Female secretion examination

The examination of female secretions is a very important examination. Leucorrhea, as a normal secretion, is very easy to be abnormal in daily life, mainly manifested in abnormal quantity and color. In many cases, it is difficult to determine the specific cause based solely on symptoms. The final conclusion can only be drawn after testing the leucorrhea. So, what is the process of checking female secretions? Let’s take a look below.

examine

1. General characteristics inspection

Normal vaginal discharge is white, thin, and odorless, with variable amounts. Its properties are related to estrogen levels. Near ovulation, the stool is clear, transparent, thin like egg white, and large in amount; 2 to 3 days after ovulation, it becomes turbid and sticky, and the amount decreases; before menstruation, the amount increases; after menopause, it decreases.

(1) Purulent leucorrhea: The leucorrhea is yellow or yellow-green in color, pus-like, and has a foul odor. It is usually caused by infection, and is common in Trichomonas vaginitis, chronic cervicitis, vaginitis, endometritis, etc.

(2) Bloody leucorrhea If the leucorrhea is stained with blood, you should be alert to malignant tumors such as cervical cancer and uterine cancer. This symptom may also occur in cervical polyps, severe chronic cervicitis, intrauterine devices, senile vaginitis, etc.

(3) Curd-like leucorrhea is a characteristic of candidal vaginitis.

(4) Yellow watery leucorrhea is common in cervical cancer, submucosal uterine fibroids, fallopian tube cancer, etc.

(5) Purulent and bloody leucorrhea is a characteristic of amebic vaginitis.

2. Cleanliness inspection

Vaginal secretions can generally be subjected to smear examination. The vaginal secretions are smeared on a glass slide with saline drops and examined under a microscope. The cleanliness of the vagina can be determined based on the number of various cells and different types of bacteria under the microscope.

Specimen collection

The collection of female vaginal secretions includes the collection of vaginal secretions, cervical secretions, and uterine cavity contents.

1. Vaginal discharge

Use a speculum to dilate the vagina, avoid using lubricants, and use a sterile cotton swab to collect secretions from the inner wall 4 cm within the vaginal opening or the posterior fornix for culture or smear microscopy.

2. Cervical secretions

Use a speculum to dilate the vagina and first use a sterile cotton ball to wipe the cervical secretions. Insert a sterile cotton swab 2 cm into the cervical canal, rotate it and leave it there for 10 to 20 seconds to allow the swab to fully absorb the secretions.

3. Uterine contents

In case of infection in the amniotic cavity, amniotic fluid can be extracted through amniocentesis of the abdominal wall or through cervical cannulation for pathogen testing. The extraction of amniotic fluid through cervical cannula for cell culture is easily contaminated by bacteria from the vagina or cervix, and has limited clinical application value. When acute intrauterine infection is suspected, uterine secretions should not be collected in principle to avoid the spread of infection.

Clinical significance

1. Vaginal secretion examination can determine whether the vagina is inflamed, and can further diagnose the cause of the inflammation. When the cleanliness reaches level III or IV, in most cases it can be diagnosed as vaginal inflammation, such as bacterial vaginitis, Trichomonas vaginitis, candidal vaginitis, etc., providing a direct basis for the treatment of inflammation. Simple increase in cleanliness is more common in nonspecific vaginitis.

2. If vaginal Trichomonas is found during the examination, it can be diagnosed as Trichomonas vaginitis or Trichomonas infection. When vaginal fungi are found, it can be used as a basis for the diagnosis of candidal vaginitis.

3. A positive fungal test in vaginal secretions is often seen in fungal vaginitis, and the diagnosis is based on finding the fungus. Vaginal fungi are mostly Candida albicans, which usually parasitize in the vagina. When the glycogen in the vagina increases and the acidity rises, it can multiply rapidly. It is common in: diabetic patients, pregnant women, and those who use large amounts of broad-spectrum antibiotics or cortical hormones to cause vaginal flora disorders.