Rod flora in large quantities during pregnancy

Vaginal microflora and its diagnosis

A woman’s reproductive tract is in constant interaction with the environment, so reliable protection against infection by viruses and bacteria is necessary.
Many microorganisms that enter the mucous membranes of the urogenital tract are expelled by a current of mucus, urine, and the activity of the mucociliary epithelium, that is, they are transient. information Only those microbial cells that are able to attach to the surface of the epithelium and multiply under these conditions constitute the microflora of the woman’s genitourinary system.

Disconnection of the vagina and the external environment

due to the physiological hypertonicity of the perineal muscles, narrowing the vulvar ring, contact of the labia majora and labia minora;

Hormonal mechanisms.

Under the influence of estrogen and progesterone, multilayered squamous epithelium proliferates, glycogen is synthesized in it, and mucous secretion is formed in the cervical canal. Mucus is rich in carbohydrates that bind bacterial receptors, preventing them from attaching to epithelial cells. Mucus contains lysozyme, lactoferrin, defensins - substances with a wide spectrum of antimicrobial activity.

Symbiosis –

mutually beneficial coexistence of microorganisms and the woman’s body. At the same time, bacteria of normal microflora create colonization protection in the genital tract from pathogenic microorganisms, while receiving nutrients and assistance from the macroorganism in the fight against competitive flora.

What happens to the vaginal microflora during pregnancy?

During pregnancy

under the influence of hormonal changes, an increase in vaginal epithelial cells occurs and glycogen accumulates in them.
And glycogen is the main substrate for the production of lactic acid by lactobacilli. Thanks to this, an acidic environment in the vagina is maintained (pH 3.8 – 4.5) Source

Flora rodum: what is it?

Rod flora is an indicator of women's health and the ability to become a mother. A woman's vagina contains many different organisms and enzymes, including rod-shaped ones. Gynecologists most often call them lactobacilli . A woman is considered completely healthy only if at least 95% of lactobacilli are present on the vaginal mucosa. Sometimes these bacteria are also called Dederlein's bacillus , named after the scientist who was able to prove their benefits.

Sticks of this type create normal acidic flora, which can preserve women's health. It simply does not allow infections and bacteria to enter the reproductive system .

If for some reason the Dederlein bacillus begins to die, small bacteria hemophilus and gardnerella . These sticks begin to provoke infectious and inflammatory processes, a woman may experience pain in the abdomen and perineum, the natural flora will be disrupted, and vaginosis may appear .

What does the presence of key cells in a smear for flora mean in women?

Key cells are detected in the smear as a result of the appearance of opportunistic bacteria called gardnerella in the vagina. This indicates dysbiosis of the vaginal epithelium - an incorrect ratio of bacteria beneficial to the body with opportunistic pathogens. The research process is carried out in a laboratory under a powerful microscope and is called bacterioscopy.

The walls of the vagina are flat epithelial tissue in which various microorganisms are present that create an optimal environment. Key cells in a smear in women is a figurative concept used by gynecologists. Using these cells, you can determine whether the balance of the vaginal microflora is disturbed.

In the absence of dysbacteriosis, rod flora, leukocytes, and Staphylococcus aureus are detected in the smear. A sufficient number of beneficial bacteria not only ensures normal microflora, but also provides protection from harmful microorganisms. If the balance of the flora is disturbed, various pathogenic bacteria are present. The most common opportunistic microorganisms are spherical cocci and gardnerella. As a result of their action, the epithelium acquires a granular structure.

Typically, key cells are found in a smear when diagnosing bacterial vaginosis, a rather unpleasant and common problem whose symptoms include:

If, with the indicated symptoms, pathogenic organisms are not detected, the patient is sent for a second smear test. There are several reasons why key cells are identified:

The vaginal microflora can be disrupted quickly, and its restoration is a long process that requires complex measures. In addition to the symptoms of dysbiosis and bacterial vaginosis, the presence of key cells in the smear can be judged by frequent attacks of thrush.

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Good and bad flora

The microflora of the vagina is the totality of microorganisms that inhabit it. Each woman has her own, so using other people’s hygiene items is strictly prohibited (we are taught this from childhood). But the laws of nature apply the same to everyone, and this is what they say.

