Vaginal Secretions

What testing is done on vaginal secretions?

- diagnose infection
- pregnancy complications
- forensics
- cervical cancer, HPV
- gonorrhea/chlamydia
- vaginitis

What percent of females can be asymptomatic with gonorrhea/chlamydia?

50%

What is vaginitis caused by?

vaginal atrophy, pH imbalance, trichomonas, bacteria

What are the primary symptoms of vaginitis?

abnormal discharge, odor, pruritis, irritation, dysuria, dyspareunia

Vaginitis occurs secondary to which conditions?

BV, vulvovaginal candidiasis, or trichomonas

What is the collection method for vaginal secretions?

swab of vaginal walls and vaginal pool

What NOT to use for vaginal specimens:

- lubricants (antibacterial agents)
- cotton swabs (toxic to N. gono)
- wooden shafts (toxic to C. trachomatis)
- calcium alginate (inactivates HSV)

What does normal vaginal discharge look like?

- white w/ flocculent discharge
- large rod g + lactobacilli
- squamous epithelial

Abnormal discharge:

thin white-gray: BV
cottage cheese: candida
yellow-green, frothy: T. vaginalis
yellow-opaque: C. trachomatis

Normal pH of vaginal secretions

3.8-4.2

What does the acidic environment help with?

suppresses the overgrowth of infectious organisms

How does the vagina remain so acidic?

lactobacillus help maintain low pH by producing lactic acid from glycogen metabolism and hydrogen peroxide

What is a clue cell?

squamous epithelial cell covered w/ Gardernella vaginalis

What is a normal amine (whiff) test?

no fishy odor

Abnormal amine test

fishy odor indicates presence of anaerobic bacteria

What is the most common vaginal fungal infection?

Candida (more susceptible when excessive sweat/heat builds up)

Fetal Fibronectin Test (FFT)

- adhesive glycoprotein in the maternal/fetal interface
- associated w/ preterm delivery

Premature Rupture of Membranes (PROM)

- rupture of fetal membrane
- PAMG-1 present in amniotic fluid