ᐉ Treatment of a pregnant woman after a culture test. Urine culture during pregnancy: deciphering the indicators. What tests are taken

What is tank smear culture

Bacteriological culture is an analysis to determine the provoking factor and how sensitive it is to a particular drug.
This research method is widely used in medicine.

Almost any liquid biological material can become a substance for study. Collection from the genitals is preferable.

Based on the results, correct and successful treatment can be prescribed.

How to assemble correctly

Before donating a urine culture to the tank, you need to follow a number of rules. The rules for collecting urine for pregnant women are quite simple; every woman can follow them, without any experience in this matter.

A few important recommendations:

The first step is to go through the entire preparatory stage.
Immediately after the woman has washed, a disposable cotton swab should be placed into the vaginal cavity to prevent the penetration of vaginal fluid.
It is very important to collect average urine. First, the stream is directed into the toilet, then immediately into the container, and then back into the toilet. 60-80 milliliters of biomaterial will be enough.
After the urine has been collected, you need to close the container as tightly as possible. It is important to avoid opening it before the examination site.
No more than 2 hours should pass from the moment of urine collection to the time it is submitted to the laboratory.
In addition, under no circumstances should you drink various diuretics and medications 48 hours before collection.

By following these simple recommendations, a pregnant woman will receive reliable results.

Objectives of the study

In the female reproductive system, the balance of the acidic environment plays an important role. It consists of protective microbes that prevent infections from entering.

Under the influence of negative factors, pathogenic bacteria multiply to huge numbers and exceed the indicators. A chain reaction of inflammation occurs.

A smear culture during pregnancy is prescribed to identify harmful bacteria. The doctor takes a smear from the genital mucosa, since then the most accurate results are obtained.

Bacteria are placed in a comfortable environment for them to develop and examined under a microscope.

Bacteriological culture plays a huge role in the detection of infectious diseases. Research methods may differ, but the goal is the same: to obtain indications and identify pathogens without foreign impurities.

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.

Indications for analysis

What is the sowing tank used for? Biological material from pregnant women can be examined routinely at scheduled times at the discretion of the gynecologist. The fence is made from the cervical canal.

Also prescribed according to some indicators:

when a woman plans to become a mother in the near future;
with inflammation of the female genital organs and
microflora disorders;
if the results of the previous smear are questionable;
in cases where the uterus is constantly susceptible to infection.

The various visible manifestations of infectious diseases are also taken into account. For example, unpleasant vaginal discharge, itching, burning, irritation.

Using this diagnostic method, you can determine why the menstrual cycle is delayed.

For pregnant women, the test is prescribed if a genitourinary infection is suspected, or for the purpose of its prevention.

The development of pathogenic infectious parasites in the uterus cannot be ignored. This can lead to miscarriage or infection of the fetus.

Is a smear taken during pregnancy if the patient has no complaints?

Smears during pregnancy are included in the list of mandatory diagnostic measures and are given even if the patient has no symptoms or complaints.

Many inflammatory processes and infections can occur for some time without the development of specific symptoms, and bacterial culture of a smear during pregnancy makes it possible to identify pathology at the earliest stage of development.

If a smear is bad during early pregnancy, a woman is prescribed special treatment to eliminate the inflammatory process and prevent infection of the child during pregnancy and childbirth.

There is a common misconception that pregnant women should not take any medications. Expectant mothers need to understand that for the prevention and treatment of various inflammatory processes, the obstetrician-gynecologist selects the most gentle medications that are safe for the unborn baby.

But an untreated infection can lead to:

I'll miscarry
intrauterine infection of the fetus,
fading pregnancy,
intrauterine growth retardation, etc.

Therefore, all treatment should be prescribed exclusively by a specialist, based on the examination results.

How the research is carried out

Tank seeding from the cervical canal during pregnancy is carried out quite often. With normal gestation, this occurs at 30 weeks.

If there are specific complaints or there have been previous miscarriages, infection of the fetus in the womb, and so on, a smear is given as prescribed by a doctor.

The collection of material is carried out by a midwife or nurse from the antenatal clinic.

In this case, preparation for tank sowing includes:

exclusion of water hygiene procedures;
you cannot douche and use antiseptics;
do not insert suppositories or other medications;
if during planning the procedure coincides with menstruation, then a smear cannot be taken; it is taken 2 days after the complete end of menstruation;
tank analysis is not taken immediately after colposcopy;
Any treatment that includes antibiotics or drugs interferes with reliable results.

The patient is positioned on a gynecological chair. The health care provider inserts a speculum into the vagina and then uses a sterile probe with a small loop to take a swab.

The procedure is absolutely painless and safe for the child.