Normally, a woman's vagina (as well as the cervix and urethra) is inhabited by lactobacilli that produce lactic acid. An acidic environment is unfavorable for the reproduction and life of other (pathogenic) microorganisms and is a natural defense against such undesirable factors. Lactobacilli are also called Doderlein bacilli, lactobacilli or lactomorphotypes, and in the analysis (flora smear) they are simply defined as bacilli. However, they are not alone in our flora.

Each vagina also contains opportunistic pathogenic flora. These are potentially dangerous microorganisms that are activated only under certain circumstances: stress, decreased immune functions of the body, taking certain medications (antibacterial drugs, birth control pills), changes in a woman’s hormonal levels (during pregnancy, diabetes or infectious diseases) and others. Conditionally pathogenic flora includes various Cocci (staphylococci, streptococci, enterococci, peptococci, peptostreptococci), Gardnerella (cause bacterial vaginosis), fungi of the genus Candida (cause candidiasis, or thrush), Enterobacteria, Bacteroides, Diphtheroids, Fusobacteria and others.

But the most dangerous for a woman, especially during pregnancy, are pathogenic organisms that enter the vagina from the outside (most often as a result of infection during sexual intercourse) and begin to multiply quickly here. The most famous of these enemy bacteria are Trichomonas (cause the development of trichomoniasis), Gonococcus (cause gonorrhea), human papillomavirus, herpes and other viruses. And that’s what they look for first (and also check the number of opportunistic microorganisms) when they take a smear for flora during pregnancy. It helps determine the type and quantity of bacteria, which is a decisive factor in treatment.

By the way, mycoplasma, ureaplasma and chlamydia can only be determined by culture for hidden infections. A smear on flora during pregnancy does not reveal these diseases. In general, it is a preliminary study, after which, if pathogenic flora is detected, it is necessary to take a culture.

Bacterial vaginosis: causes of the disease, effect on pregnancy, treatment

Bacterial vaginosis is a non-inflammatory disease of the vagina associated with changes in its microflora. This condition is extremely widespread among women of fertile age (20-45 years), its occurrence in this group reaches 80%. That is, out of ten women, 8 experience bacterial vaginosis at least once in their lives. The disease does not pose a danger to the patient herself, but can negatively affect her reproductive function. Bakvaginosis often causes miscarriages, intrauterine infection of the fetus, complications after childbirth, abortions and invasive interventions on the genitals. How the disease is transmitted and how to get rid of it, read on.

How does bacterial vaginosis develop?

Human existence is inseparable from the activities of various microorganisms. Those of them that, in the process of evolution, have adapted to productive cooperation with people are called normal microflora/biocenosis. Its composition is constant: some microorganisms are found only on the skin, others in the mouth and intestines. In their habitat, they perform essential functions: they protect the host’s body from pathogenic bacteria, produce vitamins, and stimulate the immune response.

Normally, the vagina is populated by lactobacilli - short, thick rods. They break down glycogen, which is rich in vaginal epithelial cells, producing lactic acid. Thus, an acidic environment is constantly maintained in the woman’s lower genital tract, which prevents the establishment and growth of pathogenic microflora. To maintain normal conditions and the protective function of the vagina, a large number of lactobacilli are necessary, so their share in its biocenosis is 95-98%.

Due to various reasons listed below, lactic acids are displaced

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Key cells during pregnancy

The incidence of bacterial vaginosis varies from 4% in females who do not complain to 86% in patients who visit various clinics. And in pregnant women, this pathology is detected in 15–37% of cases, and in the first three months it is 2 times more often than in subsequent months.

In pregnant women, bacterial vaginosis is a very serious reason for the development of infectious complications. During pregnancy, chronic diseases often worsen and, as a result, weakened immunity occurs. The disease can cause many troubles for pregnant women: intrauterine infection of the fetus, late-term abortion or premature birth.

The main female analysis is a smear on the flora: simple about the complex

A smear on flora - biological purity or microflora - is one of the main research methods practiced in gynecology. Material for such a study is taken from the mucous membranes of the vagina, cervix and urethra. The main task of the gynecologist taking the analysis is to obtain information about the state of the microflora and the presence of pathogens of genitourinary diseases.

