take this analysis again for a period of 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 found in a smear of a woman 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 restructuring exacerbates chronic processes that have been dormant in the body for many months or even years. So, the material was taken and now the results of the analysis are in the hands of the doctor. How to find out if the obtained indicators are the norm of 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 knowing the reference values will also help draw conclusions. Depending on the detected number of leukocytes, there are 4 degrees of purity of the vaginal smear:

1 degree - the content of leukocytes 0-5. This type of smear can be called ideal, since there are lactic acid bacteria and a minimum of leukocytes.
2 degree - the content of leukocytes 5-10. Similar values also fit the term "norm". There may be a small number of opportunistic pathogens, but the number of lactobacilli still prevails.
3 degree - the content of leukocytes 10-50.
4 degree - the content of leukocytes entirely. In this case, a lot of leukocytes are determined in a smear, which is especially dangerous during pregnancy.

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

An increase in the 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" intrauterine infection, the pregnancy can be terminated earlier than the term prescribed by nature.

Elevated white blood cells in a smear during pregnancy: causes of a “bad” smear

Having received bad results of the analysis, 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 inflammatory pathologies that affect the organs of the genitourinary system. The localization of the focus of the disease determines the type of disease:

Cervicitis - if inflammation has captured the cervical canal.
Colpitis - in case of damage to the vaginal mucosa.
Endometritis is an inflammation of the lining of the uterus.
Urethritis - a pathological process occurs in the urethra.
Inflammation in 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 causes poor tests? Banal thrush (candidiasis), as well as vaginal dysbacteriosis (vaginosis) also lead to leukocytosis. A “bad” smear may be present in pathologies not related to the genitourinary system of a woman, for example, with intestinal dysbacteriosis.

Other factors

If, according to the results of the analysis, an increase in leukocytes is revealed, you should not immediately look for reasons in the presence of "terrible" diseases. A similar picture can also occur in conditions such as:

Allergic reaction to herbs, drugs, lubricants.
Insufficient hygiene of the genitals, or vice versa - passion for douching, excessive hygiene.
Mechanical damage - tight or synthetic underwear, rough manipulation during sex.
Stress, fatigue.

Additional tests and examinations with an increase in leukocytes in a smear during pregnancy

If the smear results raise questions about the woman's condition, the doctor may prescribe additional examinations.

Seeding for microflora

If leukocytes are found in a smear, it would be advisable to carry out a culture on the flora during pregnancy. Sowing 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", as well as find out its susceptibility to the active components of antibacterial drugs.

PCR diagnostics

An additional study, if leukocytes in a smear are increased during pregnancy, PCR diagnostics can serve. This research method is highly accurate and with a probability of almost 100% will help to establish the presence or absence of latent genital infections. Such ailments may not make themselves felt for a long time and manifest themselves at the most undesirable moment. For diagnostics, a biomaterial is taken from a pregnant woman and examined.

ultrasound

Accurate ultrasound examination with a transvaginal probe will help to establish the presence of inflammatory diseases of the uterus, appendages, the presence of neoplasms.

How to reduce white blood cells in a smear during pregnancy: treatment

The normalization of the level of leukocytes is directly related to the elimination of the problem that caused this condition. Based on the results of the assessment of symptoms, as well as the data obtained from additional examinations, the doctor determines the cause of the increased number of leukocytes in a smear during pregnancy and the scheme of necessary therapy. It is important to remember that self-administration of drugs is strictly unacceptable.

Drug treatment of leukocytes in a smear during pregnancy

If a disease is detected, then one treatment with "herbs" 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. So, for example, when gonorrhea, ureaplasma or syphilis is detected, Ceftriaxone, Azithromycin, Erythromycin often become the drugs of choice.
Treatment for genital herpes is not always prescribed. But in cases where the doctor sees the appropriateness of therapy, Zovirax ointment can be used.
In cases of detection of candidiasis, treatment with such drugs as Pimafucin, Polygynax, Livarol, Clotrimazole, Terzhinan is possible (the last 3 drugs are prohibited for use in the first trimester of waiting for the baby)
Solutions of potassium permanganate, miramistin, chlorhexidine, chlorophyllipt can also be used to treat the genitals.

