Pass gynecological tests. Gynecological tests

The list of services offered by the ONMED medical center includes mandatory gynecological tests. We perform all types of procedures that relate to diagnosing diseases, planning pregnancy or monitoring treatment. We will help solve absolutely any problem related to women's health in the sexual sphere.

Blood analysis

• blood analysis;
• histology analysis;
• identification of all types of infections;
• diagnosis of any viral diseases.

In modern medicine, gynecological tests are carried out on the basis of different biomaterials. The most basic of them is a flora smear, which is taken during an initial or regular examination. The process of taking a smear is quite quick and absolutely painless.

Comprehensive examination at the ONMED medical center

Our center offers its patients a comprehensive examination using special programs that we have developed in order to obtain the most comprehensive information. We offer:

• prepare for pregnancy;
• diagnose any sexually transmitted diseases;
• take tests for women who have entered menopause.

In addition to the usual tests and tests, our specialists use additional methods to clarify the diagnosis. At the ONMED medical center in the field of gynecology, many modern diagnostic techniques and devices are used.

Ultrasound in gynecology

This is an indispensable way to diagnose diseases of the pelvic organs. It makes it possible to identify various inflammatory processes, and also determines the nature of the disease.

Laparoscopy

In gynecology, this procedure is used to identify and remove any adhesions:

• ovarian cyst;
• myoma;
• polyps.

Thanks to the use of a laparoscope, it is possible to easily restore the patency of the fallopian tubes.

Hysteroscopy

It is performed using a special device that is necessary to examine the uterus. This device not only allows you to detect, but also simultaneously remove tumors.

Modern laboratory studies of gynecological tests

Specialists of the ONMED medical center will select the most effective and accurate diagnostic methods for you. High-quality materials, reliable equipment and experienced staff will ensure the results of your treatment at the highest level.

We offer the following types of gynecological tests:

• polymerase chain reaction;
• smear analysis;
• bacterial sowing;
• blood test for hormones.

Testing for different types of infections

Correct identification of infection makes it possible to prescribe effective treatment. The list of prescribed gynecological tests depends, first of all, on what complaints you came to the gynecologist with; Each clinic determines prices for them at its own discretion. Tests for infections can be taken from:

• vagina;
• cervix;
• urethra;
• anus.

All kinds of female diseases can manifest with different symptoms and have an uncertain medical picture. To clarify the situation and make the correct diagnosis, gynecology uses many different methods for diagnosing infections.

Reading time: 6 min

A mandatory procedure when visiting a gynecologist is to take biological material to assess the condition of the microflora and epithelial cells of the vagina, the internal mucous membrane of the uterine body, endometrium, and cervical canal.

A gynecological smear, the examination and interpretation of which is carried out in a laboratory setting, is highly informative.

The analysis allows us to determine the hormonal level of the reproductive system, the amount and composition of vaginal discharge, the bacterial content of microflora in women, prevent inflammatory processes, identify developmental pathologies, the presence of neoplasms and infections that are sexually transmitted.

Diseases of the female reproductive system are dealt with by a specialized branch of medicine - gynecology.

There are many reasons for patients to apply: undergoing a medical examination for employment, pregnancy, painful or unpleasant cramping sensations in the lower abdomen, itching or burning, thrush, heavy menstruation or discharge of unknown origin.

A general smear or microscopy is performed during a preventive examination or during pregnancy planning. The result is the study of the cervical and urethral canal, vagina, and in virgins - the rectum.

Papanicolaou cytology analysis makes it possible to timely detect the papilloma virus, precancerous conditions of the epithelium, and cervix. It is recommended that all females with hereditary cancer diseases and those over 21 years of age undergo a Pap test.

A bacteriological research method, bacterial culture in women, is recommended if there is a suspicion of an inflammatory process, a disorder of the microflora, which was caused by opportunistic and pathogenic microorganisms.

PCR is carried out in the form of an analysis for infections transmitted mainly through sexual contact. Provides complete information about the bacterial composition of the internal microflora.

The effectiveness and reliability of the method is 98%.

Preparing for a smear test

Before prescribing an examination, the gynecologist or laboratory employee is obliged to warn the patient about how to properly take a smear for flora, what can and cannot be done before the procedure.

Preparation for a microscopic examination involves avoiding strong antibiotics 2 weeks before the expected analysis and visiting the bathroom the day before. You should try not to go to the toilet 2 hours before the test.

