High vaginal swab

Uses

A high vaginal swab is a medical procedure generally to test vaginal discharge for the presence of vaginal thrush, bacterial vaginosis and trichomonas vaginalis. It may be performed when there is vaginal bleeding alone and can be done at the same time as a smear test.

Technique

The procedure is carried out with good light and in clean conditions by a healthcare professional. After inserting the swab to the top of the vagina, it is rotated to obtain a sample of the discharge and subsequently, the speculum is removed and the sample sent for microscopy, culture and sensitivity, in charcoal-based transport medium. If the sample cannot be sent to the laboratory immediately, it may be stored in a fridge.

It cannot be used to look for chlamydia or gonorrhoea.

Evaluation

Although the presence of laboratory facilities is ideal, in places where resources are limited, a HVS can be performed and evaluated at the bedside. Using HVS, candida and trichomonas may be diagnosed with a wet mount microscopy.

References

References

1. (2010). "Skills for Midwifery Practice". Elsevier Health Sciences.
2. (2010). "A Pocket Guide for Student Midwives". John Wiley & Sons.
3. (2021). "The Royal Marsden Manual of Clinical Nursing Procedures, Student Edition". Wiley.
4. [https://www.ouh.nhs.uk/microbiology/diagnostic-tests/atoz/documents/discharge.pdf "Investigation and Management of Vaginal Discharge in Adult Women"] {{Webarchive. link. (2017-12-15 . Oxford Clinical Commissioning Group. December 2014)
5. (2014). "Confronting the Challenge of Reproductive Health in Africa: A Textbook for Students and Development Practitioners". Women's Health and Action Research Centre.