Genital inflammatory diseases 朱芝玲 复旦大学附属妇产科院
Genital inflammatory diseases 朱 芝 玲 复旦大学附属妇产科医院
Female Reproductive Organs Uterine (fallopian) tube Fimbriae Ovary. Uterus rectum Pubic bone Cervix Urinary bladder Vagina Urethra Clitoris Anus Labium Labium minus majus (a) Side view section of female pelvis showing reproductive organs
Female Reproductive Organs
NORMAL VAGINAL FLORA DISCharge HEALTHY VAGINA IS AN ECOSYSTEM DYNAMIC EQUILIBRUM EXIXTS BETWEEN Epithelium Normal Colonizing Organisms (mostly Lactobacilli SPP) Local Secretory and Celluar Immune Factors Vaginal pH maintained o Acidic(3.8-4. 4) o Creates unfavourable environment for Pathogens
NORMAL VAGINAL FLORA & DISCHARGE HEALTHY VAGINA IS AN ECOSYSTEM DYNAMIC EQUILIBRUM EXIXTS BETWEEN: - Epithelium - Normal Colonizing Organisms (mostly Lactobacilli SPP) - Local Secretory and Celluar Immune Factors - Vaginal pH maintained o Acidic (3.8 – 4.4) o Creates unfavourable environment for Pathogens
NORMAL PH MECHANISM Estrogen increases Epithelial Glycogen Lactobacilli Metabolise Glycogen into Lactic Acid Lactic Acid maintains acid pH
NORMAL pH MECHANISM • Estrogen increases Epithelial Glycogen • Lactobacilli Metabolise Glycogen into Lactic Acid • Lactic Acid maintains acid pH
SIMPLE OFFICE ANALYSIS pH-litmus/nitrazine paper (nitrazine turns blue) Whff test-10% KOH-2 drops Microscopy -Wet mount, WBCS. Trichomonas, Monilia If no microscope available o Add hydrogen peroxide 1-2 drops of 5-10% KOH o Foaming bubbles if there are WBCS Wooden stick o No bubbles if no WBCs(BV for mixing under Yeast the nose 1-2 drops of vaginal
SIMPLE OFFICE ANALYSIS • pH – litmus/nitrazine paper (nitrazine turns blue) • “Whff” test – 10% KOH – 2 drops • Microscopy – Wet mount, WBCS, Trichomonas, Monilia • If no microscope available o Add hydrogen peroxide o Foaming bubbles if there are WBCs o No bubbles if no WBCs (BV, Yeast)