There are many microorganisms in the female genital organs, some of them are dangerous, others are harmless to the body, while there are few of them, and others are absolutely necessary for women’s health, as they help fight pathogenic bacteria that cause inflammatory processes. A flora smear (vaginal cleanliness smear) helps determine the composition of the flora and the quality of the environment in which it lives.

What can be detected in a smear to check the cleanliness of the vagina?

Epithelium

. These are dead epithelial cells covering tissue organs, in particular the vagina and cervix. Normally there should be little of it. If there is a lot of biomaterial in the test sample, it means that an inflammatory process is occurring in the body. The absence of epithelium is observed in women with hormonal imbalances, with excess testosterone and lack of estrogen. This is an equally dangerous symptom, leading to early aging of the body and decreased sexual function.

Leukocytes

. These are special cells - protectors against infections, produced by the immune system. Leukocyte cells are white in color, which is why they are called white blood cells. Normally, there should be a small amount of them to resist attacks from pathogenic bacteria. A sign of inflammation is an increase in the number of leukocytes.

Red blood cells

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Red blood cells are part of the blood - they give it its red color. Their concentration in the smear depends on the phase of menstruation Source

Feasibility and features of treatment

Treatment is mandatory if a flora smear reveals an unacceptable decrease in the number of gram-positive rods against the background of the growth of pathogenic microflora, represented by small rods, leukocytes, and cocci.

Treatment tactics depend on determining the root causes of disturbances in normal microflora.

Deviations from the norm in the flora smear are associated with bacterial vaginosis, which is treated with antibacterial drugs.

The therapy is complemented by nutritional correction according to the requirements of a fermented milk diet in order to reduce the number of pathogenic microorganisms in the vagina.

To combat pathogens directly, antibiotics, antifungal and antibacterial drugs are prescribed.

In order to eliminate disturbing symptoms, which may manifest as characteristic discharge, itching and burning in the genital area, douching and suppository procedures are recommended.

how to get pregnant after vaginosis treatment

Bacterial vaginosis, suppositories and usage patterns

Treatment of bacterial vaginosis involves the combined use of systemic and local drugs.

Almost all doctors say that suppositories are many times more effective than systemic drugs, although the active substance used is the same.

Why? The fact is that the tablets first dissolve in the stomach, then are absorbed by the mucous membrane and only then enter the bloodstream, affecting not only vaginosis, but the entire body.

The main effect of metronidazole is antiseptic; treatment of bacterial inflammatory processes in the vagina with this drug almost always gives a lasting effect, without side effects and relapses, vaginosis does not return!

Recommendation: this medicine of any type of action, local or systemic, cannot be combined with the consumption of alcoholic beverages.

In parallel, as a rule, the sexual partner is examined and treated. Douching should be avoided during treatment with metronidazole.

Nifuratel has an antiseptic effect; almost all pathogenic microorganisms that cause bacterial vaginosis are sensitive to this substance.

It affects all pathogenic bacteria, the effect is noticeable within an hour after using the medicine, vaginosis does not go away immediately, but the symptoms are reduced.

Neomycin sulfate is an antibiotic that destroys pyogenic microorganisms that provoke the development of the inflammatory process;

This drug acts very quickly and effectively, has a pronounced bacteriostatic and bactericidal effect.

The medicine should not be combined with other similar drugs; sexual intercourse should be completely avoided during the treatment period.

what you can eat in the third trimester of pregnancy The third trimester of pregnancy is the most important and exciting period. In the last trimester of pregnancy, a woman experiences frequent mood swings, and some problems with well-being may arise. 7, 8

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Treatment of genital diseases during pregnancy

If the research reveals the source of infection, the doctor will prescribe special treatment. For each pathogen, there are drugs that neutralize its activity and destroy it.

Various medications are presented in the form of suppositories, creams, and vaginal tablets. It is better if the chosen product does not contain antibiotics. In cases of acute bacterial infection, courses of antibiotics that are safe for the fetus are prescribed.

Often infectious diseases occur hidden, but still have an impact on pregnancy and the development of the baby. Therefore, it is very important, even when planning a pregnancy, to undergo examinations before conception to identify the presence of a sexually transmitted infection.