It is better to do diagnostics not before, but during menstruation and in the first two days after.

To increase the sensitivity of the test, microflora culture is carried out in the absence of treatment with antibacterial drugs and douching. Be sure to follow a special diet 2-3 days before the bacteriological analysis: limit foods that provoke fermentation or intestinal upset.

Refrain from sexual intercourse with your partner and do not wash yourself 24 hours before data collection.

3-5 days before the prescribed PCR diagnosis, taking any antibacterial and contraceptive drugs is prohibited. It is necessary to avoid sexual intercourse for 36 hours. It is advisable not to shower the day before the PCR and on the eve of the test. The material is taken during menstruation and for 1-2 days after its end.

How to take a smear from women

The technique for collecting material is usually carried out in the morning in the gynecology department or directly in the laboratory itself. Taking vaginal discharge and areas for examination is prescribed only for women who are sexually active. In girls, it is taken more carefully from the lateral vault of the vagina to prevent damage to the hymen, and from the intestines, secretion.

All manipulations take place on a gynecological chair. At this time, the specialist introduces a special mirror depending on the age and physiological characteristics of the patient. If the organs are not yet formed, size XS is used, girls will need a mirror S. After labor, examination instruments with a diameter of 25-30 mm, sizes M, L are used.

The material is collected with a spatula or spatula, brush, applied to a glass slide or placed in a test tube for further transfer of the results to the laboratory.

Microflora smear: interpretation

It is impossible to independently draw a conclusion about how good or bad a smear is without the appropriate knowledge. Using special notations, it is very easy to decipher a microscopic examination of a smear. Depending on the location of the biological material taken, they are distinguished: vagina - “V”, cervix - “C” and urethra - “U”.

Gram-positive rods, “Gr.+” and the absence of coccal flora. The result is “++++”. It is observed quite rarely, most often it is a consequence of intensive antibacterial therapy. Norm: “++”, “+++” rods, the number of cocci does not exceed “++”.

Gram-negative bacteria gonococci - “Gn”, trichomonas vaginalis - “Trich”, yeast of the genus “Candida”. Corresponds to diseases such as gonorrhea, trichomoniasis and candidiasis.

The presence of key cells and E. coli, if they are listed in the microflora, indicates that the patient has bacterial vaginosis.

Flora smear: normal in women

All patients, without exception, from the age of 14 until the onset of menopause, correspond to the same standard, obtained as a result of laboratory microscopic examination.

Leukocytes. Providing protection for the body from penetrating viruses, bacteria and infections, they can be in the field of view, but should not exceed the indicator in the vagina - 10, in the cervix - 30, urethra - 5.

Epithelium. A moderate amount of epithelial tissue is normal. A high number indicates possible inflammation, while a too low number indicates insufficient production of the hormone estrogen.

Slime. A small amount or no quantity is allowed. The maximum daily rate of secretion from the glands of the cervical canal is 5 ml.

Gram-positive rods, “Gr.+”. Lactobacilli and Doderlein bacilli must be present in large quantities. They are responsible for the body's immune response to foreign bodies. They should not be in the cervix and urethra.

“Gr.-”, gram-negative, anaerobic rods are not detected.

Gonococci with the symbol “gn”, Trichomonas, chlamydia, key and atypical cells, fungi, yeast, Candida are absent. If they are detected in the results, the patient is prescribed additional testing for gonorrhea, trichomoniasis, chlamydia, bacterial vaginosis, and thrush.

Smear for purity level

To avoid complications during pregnancy, pregnant women are advised to determine the degree of purity of the gynecological smear. Normally, in a healthy woman, 95-98% of the vaginal microflora consists of Bacillus vaginalis or Lactobacillus bacillus Doderlein. They produce lactic acid, which helps maintain acidity levels.

Pathogenic and opportunistic microorganisms are not able to survive in such conditions. But under the influence of various factors, such as sexual activity, menopause, the menstrual cycle and decreased immunity, microflora indicators can change.