Preparing for the study

To ensure that the analysis picture is transparent and does not raise questions for the doctor observing you, careful preparation is necessary. A distorted result is the path to incorrect treatment and unpleasant consequences.

It is better to start preparing for the analysis a few days in advance, and if possible, 1-2 weeks in advance.

Stop taking any antibacterial drugs.
Don't douche.
Avoid the use of contraceptive vaginal suppositories and creams.
A day before the study, stop having sex.
If a few days before the analysis, colposcopy or other diagnostic procedures were performed with the introduction of mirrors into the uterine cavity, then it is better to postpone the study for some time.
Immediately before taking a smear, do not go to the toilet for minor needs and do not wash yourself.

Important! For pregnant women, this procedure is performed only by a gynecologist with sufficient experience.

The results are ready 4-5 days after taking the material.

https://youtu.be/6SQvIkcNr0Y

What does the results show?

The female genital organs have many microorganisms in their flora. Some of them do not pose a danger, and some are not the norm for beneficial gestation.

Normal tests should show the presence of: lactobacilli, bifidobacteria. Other microorganisms that are inherent in the intestines should not be detected, except in a single quantity.

If the culture shows a large accumulation of them, this indicates that the genitourinary system is inflamed.

Purity levels

How normal is your microflora, microbiologists draw conclusions by indicating the state of the biocenosis or the “degree of vaginal cleanliness” - from first to fourth.

The first speaks of an almost ideal vaginal environment in which, as expected, beneficial lactobacilli live. Such an analysis will detect only rods, epithelial cells in small quantities and, possibly, single leukocytes in the smear.

In the second degree, some gram-negative (conditionally pathogenic) bacteria are detected in small quantities. In the third degree, pathogenic bacteria predominate over natural fermented milk bacteria. And in the fourth degree, the vaginal flora consists only of pathogenic microorganisms and a large number of leukocytes - the inflammatory process is in full swing.

As you move from the first to the fourth degree of purity of the vagina, its environment changes - from acidic to alkaline. This indicates a decrease in the number of beneficial lactobacilli.

Do not be confused by the discovery of single leukocytes in the smear: normally they are present in the mucus in small quantities (up to 15 leukocytes in the field of view, or up to 10 in the vaginal mucus and up to 30 in the cervical mucus). An increase in their level should be a cause for concern, since leukocytes always rush to the site of the lesion to fight infection. That is, an increase in the number of leukocytes in a smear for flora during pregnancy indicates the course of the inflammatory process.

Another confirmation of this is the presence of a large amount of squamous epithelium, since during infections the cells die faster than usual.

The infection will also be indicated by the so-called “key cells” that are formed during the development of STDs.

Threads of mycelium in a smear indicate the development of thrush. But the gynecologist will give you a final diagnosis only after receiving the results of an additional study - culture.

What do deviations mean?

The results do not always show normal values. Poor culture during pregnancy is not uncommon.

Depending on the identified pathology, possible treatment options are considered.

The absence of squamous epithelium indicates a decrease in estrogen; an excess of these components indicates inflammation.

Yeast-like fungi indicate characteristic diseases, for example staphylococcus in the cervical canal in pregnant women.

Abundant mucous discharge also indicates inflammatory processes.

In connection with the detection of any deviations from the norms, additional procedures are prescribed. A pregnant woman undergoes tests to examine vaginal discharge.

First of all, they consider options for harmful bacteria acquired through sexual contact.

Treatment is prescribed based on the timing of pregnancy.

The preferred treatment option during this period is topical remedies without antibiotics. Medicines should not adversely affect the fetus.

In the second trimester, more radical methods are allowed, but in case of urgent need.

Important! There are infections that do not manifest their existence openly in the body. That is, they develop in a latent form and affect the development of the child while in the womb. Therefore, even without any apparent reason, it is advisable to take this test.

Good and bad flora

Each vagina also contains opportunistic pathogenic flora. These are potentially dangerous microorganisms that are activated only under certain circumstances: stress. a decrease in the body’s immune functions, 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.

By the way, mycoplasmas. Ureaplasma and chlamydia can only be determined by culture for latent 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.

Degrees of quality and growth of bacteria

There are microorganisms that live without actively manifesting themselves. At the time of immune and hormonal disorders, they are activated and begin to actively multiply. Each of the parasites finds its own habitat, where it is more comfortable. That is why one or another flora is used for analysis.

The results of the readings are based on the possibility of rapid development of harmful microorganisms.

The following options are possible:

first degree. This is when there is a slight growth of bacteria and only relative to its environment;
the next step is about a dozen colonies in another solid medium;
at the third stage there is an increase to 100 colonies;
in the last stage, more than 100 colonies of the same type are observed.

