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
present
0
NA
I (normal flora)
reduced
mixed
II
none or few
III
Gram-positive cocci
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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Specialty: Infectious Diseases