Methods of folk therapy for leukocytes during pregnancy

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

Decoctions of herbs will help normalize the vaginal microflora. St. John's wort leaves, chamomile, aloe, oak bark or red root are suitable for these purposes. For the procedure, it is necessary to prepare a warm sitz bath with a healing decoction. Sage, coltsfoot, calendula also have a good effect.
Candles with sea buckthorn oil. Mix 10 g of oil with beeswax. Melt the resulting composition in a water bath, simultaneously mixing in 3 g of pine resin. Pour the resulting mass into molds (future suppositories) and cool. Candles inserted vaginally 1 before bedtime.
It is necessary to establish nutrition by saturating the diet with sour-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 to establish the exact cause of the violations and effectively deal with them.

According to the level of leukocytes, which is easily determined by specialists under a microscope, they judge the existing inflammatory process. As for gynecology, white blood cells are determined and counted in the following studies - smears on:

flora (microscopy);
cytology;
degree of purity.

Analysis of the composition of microflora

A urogenital smear for microflora is taken from three points: the vagina, cervix and urethra. If an inflammatory process is detected, then it is called colpitis(if the vagina is affected), cervicitis(if leukocytosis is fixed in the cervical canal) and urethritis(there is a problem in the urethra).

In addition to leukocytes, doctors are interested in the amount of epithelium and mucus. This additionally speaks of health or pathology.

So, in the norm of leukocytes in a smear in women, this should be how much.

As you can see, 0 is also indicated in the table, which means that the absence of leukocytes is also a valid option. Not below normal.

Purity Analysis

A smear is similar to microscopy in terms of purity. And often in the results you will see a numerical indication of the "purity" of the genital tract. If single leukocytes are found - 1-3-5 in the field of view, then speak of the first degree. In addition, a lot of useful microflora - lactic acid sticks - is found in the woman's vagina.

With the second degree of leukocytes, there are still not too many, perhaps a little more than normal, for example, 10-15 , but in the vagina, in addition to Dederlein's sticks, conditionally pathogenic microorganisms are determined - Klebsiella, Candida mushrooms, gardnerella, etc.

At the third degree in the vagina - that is, a lot of opportunistic bacteria. Leukocytes are found in clusters, in large numbers. Their approximate level 25-30 or even 40-50.

At the fourth degree in a smear from 60 white blood cells. Sometimes they completely cover the entire field of view, that is, their number reaches above 100. Very high leukocytes are diagnosed against the background of other signs of the inflammatory process - coccobacillary flora and the almost complete absence of lactobacilli.

Analysis for atypical cells of the cervix (oncocytology)

In a cytological smear, information about the number of leukocytes is important if a woman has atypical cells of the cervix or is suspected of having them. The fact is that cervicitis, which is characterized just by leukocytosis, causes reactive processes in cells similar to those that occur with precancerous diseases.

If the leukocytes are high, you first need to be treated, and then, when their level becomes low, after 2-3 months, repeat the analysis. Recall how much the norm of white blood cells in the cervical canal is up to 30 units.

Causes of elevated white blood cells in a smear in women, symptoms and treatment

The culprit of this is the inflammatory process. And it is provoked by various bacteria, fungi and viruses.

Urogenital infection. Chronic or acute cystitis

In girls, it often occurs simultaneously with vulvovaginitis, that is, the mucous membrane of the labia and vagina turns red, becomes swollen. Cystitis is a very common disease in women due to their anatomical features - a small distance separating the vagina, rectum from the urethra and a very short and wide urethra, through which the infection easily enters the bladder.
Hypothermia or the so-called cold plays a negative role and leads to the rapid progress of inflammation.

At the same time, the following pathogens are diagnosed in the sowing or in the smear by PCR:

Chlamydia trachomatis (chlamydia);
Mycoplasma genitalium (genital mycoplasma);
Ureaplasma urealyticum (ureaplasmas);
Mycoplasma hominis (Mycoplasma hominis);
E. coli (E. coli);
Staphylococcus saprophyticus (saprophytic staphylococcus);
Enterococcus faecalis (fecal enterococcus);
Klebsiella (Klebsiella);
Proteus mirabilis (Proteus miribilis).

Thrush (vaginal candidiasis)

The causative agent is yeast-like fungi of the genus Candida. Yeast is not sexually transmitted. This is a conditionally pathogenic microorganism that is present in the microflora of the vagina in almost every woman, but the disease causes only when the number of lactobacilli decreases, if its number increases.

Contribute to the development of candidiasis:

diabetes;
pregnancy;
taking antibiotics;
HIV infection.

Signs of the disease:

itching and burning in the area of the labia;
white curdled or creamy discharge, worse before menstruation;
pain during sex;
painful urination if the urethra is also affected by fungi.

Diagnosis of candidiasis is carried out with the help of bacterial culture. In microscopy, there are not always clear signs of the disease.

