Vigilant control. Examinations and examinations during childbirth

Vaginal examinations during childbirth: an emergency or a precaution? Why and how often should such inspections be carried out?

Emergency room

If labor begins at a woman’s home (and not in the pregnancy pathology department), she is admitted to the emergency room, where she is questioned in detail (they clarify when exactly labor began or the waters broke, whether the woman slept at night, whether she took any medications) . After this, a general examination is carried out: temperature, blood pressure are measured, height is determined, weighing is carried out, the presence of edema and varicose veins, the thickness of subcutaneous fat, etc. are determined.

Then they proceed to an external obstetric examination (the fetal heartbeat is listened to, the external dimensions of the bony pelvis, abdominal circumference, and the height of the uterine fundus are measured). Using palpation (palpation) of the abdomen, the tone of the uterus, the position of the fetus (longitudinal, transverse, oblique), and the presenting part (head or pelvic end) are determined.

In the emergency room, the doctor’s main task is to determine whether labor has actually begun. If the presence of labor or rupture of amniotic fluid is not confirmed, the woman is hospitalized in the pregnancy pathology department. If a woman is admitted with a suspicion of rupture of amniotic fluid, and it is definitely ruled out, the expectant mother does not make any further complaints (of pain, pulling sensations in the lower abdomen), then she can be sent home. If the onset of labor is confirmed, the woman is admitted to the maternity ward. In doubtful cases, hospitalization is carried out in the maternity ward and the patient is constantly monitored there.

In most maternity hospitals, a woman in labor entering the maternity unit is given a cleansing enema. This is done not only for “aesthetic” reasons (so that the contents of the intestine are not released during pushing), but because an overcrowded intestine can interfere with labor and make examination difficult. In addition, an enema promotes the development of labor.

After a cleansing enema, the woman in labor has her genital and pubic hair shaved off, so treatment with a disinfectant solution is more effective. In addition, hair on the labia can interfere with stitches after childbirth. In some maternity hospitals, shaving the genitals is now considered optional; it is enough for the hair to be cut short.

Before entering the maternity ward, the woman showers and puts on sterile underwear.

Vaginal examination during childbirth

In the maternity ward, a vaginal examination is carried out, monitoring the condition of the fetus and assessing the nature of labor.

Upon admission to the maternity ward, a woman is examined in speculum (the cervix and vaginal mucosa are examined using a gynecological speculum), and a vaginal examination is performed. Before the procedure, the genitals are treated with a disinfectant solution. The doctor conducts a gynecological examination wearing sterile gloves, which he puts on after treating his hands (the doctor washes his hands, then treats them with a special disinfectant solution).

Initially, the appearance of the external genitalia is assessed: how they are formed, whether there are varicose veins, whether there are signs of an inflammatory process or sexually transmitted diseases.

When examined in mirrors, the appearance of the vagina and cervix, as well as the nature of the discharge, are assessed.

Frequent vaginal examinations increase the risk of developing infectious complications.

During a manual (manual) examination, the condition of the vagina (wide or narrow, the presence of scar changes), the condition of the cervix (degree of maturity, opening) are assessed. The presence of the amniotic sac is checked (intact or absent); if the amniotic sac is intact, the amount of anterior waters (those waters that are in front of the head) is assessed. If there is little or too much anterior water, it may be necessary to open the amniotic sac, since in these cases the amniotic sac may interfere with labor. Next, the presenting part (head or pelvic end) is diagnosed. When the head is presented, the nature of the insertion is determined (normally the head is bent, the occiput is born first). But the head can be inserted not only from the back of the head, but also from the forehead or face, etc. Incorrect position of the head can cause a discrepancy between the fetal head and the mother’s pelvis. In order to determine the insertion, the sutures and fontanelles are palpated on the head (they serve as landmarks). If the pelvic end is presented, determine the type of pelvic presentation (foot or breech). They talk about leg presentation if the legs are presented, if the legs are bent at the hip joints and the buttocks of the fetus are in front of them, then this is a breech presentation. If both the legs and the buttocks are visible (the baby seems to be squatting), this is called a mixed breech presentation.

