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Cytological study of vaginal smears of women of fertility age in the screening population.


Ecology and its impact on public health are one of the most important issues of our time, which require a most careful and comprehensive study now. Increases in production capacity without regard to the impact on the environment have led to disastrous changes in the environment of people and wildlife. In some regions, there is a very unfavorable ecological situation, which is characterized by an increase in chemicalization of water, soil, and plants. The negative impact of environmental factors on health, particularly on the reproductive health of women of childbearing age is evidenced by numerous data from the literature [1-3]. This suffering during pregnancy and labor increased congenital anomalies of the fetus, thus increasing the death rate of women in childbirth and babies.

In Kazakhstan, there are also regions where adverse environmental conditions have had an impact on the health of local people. One of those places in our country is the Aral Sea area. Among the negative environmental consequences of the Aral crisis should be included the annual reduction in sea level of about 80-100 cm, a decrease of two-thirds, and an increase in the salt content of the water by 2.5 times. It is extremely dangerous and a consequence is the huge amount of sand and salt at the exposed bottom of the former sea. More than 70% of adults and 80% of children suffer from one or more diseases. Up to 90% of pregnant women are sick with anemia. All this leads to a permanent reduction in life expectancy in the region.

In the Aral Sea region, more than half of the pregnant women suffer from extra-genital diseases; there are a large number of abortions. Results of the study showed adverse effects of environmental factors of the Aral Sea region on somatic indicators, gynecological diseases, etiology, and structure not carrying a pregnancy. This poor health of women is reflected in the health of their children; in the Aral Sea area, infant mortality is 2.5 times higher than the average national figures, in the Shalkar district of Aktobe region, the rate is 28.7 per 1,000 live births, and in the Aral and Kazaly areas the rates are 35.7 and 29.7 per 1,000 live births [4,5].

The aim of the study involved assessing the significance and information content of the cytological study of vaginal smears in the study of the reproductive sphere of women of fertility age by screening the population.

Materials and Methods

During the screening of public health in these regions in 2014 and 2015. 2,170 women of reproductive age were examined. The women surveyed were divided into three groups according to age: 18-29, 30-39, and 40-49. These gynecological smears were processed using conventional histological techniques and subjected to microscopic examination.

For discharges from upper vagina injected mirror and forceps jaws are taking discharge. If you want to take a spin-off from the cervical canal, the vaginal part of the uterus exposed mirrors, outer mouth is rubbed with sterile cotton ball, and Volkmann spoon or forceps jaws are taken from the cervical canal discharge. After preparing smears carried out by the method of staining micro preparations Romanovskii--Gimza and examined under a microscope abnormal cells.

The microscopy of vaginal smears identified cellular elements of inflammation, sometimes by a change to the background microflora. The cellular elements of inflammation are often detected in women of middle- and older-age groups and in the Kazaly and Aral areas. The background of inflammation was determined by changes in the epithelial cells lining the vagina. In some cases, these changes were minor in nature that can be regarded as a manifestation of reactive and regenerative processes in the epithelial cells. In some cases, these changes were significant and were the manifestation of dysplasia cells. According to the WHO, dysplasia is a pathological process in which part of the column in the epithelial cell layer is identified with varying degrees of atypia that disrupts the ability of cells to differentiate.

Results and Discussion

When smear microscopy identified changes in the cells it was difficult to differentiate between reactive changes and epithelial dysplasia (ASC-US); these changes were more often in the background of the inflammatory process (Figure 1). In these cases, the cells had a slight change in the ratio of the nucleus and cytoplasm, nuclear shape, and chromatin changes in distribution therein.

Also smears showed the dyskaryosis phenomenon. As the severity of the changes in different cell layers have been identified the epithelial lining cells of the degree of dysplasia. For example, in mild dysplasia, where the nuclear-cytoplasmic ratio was shifted more in favor of the nucleus, the contours of the nuclei were irregular chromatin, was moderately hyperchromatic, and had a grainy appearance.

Moderate dysplasia of the epithelial cells was characterized by more pronounced changes in cell nuclei. The changes have been vulnerable to the cell surface and the intermediate and parabasal layers. Marked variability forms cells (Figure 2).

With increasing signs of dysplasia, the dyskaryosis increased. For small changes in the size of the nuclei, the nuclear-cytoplasmic ratio shifted more toward the nucleus, defined areas of clutter chromatin. The contours of the cells themselves are uneven and sometimes blurred (Figure 3).

Thus, without a doubt, the environment in which man lives has an influence on his health, including reproductive. The changes begin in the cell body, which first appear in the individual cells, and only then generalizing, disrupting the function of cells, tissues, organs, and finally the body.


Figures 1-3 show smears with the dyskaryosis phenomenon. As the severity of the changes in different cell layers have been identified the epithelial lining cells of the degree of dysplasia.

In our opinion, the presence of inflammatory processes, as well as dysplastic changes defined in the genital cells of women of fertility age in ecologically troubled areas have a direct connection with the peculiarities of the areas of residence. Vaginal cytology smears and cervical smear in the screening of population in the Aral Sea region determined a group of women who require more rigorous research methods and additional health and follow-up treatment.


[1.] Alnazarova AS (2009) The urgency of the problem of the impact of environmental hazards public health of the Aral Sea region. Materials V internal Science-practical conference "New Scientific Achievents", Sofia, 2009, pp. 39-41.

[2.] Ailamazyan EK (2005) Environment and reproductive health of women. J Obstet Gynecol Dis II: 5-6.

[3.] Bobyreva MM, Shaikhislamov KN, Dema EB. Environmental problems in Western Kazakhstan. htm

[4.] Omarova MN, Orakbai LZ, Alnazarova AS (2010) Morbidity of the population of the region of ecological trouble Kyzylorda region. Materials republic science-practical conference "The demographic situation in the Republic problems and prospects", Karaganda, 2010, pp. 97-100.

[5.] Kosheleva NG, Gabrilova EG (2005) Prevention of adverse environmental effects in pregnant women. J Obstet Gynecol Dis 1: 35-41.

Berikbay Kultanov *, Aigerim Seiilkhanova, Kulshat Anis, Roza Yessimova, Kulash Nurseitova, Raushan Dosmagambetova

Karaganda State Medical University, Karaganda, Kazakhstan

* Corresponding author: Kultanov B, Karaganda State Medical University, Karaganda, Kazakhstan; E-mail:

Received: Oct 26, 2015; Accepted: Nov 27, 2015; Published: Dec 30, 2015
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Title Annotation:Short Communication: Open Access
Author:Kultanov, Berikbay; Seiilkhanova, Aigerim; Anis, Kulshat; Yessimova, Roza; Nurseitova, Kulash; Dosma
Publication:Biology and Medicine
Article Type:Report
Date:Dec 1, 2015
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