If pathogenic microflora is detected in a smear already during pregnancy, you should not panic. The main condition for successfully combating the disease is strict adherence to the doctor’s instructions. The course of therapy should not be interrupted (important when using suppositories). Pay special attention to personal hygiene - wear cotton underwear, wash and iron clothes thoroughly with a hot iron.

If you provide this with due attention, the process of normalizing the vaginal microflora, even during pregnancy, will be faster and more effective.

This phrase should not cause bewilderment or surprise in a modern woman. After all, every girl who cares about her health, with the onset of sexual activity, is obliged to undergo regular examinations by a gynecologist, which includes this analysis. However, with the onset of pregnancy, we perceive many things differently. And the smear, which previously was of little interest to us, now raises a bunch of questions, doubts and fears. Let's listen to what gynecologists say about him.

How quickly does cervical cancer develop from a precancerous condition?

How quickly cervical cancer (CC) develops worries many women. This is not surprising, given that this type of oncopathology ranks second or third (data from different sources vary) among tumor diseases of the fair half of humanity.

We can immediately make a reservation: cervical cancer is not an acutely developing pathology. Several years pass from its initial stage, when the disease responds well to treatment, to the invasive state, when the prognosis becomes not very good. In addition, it is possible to identify a precancerous condition, which can be diagnosed using simple and inexpensive tests. Any clinic can handle them, so there is a chance to start taking the first steps towards recovery when the cancer has not yet reached a severe stage.

Cause of cervical cancer

Despite the fact that medical science has reached great heights, no one can say with one hundred percent certainty why people get cancer. But in the case of cervical cancer, scientists have determined that it is virus-dependent. Without exception, all patients with this disease were diagnosed with human papillomavirus (HPV) or in Latin human papillomavirus (HPV).

This pathogen has a variety of species - more than eight dozen. About a third of them affect the human reproductive system. Half of this group cause cancer. But only four serotypes are “responsible” for malignant tumors of the cervix - 16, 18, 31 and 45. The first two of them are the most aggressive and manifest themselves in almost 80% of detected cervical cancer.

when are the days of ovulation in women calculated taking into account age calculator The release of an egg from the ovary into the pelvic cavity as a result of rupture of a mature follicle. From the pelvic cavity, the egg enters the fallopian tube, where fertilization occurs. Biological meaning of ovulation

Human papillomavirus is perhaps the leader among the causative agents of sexually transmitted diseases. But, fortunately, not all people who have contracted this “charm” are future cancer patients. Clinic development

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Preventive actions

Having cured the disease that caused the appearance of key cells in the smear, you should not forget about prevention in order to prevent their reoccurrence. To maintain a normal vaginal environment, the following recommendations should be followed:

Take the necessary time to rest. It is important that a woman’s rest is complete, so she should strictly adhere to the daily routine, not forgetting to set aside the appropriate time for sleep and rest.
Maintain personal hygiene. It is necessary to pay due attention to intimate hygiene every day; in addition, you should take a responsible approach to the choice of products for maintaining personal hygiene and give preference to soaps and shower gels that contain extracts of medicinal herbs and the amount of artificial dyes is minimal. It is important to adhere to the rules for using tampons and sanitary pads, change them on time and select products suitable for delicate skin.
Wear only high-quality underwear, made from natural fabrics that do not irritate the skin. It is better to put aside synthetic underwear that does not allow the skin to breathe.
Watch your diet. If possible, exclude spicy, sweet and fatty foods from your diet. Eat plenty of fruits and vegetables rich in vitamins. You can buy a complex of vitamins at the pharmacy. Taking such measures will significantly strengthen the immune system.
Treat any developing infectious disease promptly. If you need to take antibiotics, you must agree on the duration of the course of treatment and dosage of medications with your doctor.

If treatment is not taken in time, the key cells in the smear can lead to the fact that the disease that provoked them can become chronic. In the alkaline environment of the vagina, pathogenic bacteria will actively multiply, continuing to displace healthy epithelial cells. Therefore, every woman should be attentive to her health, and if unusual vaginal discharge often appears, immediately undergo examination by a gynecologist.

In addition, you need to make it a rule: you need to be examined by a gynecologist and take a smear test at least 2 times a year (ideally once every 3 months).