During a vaginal examination, the condition of the bone pelvis is necessarily assessed. The doctor tries with his finger to reach the promontory of the sacrum (the most protruding point in the pelvic cavity). If the cape is not reached, then the pelvic capacity is sufficient. If the cape is reached, then there is some narrowing of the pelvis. In addition, the presence of deformities of the pelvic bone is determined. Repeated vaginal examination should be carried out no earlier than after 4 hours, since frequent vaginal examinations increase the risk of developing infectious complications in the postpartum period. More frequent vaginal examinations can be carried out only strictly according to indications: when amniotic fluid ruptures, if there has been premature rupture of water - at the onset of labor (the appearance of contractions); when bleeding occurs; before anesthesia; in case of deviation from the normal course of labor (suspicion of the development of weakness or incoordination of labor, lack of advancement of the head). The reasons for conducting a vaginal examination must be recorded in the birth history. It is unacceptable to conduct a vaginal examination without clear indications. Multiple vaginal examinations (more than four) during childbirth are an indication for the prescription of antibiotics in the postpartum period.

Observation

To assess the development of labor, at least every hour, the doctor or midwife evaluates the frequency, strength and duration of contractions. To do this, the doctor places his hand on the woman’s stomach and records the time. Normally, over time, contractions become more frequent, increasing in strength and duration.

Normally, over time, contractions become more frequent, increasing in strength and duration.

Using an external examination, the location of the presenting part of the fetus in relation to the pelvis is determined approximately every 2 hours. The presenting part can be felt completely or partially above the entrance to the pelvis (above the pubis). If the presenting part is located in a narrow part of the small pelvis or on the pelvic floor, that is, the fetus has already moved significantly “toward the exit,” then during external examination it cannot be felt through the anterior abdominal wall.

In addition, the woman’s condition is assessed. Temperature and pressure are periodically measured, and the pulse is calculated (these manipulations can be carried out by a midwife). All data is entered into the birth history.

Fetal assessment

No less carefully than the condition of the mother, you need to monitor the condition of the fetus.

Every 20-30 minutes, the doctor listens to the fetal heartbeat using an obstetric stethoscope (wooden tube). Be sure to wait for the contraction to assess how the fetal heartbeat changes during and after the contraction.

The fetal heartbeat is recorded at least 1-2 times using a special device - a cardiotocograph (fetal monitor). The expectant mother, lying on her side or on her back, has a special sensor attached to her stomach, with the help of which a graph of the fetal heartbeat is recorded on a paper tape - a cardiotocogram (CTG). In some cases, recording of the fetal heartbeat using a cardiotocograph is carried out continuously throughout the entire birth. This is necessary in the following cases:

• with severe gestosis in the mother (preeclampsia is a condition associated with pregnancy, the main symptoms of which are swelling, increased blood pressure and the appearance of protein in the urine);
• during labor stimulation (stimulation of labor after the onset of labor with the help of medications) or labor induction (when labor is induced artificially);
• in case of premature or post-term pregnancy;
• during multiple pregnancy;
• if the mother has severe chronic diseases (diabetes mellitus, cardiovascular pathology);
• during epidural anesthesia (since it is possible to reduce a woman’s blood pressure and, as a result, malnutrition of the fetus);
• with delayed fetal development;
• if, when listening with an obstetric stethoscope, a disturbance in the fetal heartbeat is detected.

The advantage of continuous recording of the heartbeat is constant monitoring of the condition of the fetus, the disadvantage is its inconvenience for the woman, restriction of her freedom and physical activity.

In some cases, the cardiotocograph has 2 sensors, one of which records the fetal heartbeat, and the second records uterine contractions. This is convenient because you can see how your heartbeat changes during a contraction.

