The diagnosis of early human pregnancy by the vaginal smear method

Abstract

The study of a large number of vaginal smears from different mammals, especially from guinea pigs, during the last several years has led me to realize that pregnancy as well as different pathological conditions of the ovaries and the genital tract might be diagnosed more or less accurately by such smears. The entire composition of the vaginal smear changes rather typically under different conditions. Pregnancy, cystic or other degenerative changes of the ovaries, inflammatory processes, growths, etc., affect the entire genital tract, including the vagina, in a way which produces definite and typical changes in the consistency and make-up of the vaginal smear. The presence or absence of different types of desquamated cells, as well as the varying form and number of leucocytes, lymphocytes and erythrocytes and bacteria, offer a variety of criteria upon which a diagnosis of certain conditions may be based.

Since diagnostic reactions are of more interest and importance in man than in other mammals, I have tried for some time to secure proper human material on which to further these studies. It had been difficult, however, to obtain good reliable human vaginal smears until recently. This has now been rendered possible by a coöperative arrangement between the Department of Anatomy of Cornell Medical College and the Woman's Hospital of New York aided by the Maternal Health Committee.

This arrangement has afforded the opportunity to study a large number of human vaginal smears from normal cases as well1 as from cases of pregnancy, and from several pathological lconditions. The normal human smears differ considerably in. cellular composition from those of lower mammals, yet they nevertheless show typical and characteristic changes which may serve to indicate a number of distinct stages.