This approach will not only prevent the occurrence of various diseases, but also detect cancer at a very early stage. This means that the likelihood of developing a serious disease, and as a result, the emergence of key cells, will be minimized!

In an absolutely healthy woman, key cells should not be found in the smear. Their presence indicates a violation of the vaginal microflora and the development of a favorable environment for the proliferation of bacteria. For a woman, this may mean that it is time to seriously think about her health.

Is it possible to get pregnant with bacterial vaginosis?

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Questions and answers on: is it possible to get pregnant with bacterial vaginosis?

Hello, Elena! Bacterial vaginosis does not make a woman 100% infertile, but it can complicate the process of conception and become one of the reasons for spontaneous abortion in the early stages. Take care of your health!

Hello) 5 years ago I went to the gynecologist with a complaint about discharge and an unpleasant odor. A diagnosis of bacterial vaginosis was made. Gardnerella key cells. My partner and I were treated together. A year later, everything came back again and, in addition, cervical erosion. We were treated together again. The gynecologist said not to treat the erosion yet, since she had not given birth yet.

After half a year, I became pregnant. During pregnancy, all tests were normal. When I stopped breastfeeding, I went to the gynecologist to treat erosion. They said that the erosion was very inflamed and again they found gardnerella (key cells). My husband also got tested. They didn’t find anything on him. I treated Gardnerella. I was tested for infections using the PCR method and found ureaplasma urelitikum. It had never been found in me before. Where could she have come from? Is it necessary to donate blood for antibodies to ureaplasma? Is it necessary to treat it if there are no complaints? And is it possible to treat erosion in the presence of ureaplasma? Thank you)

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Causes of the phenomenon

Before starting treatment, it is necessary to identify the reasons for the presence of key cells. The most common reasons for the appearance of key cells in a smear include the following:

Bacterial vaginosis. With this disease, a woman is bothered by severe pain in the lower abdomen, which is accompanied by severe itching and burning in the vagina, as well as copious discharge with a strong unpleasant odor. A woman’s immunity drops sharply, and if treatment is not taken in time, negative consequences are possible, including the development of a malignant tumor in the cervical area.
Taking antibiotics. In this case, we are talking about long-term treatment with antibiotics, which was not supervised by doctors. This leads to a sharp decrease in immunity and contributes to the disruption of the natural microflora of the vagina: the environment becomes not acidic, but alkaline, and pathogenic bacteria begin to actively multiply, destroying those beneficial microorganisms that are responsible for maintaining the vaginal microflora at the proper level.
Overwork. The female body reacts acutely to fatigue, so excessive physical activity, chronic lack of sleep, stress, and sudden changes in daily routine are quite common causes of disturbances in the vaginal microflora.
Lack of personal hygiene. In this case, we are talking not only about failure to maintain intimate hygiene at the proper level, but also about the use of various scented hygiene products, which can lead to allergic reactions and irritation of the mucous membrane. Failure to follow the rules for using tampons and pads during menstruation can be the main reason for the presence of key cells in the smear. Frequent douching also contributes to disruption of the vaginal microflora.
Various infections. As a rule, if there is an infection, a woman will experience profuse vaginal discharge, which has a strong unpleasant odor, the smell of rotten fish. Often, emptying the bladder causes pain and a burning sensation, and a smear analysis will reveal the presence of key cells of coccal forms.

Also, among the reasons that triggered the appearance of key cells, there may be reasons such as: a change in sexual partner, hormonal imbalance (due to taking hormonal drugs, during pregnancy, in the first months of lactation), the presence of an IUD (intrauterine contraceptive device - spiral). Often, the normal vaginal environment is disrupted during various diseases (cervical erosion, trichomoniasis, chlamydia, gonorrhea, cancer), and even due to the fact that a woman wears uncomfortable or poor-quality underwear.

All of the above factors can affect changes in the vaginal environment in a woman: the acidic environment becomes alkaline, which leads to a decrease in healthy epithelial cells. But only a gynecologist can accurately determine the factors that influenced the development of key cells, so you should not self-medicate. Treatment should be prescribed by a doctor after a thorough examination and an accurate diagnosis.

How to prepare for the analysis?