Treatment tactics depend on whether the disease is chronic, how often it recurs, and how bright and painful the symptoms are.

The following drugs are used for topical treatment (intravaginally):

clotrimazole tablets (100 mg once a day for 7 days, or 200 mg once a day for 3 days);
clotrimazole cream (if the labia is affected) for 1-2 weeks;
natamycin (100 mg for 6 days);
butoconazole 2% cream once;
itraconazole (200 mg for 10 days).

For oral administration (orally):

fluconazole (150 mg once);
itraconazole (200 mg for 3 days).

During pregnancy, drugs are prescribed for local use with the active ingredients clotrimazole (from the second trimester of pregnancy) and natamycin (from the first trimester).

Vaginal candidiasis is not sexually transmitted, but there are conditions that promote the reproduction of fungi, they should be avoided:

uncontrolled intake of antibiotics and hormonal drugs;
wearing thick synthetic underwear;
endocrine, gastrointestinal, gynecological diseases;
frequent use of sanitary pads;
douching;
one sexual partner (there is "addiction" to his microflora).

Complications of thrush include:

inflammatory diseases of the pelvic organs;
urethrocystitis;
during pregnancy - infection of the fetus, its intrauterine death, premature birth;
postpartum candidal endometritis.

Allergic vulvitis or vulvovaginitis

The reason is sanitary pads, tampons, intimate hygiene products. Sexual lips become swollen, itchy. Passes on its own. The main thing is not to use the allergen.

Trichomoniasis (trichomoniasis vaginitis)

The causative agent of the disease is Trichomonas vaginalis. It is transmitted sexually, very rarely household (through bedding, towels, etc.). It is detected in a general smear or bakposev and is one of the most common causes of leukocytosis in a smear.

From infection to the appearance of the first symptoms, it takes from 7 to 28 days:

frothy discharge from the vagina of yellow, gray color;
redness of the genital mucosa;
pain during intercourse;
pain when urinating;
pain in the lower abdomen.

Trichomoniasis is dangerous for pregnant women, as it causes premature rupture of the amniotic sac and premature birth.

It is the cause of paraurethritis, salpingitis.

metronidazole - 2 g orally once or 500 mg orally 2 times a day for one week;
tinidazole - 500 mg 2 times a day for 5 days or 2 g once;
ornidazole - 500 mg 2 times a day for 5 days or 1.5 g once.

In case of a complicated and recurrent course of the disease, changes are made to these treatment regimens - higher doses of drugs and a longer intake are recommended. Antimicrobials are also prescribed intravaginally: metronidazole in the form of tablets of 500 mg one by one for 6 days or the vaginal cream of the same name for 5 days.
During pregnancy, treatment is carried out with the same drugs, but not earlier than the second trimester of pregnancy (13-14 weeks).

Latent sexually transmitted infections (ureaplasmosis, mycoplasmosis, chlamydia)

There are three infectious pathogens that can cause an inflammatory type of smear with an increase in leukocytes, but they are not detected in a normal smear for flora. Only by a special PCR method. These are chlamydia, ureaplasmosis and mycoplasmosis. They are provoked by the following microorganisms: Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum.

In more than half of cases, latent infections are asymptomatic. If signs of the disease appear, they are as follows:

mucopurulent discharge;
pain during sexual intercourse;
itching and burning;
pain when urinating;
aching pain in the uterus.

Chlamydia also causes intermenstrual bleeding and erosion on the cervix.

If the infection spreads higher into the uterus, fallopian tubes, ovaries, then she is diagnosed with sapingoophoritis and endometritis.

Possible treatment regimens (one of the drugs is prescribed orally):

doxycycline monohydrate - 100 mg 2 times a day for a week;
azithromycin - 1.0 g, taken once;
josamycin - 500 mg 3 times a day for a week;
ofloxacin - 400 mg 2 times a day for a week.

In some cases, longer therapy is required - 2-3 weeks. Pregnant women are treated with the same antibacterial agents.

If microorganisms M. Hominis and / or Ureaplasma spp. are detected, with high leukocytes and there are symptoms of the disease, then the doctor should look for more obvious pathogens: Trichomonas, gonococcus, mycoplasma genitalium.

Treatment is not carried out with: the absence of symptoms of the disease, that is, the accidental detection of ureaplasma in an amount of even more than 10 to 4 degrees. Expectant mothers are an exception. If they have a history of frozen, non-developing pregnancies, premature discharge of amniotic fluid, intrauterine infection of the fetus, they need to be treated.