• 1st degree Normal vaginal cleanliness is pH 3.8-4.5. The environment is acidic. Leukocytes and epithelial cells - no more than 10.
• 2nd degree. Slightly acidic environment: pH=4.5-5. There is a slight increase in gram-positive cocci and Candida fungi.
• 3rd degree. Pathogenic microorganisms are activated, mucus appears, and epithelial indicators exceed the norm. Neutral acidity level, pH=5-7. There are over 10 leukocytes. Mucus, key cells are present, gram-negative and gram-positive microorganisms multiply in favorable microflora conditions.
• On the last one, 4 degrees, cleanliness is low. pH values ​​reach 7.5. Doderlein's rods are either completely absent or found in single quantities. The vagina is filled with pathogens.

Bacteriological research

The variety of composition, in addition to Lactobacillus bacillus Doderlein, which is an integral part of the vaginal microflora of the woman being examined, does not begin to be studied immediately. Sowing the collected biological material onto a specially created favorable environment for its subsequent growth, development and reproduction takes time.

Bacteriological culture of flora can be assessed through a microscope, provided that the number of representatives of microorganisms increases.

• 0 class. Observed during treatment with antibiotics. The pathogen is absent.
• I class. The number of bacteria does not increase or increases moderately.
• II class. Mixed nature of microflora. Up to 10 colonies of bacteria Gardnerella vaginalis or Mobiluncus, the causative agents of gardnerellosis, are detected.
• III class. There are about 100 colonies. The microflora is predominantly inhabited by Gardnerella and Mobiluncus. Symptoms of bacterial vaginosis appear.
• IV class. Lactobacilli are absent, immunity is weakened. Diagnosis of acquired infectious disease - aerobic vaginitis.

Cytological examination

The probability of detecting areas of altered epithelium, papilloma virus and oncological tumors is quite high after 30 years of age and the beginning of sexual activity.

The correct interpretation of the PAP test depends on the presence or absence of cancerous, atypical cells.

• NILM. The clinical picture is without features, CBO. Leukocytes and bacteria are released in small quantities. Primary candidiasis or bacterial vaginosis is possible. The epithelial layer is normal.
• ASC-US. Atypical areas of unknown origin were found in epithelial tissue. A repeat analysis is carried out after 6 months to look for chlamydia, dysplasia, and human papillomavirus.
• LSIL. To confirm a precancerous condition caused by atypical cells, a biopsy and colposcopy are prescribed. Weak signs of changes in the epithelium.
• ASC-H. Pronounced damage to the squamous epithelium. 1% of patients are diagnosed with the initial stage of cervical cancer, the remaining 98-99% have grade 2-3 dysplasia.
• HSIL. Concomitant symptoms preceding cancer of the squamous epithelium and cervix were identified in more than 7% of the women examined. 2% have cancer.
• AGC. Atypical condition of the glandular epithelium. Diagnosis: cervical or endometrial cancer, advanced form of dysplasia.
• AIS. Squamous cell carcinoma, cervical cancer.

PCR analysis

The molecular biological method of PCR diagnostics is distinguished by its high sensitivity and reliability of the data obtained. By creating earlier samples of the isolated and copied DNA section, comparisons are made with the resulting biological material.

Testing for infections using PCR makes it possible to quickly find the causative agent of a disease in the female genital organs by obtaining a positive or negative result.

The polymerase chain reaction facilitates the determination of chlamydia, ureaplasmosis, thrush, trichomoniasis, HPV, HIV, and the search for the causes of difficult pregnancy and hormonal disorders.

The disadvantages of PCR are cases of false data due to incorrect tests and possible mutation of the pathogen's DNA.

Regular visits to the gynecologist are necessary. This helps to identify diseases in the early stages and prevent their further development. Every second woman has gynecological problems, and the condition
The health of every third person persistently requires a detailed examination for the presence of cancer.

Therefore, once every 5-6 months, undergoing a full gynecological examination for preventive purposes is simply necessary. Experts recommend not saving on your health and agreeing to a full gynecological examination, which consists of 6 stages.

Find out what awaits you at each stage of your examination with a gynecologist.

1. External inspection.

First of all, the doctor examines the external genitalia, then begins the examination
cervix to identify possible pathologies.

2. Internal inspection.

To examine the cervix, special speculums are inserted into the vagina. This is an unpleasant part of the procedure, since most often they are metal and cold. Although modern medical centers use disposable plastic mirrors. You can also buy them at the pharmacy and bring your own mirror to your appointment.