The doctor takes a smear from the patient on the gynecological chair (regardless of whether she is pregnant or not) using a special brush or a sterile Volkmann spoon. It doesn't hurt at all and is very fast.

It is technically possible to achieve a good, even perfect smear if you sanitize the vagina with chlorhexidine or miramistin, for example. But what's the point?

Is it possible to take a smear while taking antibiotics or immediately after treatment? It is not advisable to do this within 10 days after using topical drugs (vaginal) and one month after taking antibacterial agents orally.

Microscopic examination is prescribed:

as planned when visiting a gynecologist;
upon admission to the gynecological hospital;
before IVF;
during pregnancy (especially if smears are often bad);
if there are complaints: unusual discharge, itching, pelvic pain, etc.

As a rule, a smear on the flora is taken during any initial visit of a woman to a gynecologist.

Also, indications for taking a smear and its subsequent microscopy are:

1Routine preventive examinations and medical examinations.
2Pathological leucorrhoea (vaginal, cervical, urethral discharge), its unpleasant odor, profuse nature, color change.
3Pre-conception preparation as part of planning natural and IVF-induced pregnancy.
4Screening during pregnancy.
5Unpleasant, painful sensations in the lower abdomen, which the woman does not associate with the menstrual cycle.
6Painful urination, dysuria, including symptoms of urethritis, cystitis. Urological pathology in women, as a rule, requires consultation and examination by a gynecologist.
7Completing the course of antibiotics in order to determine the nature of the flora and the possibilities of its restoration.

Often people are confused by the recording in tests of the presence of polymorphic rods in a smear. This implies that the material taken for research contains different types of rods.

The concept of polymorphic rods is a general name for many types of microbes, which unites microorganisms that differ in size and are shaped like rods.

All polymorphic rods are divided into normal, opportunistic and pathogenic.

The accuracy of the analysis depends on the preparation for the study, therefore, 2-3 days before visiting the gynecologist, you must refrain from sexual intercourse, do not take a bath, do not use suppositories and creams, do not douche, and do not take pills.

On the day of the test, you need to take a shower. An important component of preparation is intimate hygiene.

You should not use soap, shower gel or other skin cleansing products when washing, otherwise the result may be false. In 2-3 hours.

It is not advisable to urinate before lying on the gynecological chair.

You can take a smear test on any day of the menstrual cycle, except for the menstrual days themselves.

You can find out the result the next day. It is valid for 10 days. In case of a poor analysis, treatment should be started immediately.

How does vaginosis develop?

In addition to the active formation of substances important for the body, they transmit various impulses between nerve cells, thereby ensuring adequate brain activity. They control the vitamins and minerals entering the body, and in some cases, amino acids are a source of energy for certain types of tissues.

The liver is a kind of factory for the production of amino acids. It is she who processes the products entering the body, from them the necessary substances. It must be remembered that excess protein mass negatively affects internal organs, especially the liver, which processes foods by metabolizing amino acids (most often), since its abilities are quite limited.

Some amino acids cannot be synthesized inside the human body and can only be obtained externally. Among them are isoleucine, methionine, tryptophan, lysine and others. They can be found in chicken, almonds, eggs and other foods.

Moreover, amino acids can be obtained by consuming so-called dietary supplements. It is recommended to use this way of obtaining the necessary substances if you have immune diseases or if you are on some kind of reduction diet. For supporters of the vegetarian theory of nutrition, food additives are simply necessary, otherwise the body will not receive the required amount of amino acids and will not be able to synthesize protein formations.

Key cells are the squamous epithelial cells lining the vagina. They indicate the presence of an imbalance in the vaginal microflora - bacterial vaginosis, which is caused by specific pathogens. This vaginal disease is one of the most common; it is detected in women of reproductive age, regardless of pregnancy. Bacterial vaginosis is quite easy to treat, so immediate diagnosis and early treatment of the disease are very important.

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How is the analysis carried out?

Carrying out the analysis requires certain preparation:

3 days before the procedure, stop using intimate hygiene products;
avoid sexual intercourse the day before;
abstain from taking topical medications for a week;
on the last evening before the analysis, wash with warm water, do not do this in the morning;
in the morning before the procedure, do not urinate or go to the toilet 2 hours before the visit to the gynecologist.