Violation of the microflora of the vagina or nonspecific vaginitis

In addition to cocci (staphylococci, streptococci, etc.), the culprits of nonspecific vaginitis are other opportunistic representatives of the flora: Escherichia (intestinal microorganisms), fungi, Trichomonas.

Symptoms:

itching and burning;
pain during intercourse and small spotting;
swelling of the vaginal mucosa;
serous-purulent discharge.

Diagnostics. Microscopic examination reveals highly elevated leukocytes, many gram-positive and gram-negative microorganisms, and desquamated epithelium.
Bacteriological culture is carried out to accurately diagnose pathogens and determine their sensitivity to antibiotics.

Stage 1 - antibiotics and antibacterial agents locally:

Terzhinan;
Polygynax;
Neo-penotran;
Nifuratel;
Ginalgin;
Betadine;
Metronidazole;
Clindamycin;
Ornidazole.

Stage 2 - restoration of microflora:

Vagilak;
Bifidumbacterin;
Lactobacterin;
Biovestin.

Gonorrhea

The causative agent of the disease is gonococcus (Neisseria gonorrhoea - gram-negative diplococci). Common cause of female and male infertility.

Symptoms:

difficulty urinating;
itching in the vagina;
purulent discharge from the cervix.

If the disease does not affect the urethra and bladder, then it can be detected only with the help of an analysis - a smear on the flora or bacterial culture, since there are no vaginal signs of the disease in women. Leukocytes in a smear on gn are increased and pathogenic microorganisms are present.

If the disease rises higher and affects the reproductive organs, then the following symptoms are possible:

temperature up to 39 degrees and above;
nausea, vomiting - intoxication;
menstrual irregularities.

Provoke ascending infection:

abortions;
diagnostic and therapeutic curettage;
probing the uterine cavity;
cervical biopsy;
intrauterine device.

Usually the inflammatory process worsens after menstruation, childbirth.

Gonorrhea is dangerous with the following complications:

adhesive process in the small pelvis;
infertility;
ectopic pregnancy;
miscarriages and premature births;
pelvic pain;
endometritis.

Treatment is quick and simple, with one of the following drugs:

Ceftriaxone (500 mg) intramuscularly once;
Cefixime (400 mg) orally once;
Spectinomycin (2 g) intramuscularly once.

The same drugs are used to treat pregnant women, and at any time.

true erosion

It's a wound on the cervix. It may appear as a result of sexual intercourse, examination by a gynecologist, taking tests, inaccurate insertion of a suppository (candle) into the vagina, etc. It heals on its own within 10 days.

It is diagnosed during examination with a gynecological mirror or with. Sometimes for its treatment, candles "Depantol", sea buckthorn, methyluracil, douching with calendula are prescribed. Various folk remedies and healing products are used

But, as medical practice shows, within 10 days it passes on its own - even with treatment, even without.

herpes simplex virus

If there are no infections - the causative agent of the disease is not visible in the smear, hidden infections are not detected, you should look for viruses by the cultural method (analysis for HSV-1.2). This must also be done if the woman was treated with an antibacterial drug or a broad-spectrum antibiotic, but her leukocytes only became even higher or did not decrease. Antibiotics do not work on viruses.
Also, leukocytosis in a smear is determined with HIV infection.

Oncology - cervical cancer (CC)

A directly malignant tumor rarely provokes an increase in the level of leukocytes. Therefore, we put this reason in the very last place.

In bacterial vaginosis, the white blood cell count is normal. For this reason, it is not on the list above. Signs of vaginal dysbacteriosis are the presence of key cells in the smear and a decrease in the number of lactobacilli, against the background of the appearance of opportunistic flora (gardnerella, klebsiella, leptothrix, etc.). By the way, a very common disease during menopause, when the protective function of the mucous membrane of the vagina and cervix becomes weaker due to lack of estrogen.

The growth of leukocytes depending on the phase of the menstrual cycle and during pregnancy

Leukocytes are always more in the cervical canal than in the vagina. Moreover, this amount grows in the middle of the cycle (when ovulation) and before menstruation. Often doctors take a swab incorrectly - too much material or rub it too carefully on a glass slide, which causes the destruction of epithelial cells. But it is the ratio of leukocytes to is the most important sign of inflammation or its absence. Normally, this is about 10 polymorphonuclear leukocytes (PMNs, and there are other types) per epithelial cell.

In some women, for unknown reasons, white blood cells remain high for some time. And this is with a clear absence of inflammation and other good tests. Trying to reduce the number of white blood cells or even get rid of them should not be. It is not the result of the analysis that is treated, but the disease, if any.