3. Bacteriological study.

This is an examination of a smear from the vagina and cervix under a microscope. Although this procedure is not new, the accuracy of the result has increased significantly in recent years thanks to new equipment that has appeared in most clinics (meaning private and “semi-private” clinics). The number of leukocytes is counted in a smear (more than 10-20 d in the field of view says about the presence of infection) and look for the causative agents of this infection.

“As a rule, a smear can detect fungi (thrush, candidiasis), “key cells” (bacterial vaginosis, gardnerellosis), changes in the normal flora,” says Natalia Ivanovna. — And if a smear shows the presence of infection, but does not identify the pathogen, additional
lab tests".

The result of this stage of the study, as a rule, is known after a few days, but in some modern centers you will be offered an express option (that is, you will receive a “transcript” on the same day
smears, but for an additional fee).

4. Cytological examination.

A mandatory stage in diagnosing cervical pathology. Mandatory research carried out before her treatment. Even if nothing worries you, and the cervix seems unchanged to the naked eye, a woman should regularly (every year) undergo a cytological examination of cervical scrapings. This is a completely painless procedure, despite the fact that the smear is taken with pressure, scraping off layers of cells.

This technique is necessary, since the malignant process begins from the lower layers of the epithelium (covering tissue) of the cervix and progresses upward to the surface. Therefore, if only the surface layer is included in the smear, a diagnosis can only be made when the disease has reached the final stage.

5. Colposcopy.

This is an examination of the cervix under a special microscope - a colcoscope, which today is in every gynecologist's office. This procedure appeared not so long ago. And its importance is difficult to overestimate: thanks to this study, the first signs of a malignant tumor can be identified. It is also irreplaceable in diagnosing erosion.
ovaries and cervix.

6. Biopsy.

Prescribed according to the doctor's decision, if necessary. This is taking a section of tissue for histological examination (the same as cytology, only it is not the individual parts included in the smear that are examined)
cells, but a single section of tissue in a suspicious area). Histological examination allows us to make a final diagnosis. A biopsy is performed in the absence of infection, at the beginning of the menstrual cycle - on days 5-7.

Gynecological tests for infections are prescribed in order to determine the causative agent of the disease and prescribe the correct treatment.

Biological material for gynecological tests for infections is taken from the vagina, urethra, cervix, anus and vestibule of the vagina. Types of tests in gynecology.

You came to the gynecologist with complaints about discharge. In order to determine the causative agent of the infection and choose the right treatment, the doctor prescribes tests. Which ones and in what order?

Which gynecological tests are the most important to get a complete picture of your women's health?

Bacterioscopy (smear for flora)

It is taken after inserting the vaginal speculum, under eye control, using a disposable spatula (a plastic stick with a widened end). If you took care of yourself in the conditions of free medicine and brought with you a disposable gynecological examination kit, a spatula is included in it. It is incorrect to take material for a smear with a glove (since the talc with which the gloves are treated can distort the picture); a mirror (sometimes, when removing the mirror, the doctor transfers the secretions that have fallen into it onto the glass), because mainly desquamated cells from the posterior vaginal vault enter there; after a two-handed examination without inserting a mirror (since the material must be taken under the control of the eye, i.e. you can see what you are taking). Taking a smear is the doctor’s second manipulation after you are on the chair, the first is inserting a vaginal speculum. Then the light is directed into the mirror, and the doctor takes the material with a spatula, preferably from three areas, but at least from the last two: from the external opening of the urethra, vagina and cervix. Only after this is it possible to conduct extended colposcopy (staining the cervix with solutions) and two-handed examination. This order is explained by the fact that the solutions used for colposcopy kill bacteria, making the smear meaningless, and during a two-handed examination, microtrauma occurs on the surface of the cervix, desquamated cells and blood cells get into the smear, making it difficult to diagnose infections. The material taken with a spatula is evenly distributed over a clean glass slide with a wide stroke. It is incorrect to apply the material in a thick layer, a drop, or a small smear - this will make it much more difficult for the laboratory doctor to do his job. Material from different areas is placed on the glass separately, on the back of the glass the place where the smear was taken is marked: “U” - urethra, “C” - cervix, “V” - vagina. After this, the glass is air dried and sent to the laboratory.

In the laboratory, the smear is stained and examined under a microscope.

