A High Vaginal Swab (HVS) is a simple but important diagnostic procedure used to detect infections or abnormalities in the female reproductive tract. It is commonly used in gynecology and general practice to identify the cause of abnormal vaginal discharge, itching, or pelvic discomfort.
This blog post explores what an HVS is, when it is needed, how it is performed, and how results are interpreted.
What Is a High Vaginal Swab (HVS)?
A High Vaginal Swab is a microbiological test where a sterile swab is used to collect secretions from the upper part of the vaginal canal. The sample is then sent to a laboratory for analysis to detect:
- Bacteria
- Yeasts (e.g., Candida)
- Protozoa (e.g., Trichomonas vaginalis)
- White blood cells (sign of infection or inflammation)
Why Is an HVS Performed?
Doctors may recommend an HVS for several reasons, including:
- Unusual vaginal discharge (color, odor, or quantity)
- Itching, irritation, or soreness
- Suspected sexually transmitted infections (STIs)
- Recurrent vaginal infections
- Routine screening during pregnancy
- Investigating pelvic inflammatory disease (PID)
It helps rule out infections like bacterial vaginosis (BV), candidiasis, trichomoniasis, or gonorrhea, among others.
How Is the Procedure Done?
The procedure is quick, usually painless, and done in a clinical setting by a trained healthcare provider.
Steps in Performing an HVS:
- Patient Positioning: The patient lies on her back with knees bent and legs apart.
- Speculum Insertion: A sterile speculum is gently inserted into the vagina to allow visualization.
- Swab Collection: A sterile cotton-tipped swab is inserted high into the vagina (near the cervix) to collect discharge or secretions.
- Sample Handling: The swab is placed in transport media and sent to the lab for:
- Microscopy
- Culture and Sensitivity
- Wet mount for protozoa or yeast
- Gram stain
Laboratory Analysis and Interpretation
Microscopy and Gram Stain:
- Clue cells → Suggest bacterial vaginosis
- Yeast cells/hyphae → Indicate Candida albicans
- Motile trichomonads → Confirm Trichomonas vaginalis
- Numerous white blood cells (WBCs) → Inflammation/infection
Culture Results May Identify:
- Staphylococcus aureus
- Streptococcus species (including Group B)
- Escherichia coli
- Neisseria gonorrhoeae (usually by molecular testing)
- Candida species
Antibiotic Sensitivity Testing:
If pathogenic bacteria are grown, they may be tested for antibiotic susceptibility to guide effective treatment.
Limitations of HVS
- Cannot detect viral infections like herpes simplex virus (HSV) or human papillomavirus (HPV)
- May miss infections of the cervix (cervicitis) or uterus
- Sensitivity depends on sample collection technique and lab conditions
Preparation for the Test
To ensure accurate results:
- Avoid using vaginal creams or douches 24–48 hours before the test.
- Refrain from sexual intercourse the night before.
- Inform the doctor of any antibiotics used recently.
What Happens After the Test?
- Results are typically ready within 2–5 working days.
- Based on findings, appropriate treatment (antibiotics, antifungals, or antiparasitics) will be prescribed.
- In case of an STI, partner treatment may also be advised to prevent reinfection.
Conclusion
The High Vaginal Swab is a valuable tool in diagnosing vaginal infections and maintaining women’s reproductive health. It is simple, minimally invasive, and highly informative when interpreted alongside clinical symptoms.
If you’re experiencing abnormal vaginal symptoms, speak to your healthcare provider about whether an HVS is appropriate. Early detection and treatment of infections help prevent complications and ensure better quality of life.
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