vaginal discharge examination

Vaginal secretions are liquids secreted by the female reproductive system, also known as vaginal discharge. The general trait check is to observe the color and traits of vaginal secretions. Basic Information Specialist classification: gynecological examination classification: vaginal secretion examination Applicable gender: whether women are fasting: not fasting Including items: clue cells, vaginal discharge pH, vaginal secretion cytology, vaginal trichomoniasis examination, vaginal cleanliness check Tips: When taking secretions, the vaginal speculum does not apply oil. Normal value The normal leucorrhea is white, mushy, and has no odor. If the ovulation period is near, the leucorrhea is more clear and transparent, and the egg is clear, the amount is more. After the ovulation period, the leucorrhea is white, turbid, and more viscous, with less amount. Clinical significance This test is mainly used for the diagnosis of female reproductive system diseases. Yellow purulent is seen in trichomonas vaginitis, suppurative bacterial infection, chronic cervicitis, senile vaginitis, endometritis and foreign bodies in the vagina. Red blood is found in tumors, polyps, submucosal fibroids, senile vaginitis, severe chronic cervicitis, and side effects from intrauterine devices. The bean curd residue is found in fungal vaginitis. Yellow water samples are found in submucosal fibroids, cervical cancer, uterine cancer and fallopian tube cancer. Large amount, colorless and transparent is seen in ovarian granulosa cell tumor or female hormone secretion dysfunction. Positive results may be diseases: bacterial vaginosis, cervicitis, chronic cervicitis, pseudocondyloma acuminata, candida vaginitis, sexually transmitted diseases, vulvitis, vulvar sputum, chlamydia urinary tract infection, endometrial polyps precautions Disinfected scrapers used for the material, straws or cotton swabs should be clean and dry, free of any chemicals or lubricants. When taking secretions, the vaginal speculum should not be lubricated (if necessary, it can be lubricated with saline) to avoid affecting the test results. Inspection process Check operation: Take a little vaginal discharge with a leucorrhea, place it on a slide containing 1 or 2 drops of normal saline, and immediately perform a microscopic examination under a microscope. Hanging drop method (1) Method: The hanging drop method is also called wet sheet method, and there is a physiological saline hanging drop method and a 10% potassium hydroxide hanging drop method. The former is used to detect trichomoniasis and clue cells, and the latter is used to detect spores and pseudohyphae of Candida. Place 1 to 2 drops of normal saline and 10% potassium hydroxide on two slides, respectively, and take 1/3 of the secretions in the vagina (or typical secretions in the vagina) with physiological saline or 10% hydrogen on the slide. Potassium oxide is mixed and then examined under a microscope. (2) Diagnostic criteria: Trichomonas and vaccinated white blood cells can be seen on the wet sheet of physiological saline to diagnose trichomonas vaginitis. Spores and pseudohyphae can be diagnosed as vulvovaginal candidiasis on wet sheets of 10% potassium hydroxide. Clue cells are seen on the wet sheets of saline, combined with other features of the secretions, such as white, homogeneous secretions, positive amine test, pH> 4.5, can diagnose bacterial vaginosis. 2. pH determination (1) Method: pH measurement The pH value of vaginal secretions is mainly determined by using a precision pH test paper (4-7). (2) Diagnostic criteria: vaginal secretion of trichomonas vaginitis pH>4.5. Vulvovaginal candidiasis pH < 4.5, if pH > 4.5, suggesting a mixed infection, such as trichomoniasis infection. Bacterial vaginosis should have a pH > 4.5. 3. Culture method (1) Trichomonas culture: The vaginal secretions were placed in liver digestive culture medium or soy peptone medium, and cultured at 37 ° C for 48 hours, and microscopic examination showed the presence of trichomoniasis. (2) Candida culture: The vaginal secretions were placed on TBC Sabouraud medium, placed in a humid temperature or 37 ° C incubator, and colonies appeared after 3 to 4 days. If the colony is white, it may be Candida albicans. If it is red, purple or other colors, it may be non-Candida albicans. If the species identification of Candida albicans and non-Candida albicans is further carried out, it should be further cultured on corn-Tween medium, cultured at 25 ° C for 72 hours, with pseudohyphae under the microscope, and the middle part is accompanied by clustered round points. Spores, thick-walled posterior membrane spores at the top, positive for the germ tube test, ie Candida albicans. Those who do not meet the above characteristics are non-Candida albicans. Identification of other strains other than Candida albicans should be further identified by sugar fermentation and sugar assimilation tests. No cultivation should be done without symptoms. Not suitable for the crowd Not suitable for people: menstruating women. Adverse reactions and risks May cause vaginal infections.