The primary two degrees of proliferation of microorganisms indicate clogging in the microflora, and the latter show inflammation.

These changes do not exclude the possibility of development associated with the interesting position of a woman during which hormonal changes occur, immunity decreases, and medications are used.

The entry of an infection into the body and its rapid reproduction can bring not only physical discomfort to the expectant mother in the form of itching, burning and discharge. For this reason, miscarriages, infections of the child during passage through the birth canal, and many other troubles occur.

To ensure a successful pregnancy, take care of your health in advance.

Author: Daria Andreevna, neonatologist

Especially for the site kakrodit.ru

Reasons to undergo bacteriological urine culture during pregnancy

During pregnancy, a urine culture test reveals a chronic infectious course. This is an optional test, but it is ordered after a general urinalysis (UCA) if leukocytes, red blood cells and bacteria are detected in sediment microscopy.

An increased content of pathogenic microorganisms sometimes indicates a serious complication - pyelonephritis. The disease is characterized by inflammation of the renal pelvis and is manifested by the following symptoms:

hyperthermia, chills;
vomiting or nausea;
weakness, decreased performance;
pain in the lower back;
swelling;
polyuria.

Without timely treatment, the infection affects the fetus. In the first and second trimester, pyelonephritis causes intrauterine malformations. In the third trimester it provokes premature birth.

Why an examination may be prescribed, possible indications:

With a prolonged and slight increase in temperature in the expectant mother.
If there is discomfort during urination.
If there is a false urge to urinate.
If there is shooting pain in the lumbar and lower abdomen.

The above symptoms indicate the development of other inflammations, such as cystitis or urethritis. In pregnant women, infectious diseases worsen against the background of reduced immunity. During gestation, the hormone progesterone increases greatly, which causes immunosuppression, which is necessary to prevent rejection of a foreign organism. For this reason, hidden infections of the genitourinary system worsen.

What is the cervical canal and what is its significance?

The main indications for culture of microflora from the cervix:

Preventive examination.
Pregnancy planning.
Detection of pathogenic microorganisms in a smear.
Increased number of white blood cells in the smear.
Inflammatory processes of the genital organs.
Chronic, often recurrent inflammatory diseases of the external and internal genital organs.

There are many microorganisms that can persist in the genitals for a long time without causing obvious signs of infection. However, under unfavorable conditions, these microorganisms can provoke disease symptoms. In addition, some pathogenic microbes are the cause of infertility. Therefore, it is recommended to carry out tank culture from the cervical canal at least once a year in combination with other preventive examinations.

Another very important indication for conducting a bacteriological examination of the contents of the cervical canal is planning pregnancy. It is necessary to eliminate the risk of infectious diseases in the mother, which could potentially harm the child. For this purpose, bacterial culture is carried out.

The detection of pathogenic microorganisms or a significant increase in the number of leukocytes in a smear during a preliminary examination of the contents of the cervical canal is an indication for mandatory bacteriological examination. If a microorganism is detected during bacteriological examination, then it is possible to test for its sensitivity to certain antibacterial drugs and prescribe the most effective treatment.

Bacterial culture is required for inflammatory diseases of the cervix or frequently recurring infectious diseases of the genital organs. This is especially important if antibacterial therapy has already been carried out, but no positive effect was obtained.

The canal is a through hole that connects the top of the vagina directly to the uterus. It is located inside the cervix.
The length of this channel is about 4 cm.
Width - about 8 mm, during childbirth - 10 cm.
It has 2 narrowings: internal and external pharynx.

The external one is usually examined by a gynecologist using medical instruments. Nulliparous women have a pinpoint pharynx. And those who gave birth have a slit-like pharynx.

A smooth, pale pink canal is characteristic of young, healthy women. And during menopause, the mucous membrane is very pale, and almost no secretion is produced.

The main purpose of the canal is to protect against infectious diseases and facilitate the penetration of sperm into the uterus. Blood clots also pass through this channel during menstruation.

At the very beginning and after the end of the menstrual cycle, mucus from the cervical canal has an acidic environment. The mucus from the cervical canal is very viscous and blocks the passage like a plug.

Harmful microorganisms die in this acidic environment. And spermatozoa in such an environment become incapable of fertilization. The level of estrogen can be determined by stretching the mucus; the longer the thread, the more hormones in the body.

Already in the middle of the monthly cycle, estrogen levels increase significantly, and the mucus becomes thin and alkaline. And sperm gain access to the eggs of the uterus.

But after conception, the ovaries produce progesterone, and the mucus in the cervical canal becomes more viscous. A thick mucus plug forms. It protects the fetus from pathogenic bacteria. Before birth, this plug comes out of the canal.