Amniotic fluid

The appearance of the amniotic fluid after its release must be assessed. Normally, the water should be light and transparent. If the water is colored green, this indicates hypoxia (oxygen starvation) of the fetus (the green color of the water is due to the fact that during hypoxia, meconium is released prematurely - the fetus's original feces, which colors the amniotic fluid). In this case, constant monitoring of the fetal heartbeat is necessary. Waters can be colored yellow in case of Rh-conflict - the color of the water is explained by the fact that in case of Rh-conflict, blood cells are destroyed and the pigment bilirubin is released from them.

On the birth table

Once the cervix is ​​fully dilated and the second stage of labor (the pushing period) has begun, everything should be ready to deliver the baby. Delivery is carried out on a special birth table (in some maternity hospitals there are special beds that transform into a birth table).

The woman is transferred to the birthing table after the head has erupted (the head appears in the genital slit during contractions and does not disappear after contractions). During childbirth, the mother in labor is provided with a benefit called “perineal protection.” It is aimed at ensuring that the head cuts into the genital slit with its smallest size; for this it must be bent as much as possible (the baby’s chin must be pressed to the chest). Therefore, until the maximum flexion of the head, the midwife delays its advancement. In case of breech presentation, the benefit is aimed at ensuring that the fetus’s buttocks are born first and that the leg does not fall out. To do this, delaying the progress of the fetus, the doctor forces it to “sit down,” as it were.

When providing manual assistance, monitor the condition of the perineum. If there is a threat of its rupture (pallor of the skin, the appearance of cracks), it is necessary to make a dissection of the perineum - an episiotomy, since the incision heals better than a rupture.

At the same time, the doctor listens to the fetal heartbeat after each attempt. If the fetal heart rate worsens, labor must be completed as soon as possible. To do this, an episiotomy is performed; in rare cases, obstetric forceps are used.

During the birthing process, the doctor or midwife tells the woman in labor when she needs to push, and when, on the contrary, she needs to “breathe” through the pushing. This depends on the location of the presenting part and the speed of its advancement. It is important to listen carefully to medical personnel to avoid rupture and injury to the fetus.

After birth, the baby is placed on the mother's stomach and applied to the breast (if his condition allows). The umbilical cord is cut, then the baby is examined by a pediatrician.

After the baby arrives

After the birth of the fetus, the succession period begins. This is the shortest period of labor, but during it there is a danger of bleeding from the uterus.

The doctor observes the appearance of signs of separation of the placenta - the woman may feel a weak contraction; when the woman breathes deeply, the umbilical cord section does not retract, the fundus of the uterus rises higher and deviates to the right. Only after separation can the placenta be removed from the genital tract if it is not born on its own. Pulling the unseparated placenta by the umbilical cord or squeezing it through the anterior abdominal wall is not used, as this is dangerous due to bleeding.

Suture of tears is usually performed under local anesthesia.

Faster separation of the placenta and better contraction of the uterus is facilitated by putting the baby to the breast immediately after birth. This is explained by the fact that when the nipple is irritated, the hormone oxytocin is released, which has a contractile effect on the uterus.

After the birth of the placenta, it must be examined; the doctor must make sure that the placenta is intact, because if the placenta lobe is retained in the uterus, bleeding may occur. Therefore, if a defect in the placental tissue is suspected, a manual examination of the uterine cavity is performed against the background of anesthesia.

Examination of the birth canal

After childbirth, the birth canal must be examined for ruptures. To do this, special spoon-shaped speculums are inserted into the vagina. First, the doctor examines the cervix. To do this, the cervix is ​​taken with special clamps, and the doctor walks around its perimeter, interlocking the clamps. In this case, the woman may feel a pulling sensation in the lower abdomen. If there are cervical ruptures, they are sutured; no anesthesia is required, since there are no pain receptors in the cervix. Then the vagina and perineum are examined. If there are tears, they are sutured.

Suture of ruptures is usually carried out under local anesthesia (novocaine is injected into the area of ​​the rupture or the genitals are sprayed with lidocaine spray). If manual separation of the placenta or examination of the uterine cavity was carried out under intravenous anesthesia, then the examination and suturing are also carried out under intravenous anesthesia (the woman is removed from anesthesia only after completion of the examination of the birth canal). If there was an epidural anesthesia, then an additional dose of anesthesia is administered through a special catheter left in the epidural space from the time of birth. After the examination, the birth canal is treated with a disinfectant solution.