What a laboratory technician can see:

a) Epithelium. Cells that line the vagina and cervix. Normally they should be present. Their number varies depending on the phase of the menstrual cycle and the hormonal drugs used. The more female sex hormones (mid-cycle, estrogen intake, pregnancy), the more epithelium. The absence of epithelial cells may indicate epithelial atrophy, lack of estrogen, or excess of male sex hormones.

b) Leukocytes. Cells that perform a protective function, “eating” infectious agents. With inflammation in the vagina (colpitis, vaginitis), their number increases in proportion to its severity and the number of pathogens. Normally, the number of leukocytes in the first phase of the menstrual cycle is up to 10 per field of view (a section of glass visible under a microscope), in the second - 10-15 per field of view. An increased level of leukocytes is sufficient to establish the fact of infection, but not enough to determine its causative agent. And it is very desirable to find the pathogen in order to choose the right antibiotics.

c) Rod flora (morphotype of lactobacilli). This is normal flora (microorganisms that should live in the acidic environment of the vagina), except for which nothing should be detected in the smear.

Everything presented below should not be present in a normal smear:

d) Cocci. Bacteria are spherical (as opposed to rod-shaped). Sometimes appearance is enough to make a diagnosis (diplococci (double) - gonorrhea, a combination of cocci, small rods and “key” cells - bacterial vaginosis), sometimes culture is necessary for an accurate diagnosis.

d) Small stick. Most often anaerobic (not using oxygen) bacteria, gardnerella. A sign of either infection or vaginal dysbiosis, especially when there are more of them than lactobacilli.

f) “Key” cells. Epithelial cells covered with small rods. A sign of bacterial vaginosis - vaginal dysbiosis - a condition in which instead of aerobic (oxygen-loving) lactic bacteria, anaerobic organisms, including small rods, multiply in the vagina.

g) Mushrooms. Causative agents of candidiasis (thrush). Depending on the severity of the process, the smear may contain fungal spores (unexpressed candidiasis, possibly without manifestations), hyphae, and fungal mycelium (common candidiasis).

h) Trichomonas. Whole or destroyed. Causative agents of trichomoniasis. Large single-celled organisms with flagella.

Detection of points “d - z” in the smear helps to identify the causative agent of colpitis and select the appropriate antibiotics. However, you may encounter a situation where, apart from leukocytes, nothing else is found in the smear. Causes:

A). Determining pathogens requires more qualifications of a laboratory technician than finding leukocytes.

b). Viral, myco-, ureaplasma, chlamydial infection. These microorganisms are so small that they cannot be seen under a microscope. Other methods are used to diagnose them.

V). Too much leukocytosis, when their number is more than 100 in the field of view (sometimes laboratory assistants write “leukocytes completely cover all fields of view”). This means that the smear contains material containing only destroyed cells and leukocytes - pus. It is almost never possible to detect pathogens in pus.

G). Incorrect material taking (see above).

This is the same case when the discharge is disturbing, the doctor admits that the smear is bad and it is necessary to be treated, but nothing concrete was found, and it is not clear how to treat it. There are 3 options here:

a) if there are doubts about the correctness of taking the material and the qualifications of the laboratory assistant, retake the smear

b) if there is no doubt, submit the material for culture or PCR diagnostics. These methods are more sensitive. The latter allows you to detect viruses, chlamydia, urea and mycoplasma.

c) if “leukocytes completely cover all fields”, a universal treatment regimen is prescribed, i.e. a set of broad-spectrum antibiotics that affects all possible bacteria. If this does not lead to a complete recovery, then at least it reduces the number of leukocytes, which makes it possible to take material for further search for pathogens.

Bacterioscopy of a smear is performed within one day, with conventional staining with methylene blue - within 15 minutes.

The quality of the smear and the result depend, first of all, on the correctness of taking the material, and secondly, on the qualifications of the laboratory assistant. The effectiveness of treatment, in addition, also depends on the knowledge of the gynecologist prescribing the treatment regimen.

Bacteriological research (seeding, cultural method).

Growing bacteria on nutrient media. The method is much more sensitive than microscopy, because it allows you to detect the pathogen at a low concentration, when it does not enter the smear. The analysis is taken again after inserting the speculum, under the control of the eye, from the cervical canal with a special sterile swab. In your presence, they open a disposable tube with a tampon (it is sealed at the factory) and, without touching anything, insert the tampon into the cervical canal. One movement and, without touching anything, the tampon is returned to the test tube and closed tightly. The most important thing when taking material for inoculation is sterility, so that bacteria come from the area being studied, and not from the air, skin, etc.

