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Interpretive Handbook

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Test 9230:
Maturation Smear

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Maturation of the vaginal squamous epithelium is hormone dependent; estrogen stimulates proliferation and progesterone inhibits it. The maturation index, performed on squamous cells exfoliated from the intact top layer of the surface of the vagina epithelium, is expressed as a percentile relationship of parabasal cells to intermediate cells to superficial cells.

Useful For Suggests clinical disorders or settings where the test may be helpful

Assessing hormonal status in a variety of conditions including:

-Assessment of ovarian function after hysterectomy, during menstrual disorders, or in premature menses (childhood)

-Before, during, and after a pregnancy (eg, fertility studies, threatened abortion, retained placenta, hydatidiform mole)

-Investigation of functioning (hormone-producing) tumors

-Evaluation of various endocrine disorders

-Guidance for hormonal therapy

Interpretation Provides information to assist in interpretation of the test results

In the preovulatory phase of the normal menstrual cycle (peak estrogen activity), superficial cells predominate and contain glycogen.

 

In the postovulatory phase (peak progesterone activity), intermediate cells predominate.

 

Before puberty and after menopause, parabasal and intermediate cells are seen.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

An accurate assessment cannot be made on any specimen other than a lateral vaginal wall.

 

Certain conditions can affect the hormonal status of the epithelium and should be avoided when making a hormonal assessment. These include:

-Inflammation and/or infection

-Vaginal erosion

-Current pregnancy

-Cytolysis

-Faulty fixation

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Descriptive report

Clinical References Provides recommendations for further in-depth reading of a clinical nature

1. Naib ZM: Exfoliative cytology. Boston/Toronto, Little, Brown and Company, 1985, pp 56-58 

2. Koss LG: Diagnostic Cytology and it’s Histopathologic Bases. Philadelphia, JB Lippincott Company, 1992, pp 300-301