The amount of bloody discharge must be assessed. At the exit from the vagina, a tray is placed where all bloody discharge is collected; the blood remaining on napkins and diapers is also taken into account. Normal blood loss is 250 ml, up to 400-500 ml is acceptable. Large blood loss may indicate hypotension (relaxation) of the uterus, retained parts of the placenta, or an unsutured rupture.

Two hours after birth

The early postpartum period includes the first 2 hours after birth. During this period, various complications may occur: bleeding from the uterus, the formation of a hematoma (an accumulation of blood in a confined space). Hematomas can cause compression of surrounding tissues, a feeling of fullness, in addition, they are a sign of an unsutured rupture, bleeding from which may continue, and after some time the hematomas may fester. Periodically (every 15-20 minutes), a doctor or midwife approaches the young mother and evaluates the contraction of the uterus (for this, the uterus is palpated through the anterior abdominal wall), the nature of the discharge and the condition of the perineum. After two hours, if everything is normal, the woman and baby are transferred to the postpartum ward.

Doctors always try to reduce the number of examinations and medical manipulations during childbirth to a minimum in order to allow childbirth to proceed as naturally as possible and to allow the woman to focus on this most important process in life and to feel her leading role in the birth of the child.

Elena Kudryavtseva,
obstetrician-gynecologist,
Ural Institute of Motherhood
and infancy, Ekaterinburg

Home > Questions and answers > After how long can a CT scan be repeated?

During a CT scan, the body is exposed to a fairly large radiation dose, so the appointment of each new such examination should be carried out taking into account all factors. If it is necessary to re-scan, then proceed from its expediency. If possible, it is better to postpone the procedure for at least a month. But in some cases it is vital to check the condition of soft tissue or bones after an injury, for example, or in other emergency situations. The need also arises to evaluate the results of treatment, healing after surgery, etc. There are many reasons for repeated examination. Then the diagnosis is made within 2-3 weeks or even after a few days. You should also consider replacing CT scans with MRI, which uses a powerful magnetic field instead of X-rays. This will help rid the body of excess radiation exposure.

Finally, the long-awaited moment has arrived - the delay. The test showed two “pregnant” lines and, perhaps, the time has come when you need to visit a gynecologist to confirm successful conception and rule out ectopic pregnancy.

An experienced doctor can diagnose a woman’s interesting position at first glance, without a test and without waiting for the first day of delay. How does a gynecologist determine pregnancy and what manipulations does he need to perform for this?

Methods of gynecological examination

Throughout pregnancy, symptoms are divided into three parts:

1. presumptive - these are early manifestations of conception that begin even before the delay;
2. probable - signs that the doctor determines based on a gynecological examination of the patient;
3. accurate - signs characteristic of a later period and which are indisputable and reliable evidence of pregnancy (heartbeat and fetal movements).

How a gynecologist determines pregnancy has long been no secret to anyone. Before starting a vaginal assessment of conception, the doctor is interested in the general well-being of the patient and asks about the signs of pregnancy that manifested themselves before the delay. In turn, the woman must tell about all changes in the body, the presence of bad habits and previous pregnancies, if any. After collecting the medical history, the doctor makes all the necessary notes and sends the woman to the gynecological chair for a more detailed examination.

Assessment of the condition of the genital organs

Diagnosing early pregnancy is somewhat difficult for doctors, since its probable signs can be identified starting from 4–6 weeks after conception. In rare cases, signs may appear even before a missed period.

External examination involves assessing the condition of the external organs of the reproductive system, mammary glands and skin of the body. When examining external organs, the doctor pays special attention to the labia. If pregnancy is present, then they become swollen, dense, cool with a bluish tint. In other words, the patient has venous congestion.