In the laboratory, a swab is used to touch the nutrient medium (gelatin or agar-agar), on which bacteria grow. Conventional sowing is done with access to air, i.e. anaerobic (not using oxygen) bacteria cannot grow. Sowing them is also possible, but this is a special study that is not done in all laboratories. To grow viruses (herpes), chlamydia, special conditions and media are also required; these are separate tests.

Culture method- this is the so-called the “gold standard” for diagnosing many infections and the main method for monitoring the effectiveness of treatment. It is much more sensitive and specific (see below) than a conventional smear and has advantages over DNA diagnostics (PCR). The fact is that what is important is not the detection of a microbe, but the proof that it is the causative agent of the infection, and this is not the same thing. The body often contains microorganisms, the so-called. “conditional pathogens” (for example, gardnerella), which normally do not cause disease, but with a decrease in immunity and the development of dysbacteriosis, they can cause. Their detection does not prove their role in the development of infection. But their growth on nutrient media indicates that, firstly, they are viable (they can grow and cause disease), and secondly, they are numerous (individual microorganisms are suppressed by those who are more numerous, and then it is not the infectious agent that grows on the media, and normal flora). Another advantage of bacteriological research is that it allows you to calculate the amount of the pathogen (by the number of colonies grown), as well as determine sensitivity to antibiotics (different antibiotics are added to the nutrient medium and it is seen which drug kills the bacteria). The only drawback of the method is the length of time it takes (bacteria grow for several days) and the demands on the laboratory.

DNA diagnostics (PCR)

DNA diagnostics includes several methods, but the most common is polymerase chain reaction (PCR). This is the detection of pathogen DNA in the material. DNA is a molecule that contains all the information about a cell. In cells of organisms of the same species (for example, mycoplasma genitalia), certain sections of DNA are the same. Therefore, knowing the structure of these areas in the main pathogens, it is possible to create mirror copies that will find and bind to them. Finding even one such site is enough for the PCR to be positive. This indicates the extremely high sensitivity of the method.

The method is good for diagnosing infections that are not detected in smears: chlamydia, urea and mycoplasmosis, genital herpes. However, the method is unacceptable for determining the effectiveness of treatment of the same diseases, because and after the cells decay, pieces of DNA may remain in the body. Only viable reproducing microorganisms can serve as a sign of uncure, and they can only be detected by culture.

It is also undesirable to use the PCR method for diagnosing gardnerellosis, because These bacteria are normally found in the vagina. They should not be in the smear, and in this case, bacterioscopy is a sufficient method for diagnosing gardnerellosis and monitoring treatment. But the DNA of these bacteria can and should be present; this is not a criterion for the disease.

1. Failure to comply with the rules for collecting material - failure to remove mucus from the cervical canal. The most common reason. You can't control it. The only thing you can do is choose a gynecologist you trust.

2. Unsuitability of reagents. You also cannot control this reason; it lies on the conscience of the laboratories.

3. Again, non-compliance with the rules for taking the material - DNA of bacteria gets into the material from the air, from the hands, from a cover glass (for some reason, the material for PCR is often submitted in the form of a regular smear on glass. This is wrong, because glass cannot be sterile). Sterility can also be compromised in the laboratory if strangers often walk around the working sample and “sprinkle” different DNA from their clothes. You won't be able to check this either. The main mistake in the laboratory is made when the laboratory “regime” is violated - untimely replacement of the primer and other technical subtleties.

Therefore, despite the fact that PCR is the most sensitive and specific diagnostic method, it has its drawbacks. The results should be analyzed by the attending physician, taking into account the possibility of all of the above. The diagnosis is made based on complaints and symptoms. Any diagnostic method is auxiliary, you cannot rely on it 100%.

