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Description

Hay et al reported a simple classification for vaginal smears.


Examination: Gram-stained vaginal smear

 

Parameters:

(1) lactobacilli

(2) other bacteria

(3) epithelial cells

 

Lactobacilli

Other Bacteria

Epithelial Cells

Grade

none

none

present

0

present

none

NA

I (normal flora)

reduced

mixed

NA

II

none or few

mixed

NA

III

none

Gram-positive cocci

present

IV

 

Grades I, II and III are the original grades with 0 and IV added.

 

Grade III is associated with bacterial vaginosis.

 

The number of vaginal epithelial cells is dependent on how the smear is collected. A scraping of the vaginal wall should include epithelial cells.


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