The next stage is a bimanual examination and examination in mirrors. A speculum is a special device that is inserted into a woman’s vagina to assess the condition of the walls of the vagina and cervix. During pregnancy, the posterior vaginal fornix flattens and appears swollen. The mucous membrane takes on red-violet shades, and the mucus secreted by the cervical canal becomes transparent and viscous. The uterus noticeably changes its condition and shape - it becomes soft, rounded and increases in size. During the examination, the doctor examines the discharge for smell, quantity and color, and also takes a smear from the cervix to examine the flora.

Next, the doctor moves on to a bimanual examination, that is, a two-handed examination of the pregnancy. He inserts two fingers of one hand into the vaginal opening, and places the second hand on top of the stomach. Directing his hands towards each other, the gynecologist feels the body of the uterus on both sides and palpates the appendages. Using this method, the doctor assesses whether the uterus has enlarged and which of the appendages has become larger due to the content of the corpus luteum.

Transvaginal ultrasound

Ultrasound examination in early pregnancy is a necessary measure to determine the location of the embryo, exclude ectopic pregnancy, prevent the threat of miscarriage and assess the general condition of the internal organs of the reproductive system. Ultrasound is performed using a special transvaginal sensor, which is inserted into the vagina.

With the vaginal examination method, it is much easier to see pregnancy than with the usual ultrasound method.

The main advantage of diagnosis is that the woman does not need to prepare in advance. All you need is a condom, which is placed on the vaginal sensor and used for personal intimate hygiene.

Additional Research

In addition to a gynecological examination and ultrasound, the doctor may refer the patient for a blood test to detect human chorionic gonadotropin (hCG). It is this hormone that always increases during pregnancy and accompanies it throughout the early period. A blood test may be needed if the doctor has difficulty determining conception, because in the early stages there is always a possibility of not noticing pregnancy. Fertility testing or hCG testing can detect successful conception as early as two weeks after fertilization.

Some women ask the question: “Is it possible to determine pregnancy using a smear?” A smear is mandatory when registering a pregnant woman. In addition, the smear is used to look at cytology, determine the presence of infections and examine the microflora. Pregnancy has an impact on the bacterial component and there is a high probability of candidiasis (thrush) as hormonal levels and immunity change.

A smear cannot determine pregnancy, but it can check the bacterial health of the entire reproductive system.

As a rule, such tests are not rare and the doctor may prescribe them several times throughout pregnancy.

Calculating the time of conception

After the doctor has confirmed the presence of pregnancy, he proceeds to calculate its duration. To do this, each specialist uses his own usual method. Today there are many ways to determine the gestational age and here are some of them:

• By ovulation. As a rule, ovulation occurs on days 12–16 of the cycle and it is on this day that conception occurs. Based on the date of the first day of the last monthly discharge, the doctor counts the day of ovulation and calculates the gestational age for this period. You can use this method yourself, without waiting for a visit to the doctor.
• Based on the size of the uterus during a gynecological examination. An experienced doctor is able to determine the period of conception already at the first assessment of the size of the visible part of the uterus. If the pregnancy is about 1 month, then the size will be visually equal to the volume of a chicken egg, if 2 months - to the volume of a goose egg. After 12 weeks, it will be impossible to determine the gestational age from the uterus due to the individual characteristics of fetal development.
• According to the height of the uterine fundus. This technique is used in the second trimester using ultrasound. At 8 weeks, the height of the uterine fundus is limited to 9 cm, at 10 weeks – 11 cm, at 16 weeks – from 14 to 18 cm. Starting from 21 weeks, 1 cm of height is added with each new week, i.e. the week/cm ratio is leveled out ( 22/22).

If you are interested in the question: “Can a gynecologist determine pregnancy in an appointment?” So you know - maybe. While carrying a child, a woman's body changes greatly. And perhaps these changes are invisible to the expectant mother, but it will not be difficult for the doctor to identify them and voice the long-awaited two words - you are pregnant!

To be confident in your women's health, it is recommended to visit a gynecologist once every six months. But not all women adhere to such a schedule. They usually run for help when they already have any symptoms.

