music It's a typical day. A patient has noticedsome itching, or maybe an unpleasant vaginal odor. During her exam, the ian willcheck vaginal pH, examine any discharge that's present, and collect a sample. Then, it'son to the microscope. music This is where you'll gather more specificinformationabout what's causing those vaginal symptoms. We'll show you how to prepare andexamine vaginal wet preps and how to do a whiff test. The results, combined with the patient's vaginal pH test, will aidthe diagnosis.
Under the microscope, you'll be looking for trichomonads, yeast, and the clue cells associated with bacterial vaginosis. We'll show you how to recognize them. music First, the microscope itself: This is a compoundlight microscope. It has several objective lenses on a rotating mount. For our purpose,one of these has to be a 10x low power objective, and one has to be a 40x for greater magnifiion.This flat part, under the objectives, is the stage. Under the stage is the condenser. Belowthat, at the base of the microscope, is the light source. There are two knobs that controlfocus; one for coarse adjustment and one for
fine adjustment. And these are the oculars,or eyepieces. We'll come back to the microscopea minute, but first, let's look at how to prepare wet mount slides. The complete vaginal wet mount involves botha saline prep and a potassium hyoxide, or KOH, prep. When the vaginal sample was collected,the swab was placeda test tube with approximately half a milliliter of saline. So, for the salineprep, you only have to take a op of the suspension and place it on a slide. Add acoverslip, being careful to avoid trapping air bubbles. Your saline slide is ready.Place a second op of the vaginal sample on another slide and add one op of 10 percentKOH. Sniff the preparation immediately, using
your hand to waft any odor toward your nose.This is the whiff test. Note if there's a fishy or amine odor. Then add a coverslip,avoiding air bubbles. Keepmind that you must work quickly to prepare and examine thewet mounts. That's because trichomonads may lose their characteristic motility within15 to 20 minutes. Before we move on now, though, let's lookat the cast of characters you may discover. These are normal squamous epithelial cellsfoundthe vagina. They're large, flat cells with a small nucleus and a large area of cytoplasm.Note that there is some granularitythe cytoplasm.
Polymorphonuclear leukocytes are known asPolys, or PMNs. They may also be called white blood cells, or WBCs. These are small roundcells. Several lobes of the nucleus are visible within the surrounding cell cytoplasm. Findingmany PMNs may indie infection. Trichomonads are pearshaped protozoa whichmove by means of flagella. Trichomonads are similarsize to PMNs and are identifiedby their characteristic jerking movement. The actual flagella may be too thin and toorapidlymoving to be seen. A clue cell is a squamous epithelial cellcoated with enough small bacteria that at least 75 percent of the cell's border is obliterated.It may look as if someone has spread glue
over the cell and pressed itsand. Cluecells are associated with bacterial vaginosis, a conditionwhich the normal microbialflora of the vagina is disrupted. Yeast may be foundtwo forms. Pseudohyphaeare the long, tubular, branching forms. Budding yeast are paired yeast cells that resemblea shoe print. The larger part is the sole and the smaller bud is the heel of the shoe. The saline prep will allow you to see epithelialcells, PMNs, trichomonads, and clue cells. You can also see yeastsaline, but sometimesit's hidden by epithelial cells or by PMNs. Red blood cells, sperm, and bacteria can alsobe seen.
Vaginal Discharge During Pregnancy
I want your opinion of vaginal discharge duringpregnancy. If you have a sudden white mucus plug comeout, you're about to end the pregnancy and go into labor. I'm not that far along. The vaginal discharge will go back to whiteand thick after you ovulate. If you conceive, there may be ops of blood mixed in, or justbrown or orange streaksthe discharge. I'm a little farther along than that. The vaginal discharge usually increases involume during pregnancy, starting after implantation.
However, it remains white and thick throughoutunless something is wrong. I know any red bloodvaginal dischargeis dangerous, whether a sign of a miscarriage or uterine tear or something else only the will know. When you are pregnant, any bleeding is a reasonto go to the ER. Fortunately, I'm not seeing that type ofvaginal discharge. You'll normally see more white and thickvaginal discharge. Some women wear menstrual pads when pregnant to contain it. That sounds fishy to me. I didn't thinkI'd need diapers until after I had the kid.
If the vaginal discharge smells fishy or likevinegar, you have a yeast infection. I can't even take a pain reliever rightnow. What do I do about a yeast infectioné It is safe to use over the counter yeast infectiontreatment when pregnant, and you may need several. Pregnancy throws off your pH balanceand makes yeast infections much more likely. Glad I don't have that fishy smell downthere, then. It is thick and offcolor though. If it is green or yellow, you may have a bacterialovergrowth. That's dangerous during pregnancy. It could make things smell, and you do wantto talk to a about it. However, if
there are any lesions, itching and other signsof a social disease, you have to talk to a . Technically, life is sexually transmitted. A sexually transmitted disease contractedbefore or during pregnancy puts the kid at risk, and it may be flaring up worse whilepregnant because pregnancy compromises the immune system. Yes, I'd talk to the if I was worriedabout it, but I am not. Then you'll just see more white and thickdischarge. It would have increasedvolume
as the cervix thickened and rose up from thelow point after ovulation. But not as high as it would be if I wasn'tpregnant. That's where a lot of the mucus is comingfrom, but know that it will become y if you're dehyated just as when you'renot pregnant.
Pregnancy Tips How to Handle Vaginal Discharge During Pregnancy
They tell you there is going to be a lot ofchanges to your body when you are pregnant but oo, vaginal dischargeé I'm Jill fromTampa, Florida telling you how to know if your vaginal discharge is o'kay. In pregnancyit is normal with the change of hormones to have a thickening or an increasethe amountof vaginal discharge you have. But there are certain times when you can have an infectionwhen you want to make sure that you don't. If your discharge has an odor, it burns, ititches you need to go see your healthcare provider. Special circumstances are bleeding,that is a discharge that you definitely need to be evaluated by your physician. The otherareas is leaking of fluid. If you are towards
the end of your pregnancy and you have a biggush of fluid, it could be urine but it also could be amniotic fluid and you want to makesure that that is safe so I would check with your healthcare provider. Most discharge isnormal but remember you want to make sure that you don't have an infection and if youdo you want to make sure to get that infection treated. I'm Jill from Tampa, Floridahere to talk to you and explain how to know if your vaginal discharge is o'kay. Have agood pregnancy.