Cervical smear - what is the test and when should it be done?
A cervical smear is one of the basic bacteriological tests used in gynaecology. What does the examination consist of and when are there indications to perform it?
What is a cervical smear culture?
A cervical swab culture is a test to determine whether a patient has a pathological microorganisms that can cause inflammation of the cervix or adnexa and other infections of the reproductive tract.
The material collected during the examination is sent to a laboratory for in-depth analysis. If pathogens are detected in the sample, it is usually immediately done antibiogramwhich makes it possible to identify the susceptibility of micro-organisms to specific therapeutic substances. This allows an effective therapy to be carried out.
When should a cervical canal smear be performed?
A cervical canal smear can be performed in women of any age who have a symptoms of intimate infectionsuch as[1]:
- Itching and burning in the urethral and vulvar areas,
- pain or discomfort during micturition,
- a feeling of pressure on the bladder and frequent urination,
- discomfort during intercourse,
- lower abdominal pain of unknown cause,
- prolonged menstrual bleeding or spotting between periods,
- discharge.
Cervical canal culture is used not only diagnostically, to identify a specific pathogen, but also to follow-up after completion of drug therapy (to test its effectiveness).
Cervical canal culture in pregnancy is a mandatory test included in the standardised examinations of pregnant women. During pregnancy, women are much more susceptible to intimate infections due to sudden hormonal changes that affect the vaginal bacterial flora. Infections during this period can be dangerous for the developing foetus and can cause miscarriage or premature birth[2].
At the last stage of pregnancy, a cervical swab is mandatory to diagnose a possible infection with group B Streptococcus (GBS), which is responsible for the majority of life-threatening early infections in newborns.
GBS are found in up to 30% women, usually without causing infection. However, they can be transmitted from mother to child during childbirth and contribute to pneumonia or neonatal sepsis[3].
A cervical smear is also one of the tests prior to assisted reproduction proceduressuch as insemination or in vitro.
Cervical canal culture - how to prepare for the test?
When preparing for a cervical canal culture, stick to the following some important principles[4] listed below:
- refrain from intercourse 48 hours before the test,
- no vaginal medication or irrigation should be used 2-3 days prior to collection,
- swabbing is not performed during antibiotic therapy. Material for testing may not be taken until 5 days after the last dose of medication,
- swabbing is not performed during menstruation,
- on the day of the examination, wash the genital area thoroughly with running water, without using cleansers.
Cervical smear - what does the test look like?
When the patient arrives at the gynaecologist's office, she will be asked to undress from the waist down and lie on the gynaecological chair. The gynaecologist will then, using a gynaecological speculum, make the cervical orifice visible and with the help of a special spatula, called a swab, take a test materialby gently pushing the head of the stick into the initial section of the cervical canal. The collected material is then sealed in a tube and sent to the laboratory.
The study is ongoing approximately 10 minutes and is usually combined with a basic gynaecological examination. During the collection of the specimen, the patient may feel a little discomfort when the speculum is operated on and later when the cervical swab is taken. However, the procedure should not be painful. Sometimes patients experience more discomfort if the swab is taken during an active intimate infection.
Cervical swab culture - interpretation of results
Upon arrival at the laboratory, the test material is placed in culture mediumon which - if the sample contained micro-organisms - a colony of bacteria will form within a few days.
The waiting period depends on the laboratory and the culture medium used, and the average time needed to obtain a meaningful result is between 3 and 9 days.
The result can be twofold:
- negative culture - indicating no bacterial growth,
- positive culture - growth of bacteria from the collected material.
Negative cervical cultures
A negative result (also called negative culture) is a normal result. It means that no bacterial colony was cultured from the material taken during the patient's cervical swab.
Depending on the anticipated infection, the use of various culture media. A negative result on standard medium does not necessarily mean that there were no pathological microorganisms in the sample. The standard medium works for most common microorganisms (e.g. gonorrhoea), but for some (e.g. chlamydia), a non-standard medium must be used.
Therefore, cervical cultures are performed on several media to ensure a complete diagnosis.
Positive cervical cultures
A positive cervical swab culture indicates that a bacterial colony has been cultured from the sample. In this situation, the following is ordered antibiogramwhich tests the susceptibility of the detected pathogens to specific antibiotics, thus making it possible to selecting a targeted therapywhich will be most effective.
If a positive result is not accompanied by symptoms of ongoing infection and other tests performed (e.g. peripheral blood count[1] ) also do not indicate infection, the result may be false positive. This happens when the rules for collecting material for tests are not followed. In this case, the doctor may order a second swab collection[5].
Cervical canal smear - price
The cost of the examination depends, among other things, on the facility chosen and the location. In the case of a cervical smear, the price also depends on whether standard cultures are performed or, in addition, also cultures for chlamydia.
Bibliography:
- REROล, Alfred et TROJNAR-PODLEลNY, M. Vaginitis of the vagina and cervix-a continuing problem. Gin Prakt, 2004, vol. 12, p. 10-17.
- KIERZKOWSKA, MARTA, MAJEWSKA, ANNA, KฤDZIELSKA, JOANNA, et al. Evaluation of bacterial microflora of the cervix in pregnant women. Perinatol. Neonatol. Gynaecol, 2012, p. 5126-29.
- WIELGOล, Mirosลaw et PIETRZAK, Bronisลawa. Bacterial vaginosis-diagnosis and treatment. Menopausal Review/Przeglad Menopauzalny, 2012, vol. 11, no 5.
- RYSZARD, Czajka, RAFAล, Rzepka, SEBASTIAN, Kwiatkowski, et al. Bacterial colonisation of the vagina and cervical canal in patients with threatened preterm labour. Ginekol Pol, 2010, vol. 81, p. 840-843.
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