4. Determination of antibodies in the blood (serological method). An additional diagnostic method that allows you to distinguish an acute disease, its first episode from an exacerbation of a chronic infection. This method is especially often used in pregnant women after detection of the pathogen by PCR to determine the likelihood of infection of the child. The most dangerous for the body and most often transmitted to the child is the primary infection (the first hit of the pathogen), when the immune system has not yet encountered this microorganism and has no experience in fighting it. In response to the pathogen entering the blood, antibodies are formed - substances that bind to it and try to remove it from the body. During a primary infection, antibodies of one class are produced - the so-called. immunoglobulins M. Their presence in the blood indicates that the body is sick and is an indication for treatment of infection. Later, other antibodies begin to be produced - class G immunoglobulins. They persist even after treatment, for some infections (for example, rubella) - forever. The presence of immunoglobulins G in the blood indicates that the body has previously encountered an infection and has developed immunity against it; this is a favorable sign and does not require treatment. The simultaneous presence of both classes of immunoglobulins indicates an exacerbation of a chronic infection and requires treatment. If only immunoglobulin G is found and infection is suspected (signs of intrauterine infection of the fetus), a repeat analysis is done after 2 weeks to determine the titer (quantity) of antibodies. A sharp increase in titer indicates activation of the infection and requires treatment.

Determination of antibodies in the blood to the main pathogens (toxoplasma, rubella, cytomegalovirus, herpes) in pregnant women is called the TORCH complex. For all these infections, it is very important whether the woman has had them before, i.e. does she have immunoglobulins G in her blood? If not, then there is a possibility of developing a primary infection during pregnancy and damage to the fetus. In this case, you need to more carefully protect yourself from possible infection and regularly recheck the antibody content.

Antibodies to herpes. Unfortunately, in Russia it is almost impossible to separately determine antibodies to herpes virus type 1 (on the lip) and type 2 (genital). When they take your blood to determine antibodies to genital herpes, you are being deceived. Blood is taken to determine mixed antibodies to both types of virus. And since almost all of us had type 1 herpes in childhood, 98% of the adult population has antibodies to it, and the test will be positive, even if you have never had genital herpes. Therefore, this analysis has almost no value and money can be saved on it. The only indication is that you are pregnant, and it seems to you that you have never had type 1 herpes (fever on the lips). Then this analysis is carried out, and if indeed there are no antibodies at all, then it is all the more necessary to protect yourself from possible infection even with this “harmless” herpes type 1, because and its primary infection can harm the fetus. (There are laboratories in Moscow that perform AT to HSV type 2 without AT to HSV type 1, but due to the high cost of imported reagents, such tests are rare).

To determine antibodies, blood is taken from a vein. Again, a lot depends on the level of the laboratory and the quality of the reagents.

Terms and notes:

Sensitivity of the method- number of positive results (bacteria detected) in the presence of pathogens in the material. A sensitivity of 80% means that in 80% of cases where bacteria are present in the material, the specified method will detect them.

Specificity of the method- the probability that a positive result is true. A specificity of 80% means that in 80% of a positive test result the pathogen is actually present. The remaining 20% ​​of positive tests are actually false positives.

False positive result- a situation when the test result is positive (a bacteria is detected), but in fact it is not there. The higher the sensitivity and lower the specificity of the method, the greater the likelihood of false positive results. For the patient, a false positive result means unnecessary worry, a search for adultery (who infected) and unjustified treatment.

It is especially undesirable to obtain a false positive result after treatment. I was treated and treated, but chlamydia remained. Does this mean they were treated incorrectly? Or did your partner infect you again? Or are they transmitted through household means? These are the most common gynecological questions sent to the site. The main reason is that to monitor the effectiveness of treatment, the same highly sensitive methods (for example, PCR) were used as for primary diagnosis. One unfortunate, long-dead DNA molecule from a destroyed chlamydia cell can get caught and give a false positive result, but there is no chlamydia. Therefore, the gold standard for repeat testing after treatment is culture. If the infection is defeated, it will definitely not grow back.

False negative result- negative test result (failure to find the pathogen) if it is present in the body. Occurs when using low-sensitivity methods (bacterioscopy). It is unpleasant for the patient to have to repeat paid tests.

Ways to combat false results:

1. Search for a qualified laboratory and gynecologist

2. Selecting the correct diagnostic method for a specific situation and following the rules for taking an analysis.

3. Treat symptoms, not test results. Fashionable PCR gives a sufficient number of false positive results. For commercial centers this is a very valuable feature of the method. But a competent patient should not allow his tests to be treated. A very common situation is “I went to get examined and found ureaplasma. What should I do?” Treat what's bothering you. If nothing else, then the test results “just in case” are treated in the only case - if there is a pregnancy planned in the near future.

If tests for sexually transmitted infections confirm that you are sick, immediately tell your partner about it.

Malyarskaya M.M., gynecologist - www.med2000.ru Save on social networks: