Hello, I have gone through your query and understood the concern. The predominance of coccobacilli suggests presence of bacterial vaginosis. Shift in the vaginal flora can be seen when the pH of the vagina changes as in pregnancy and menopause. Infections can also cause this change. The infection has led to the presence of neutrophils. Maturation index is useful to understand the hormone effect on the vaginal epithelium. The reading may be erratic when there is overlying infection. High superficial cells in the index suggests effect of estrogen unopposed by progesterone. This can happen with hormone imbalance, menopause and estrogen treatment to the vagina. Hope this helps.