Even more leukocytes become during pregnancy. Physiological process. And if other than that nothing bothers you, you can observe. However, doctors play it safe and often prescribe a local antiseptic for a “bad” smear - Hexicon suppositories (the active substance is chlorhexidine). They can be used in any trimester of pregnancy. And at the end of it, before childbirth, the sanitation of the vagina is carried out in this way.

During pregnancy, a cervical plug is formed from leukocytes and mucus. It is she who protects the uterus from infection.

Questions from our readers on the topic

Do white blood cells interfere with pregnancy? If a woman does not have a gynecological disease that would prevent her from conceiving, for example, endometritis, then there will be no infertility for this reason. However, it is necessary to take tests for infections and treat them. After all, they are most often to blame for leukocytosis.

Will they be allowed into IVF with pathology by microscopy? If the problem is only in the number of white blood cells, it may make sense to retake a smear a little later, in a different phase of the menstrual cycle. Perhaps there is a medical error when taking the material or the laboratory. But if the result is confirmed, while there are no other problems, the doctor may prescribe an antiseptic in a small course. This is not dangerous.

Is an IUD put in with a smear of the third or fourth degree of purity? No, as this will lead to the spread of microbes into the uterus and endometritis, adnexitis, salpingo-oophoritis.

Do hysteroscopy with an imperfect smear? If a planned procedure is scheduled, then it will probably have to be postponed.

Can leukocytes be elevated due to endometriosis? Yes, it can be.

If after a miscarriage a bad smear - what to do? Get tested for hidden infections and the herpes virus. Remember that the infection interferes with carrying a child, leading to its early termination.

In preparing the material, clinical recommendations of the Russian Ministry of Health were used.

Leukocytes are cells of the human immune system that are designed to protect the body from infections.

An increased content of leukocytes in a smear can be diagnosed if more than 15 units are observed in the field of view. In this case, they say that the woman has inflammatory and infectious diseases. A large number of leukocytes in a vaginal smear indicates an inflammatory disease of the genitourinary system (bladder, kidneys or female genital organs).

What do leukocytes mean in a smear?

Since leukocytes perform a protective function of the body, they can normally be contained in a small amount. However, if a woman has a bad smear, which results in elevated white blood cells, then this may be the first sign of an inflammatory process in the vagina (vaginitis, bacterial vaginosis, colpitis, thrush, cervicitis, erosion, endometriosis). And the higher the number of leukocytes, the more acute the disease.

Constantly elevated leukocytes in a smear: symptoms

A persistently elevated level of white blood cells in a smear can be the result of an inflammatory disease of various etiologies, which is often accompanied by the following symptoms:

frequent and painful urination;
burning sensation in the vagina;
bad smell;
disruption of the menstrual cycle;
whitish vaginal discharge.

Why white blood cells in a smear are increased: reasons

The following factors can provoke an increase in the number of leukocytes in a smear:

sexually transmitted infections (, gonorrhea, ureaplasmosis);
staphylococcus;
coli;
oncological diseases of the female genital organs.

During pregnancy, a slight increase in leukocytes in a smear is possible, which is the norm and does not require intervention by a doctor. However, a woman throughout her pregnancy needs to constantly monitor the level of leukocytes to exclude the presence of an inflammatory process, as this can make it difficult to carry a pregnancy and a successful birth.

How to lower white blood cells in a smear?

To reduce the level of leukocytes in a smear, it is necessary to conduct a course of sanitation to restore the microflora of the vagina. As medicinal herbs, you can use chamomile, aloe leaves, oak bark, nettle, red root, St. John's wort. Douching with a solution of chlorophyllipt is possible. However, before using this or that medicinal plant, you should consult your doctor.

In addition to sanitation, you can do thermal baths with a water temperature of at least 45 degrees, since warming up helps to successfully fight the inflammatory process.

The doctor may also prescribe special vaginal suppositories designed to reduce the number of leukocytes: hexicon, betadine, suppositories with pimafucin, nystatin, terzhinan, genizon, polygynax.

Thus, an increased level of leukocytes in a smear indicates about the presence of a pathological inflammatory process in the vagina. However, before prescribing treatment, it is necessary to determine the causative agent of the infectious process, as a result of which there is an increase in leukocytes in the smear. However, in any inflammatory process, the main task is to restore the microflora of female organs.

If, when diagnosing an increase in leukocytes in a smear, anti-inflammatory treatment is not carried out, then in the future the inflammatory process may develop further and disrupt the functioning of the reproductive function in a woman (miscarriage, infertility, habitual miscarriage).