In this article we will talk about timing of visiting a gynecologist with and without need. We will also discuss when virgins, women after natural childbirth or cesarean section should go to this doctor.

Why go to a gynecologist?

A gynecologist can be called the chief doctor of women's health. But many representatives of the fair half of humanity do not visit him so often, believing that there is no need to go to him without a reason. The opinion is erroneous, since you need to go to a gynecologist if:

• noticed the presence heavy, unnatural discharge with an unpleasant odor;
• appeared itching and burning in the perineum, during lovemaking, urination, in a calm state;
• are planning to conceive a child;
• there is a menstrual cycle disorder;
• there is a delay;
• decided to use some methods of contraception, before which consultation with a doctor is necessary;
• present frequent change of sexual partner, since such a lifestyle significantly increases the risk of contracting sexually transmitted diseases and AIDS;
• pregnant;
• There is gynecological diseases(for treatment and prevention).

The main answer to the question why go to a gynecologist is: to maintain normal women's health. Indeed, at first, many gynecological diseases are asymptomatic and do not bother you. Neglecting checks can lead to erosion, cysts and other problems that could be avoided by visiting a gynecologist on time.

When is the best time to go to the gynecologist after menstruation?

Gynecologists agree that the most “clear picture” is observed during examination on days 7–15 of the menstrual cycle. Since this phase is characterized by the active production of estradiol, which is reproduced after the formation of a dominant follicle during the growth of the egg. During this period, the hormonal system in women works at full strength, and in case of any deviations from the norm, it is easier to identify the causes of organ failure. Having made some simple calculations, we get that You need to visit a female doctor 4–8 days after your period.

When should you go to see a gynecologist after a delay?

If the cause of the delay is pregnancy, then most likely the period is only 4-5 weeks. At this stage, the gynecologist will not be able to confirm the presence of a fertilized egg, but Ultrasound and blood test for hCG will be more informative. Waiting until 12 weeks is also not recommended, as there is a risk of developing an ectopic pregnancy.

The optimal time to visit a gynecologist can be called 2–3 weeks after the date of the missed period. It is also recommended to take a pregnancy test. Its positive result allows you to wait some more time before going to the gynecologist, but if the test is negative and there is a delay, then do not put off going to the doctor. One line on the test when menstruation is delayed may indicate the development of gynecological diseases.

When should you go to the gynecologist for an examination after a positive test?

So, two lines on the test after a delay indicate the presence of pregnancy. There is no need to go to the doctor right away. This is due to the undesirable examination on the chair, since in some cases such intervention in the early stages can lead to termination of pregnancy. This happens very rarely in predisposed women, but it is better not to risk it and wait a few more weeks.

It is considered normal to go to the gynecologist period of 9–12 weeks, but if there have been cases of ectopic pregnancy in your family, then it is better to check with an ultrasound. Such a study will confirm the presence of a fertilized egg in the uterus and dispel the fear of a possible ectopic pregnancy.

How long after giving birth should you go to the gynecologist?

In case of natural delivery without complications, a visit to the gynecologist is scheduled through eight weeks after the baby is born. Even if the lochia has not stopped yet, you should not postpone the visit. In cases where stitches were placed or any additional manipulations were performed during the birth process, the doctor schedules a visit for 2-3 weeks after birth. Further inspection trips are arranged on an individual basis.

When should you go to the gynecologist after a cesarean section?

In cases where the child was born through cesarean section, the timing of visiting the gynecologist is different if this happened naturally. A woman in labor can move independently after a cesarean section after 6–12 hours. But you must come for a routine examination, if there are no accompanying complaints about the healing of sutures. in a month. The doctor will check how the scarring of the uterine cavity is progressing and examine the genital organs.

The timing may be different, since cases are individual. Some undergo a second Caesarean, while others have problems with internal or external sutures. Therefore, the gynecologist sets a date for the next visit for each woman in labor upon discharge from the maternity hospital.

Is it possible to go to the gynecologist during menstruation?

If we look at the issue of going to the gynecologist during menstruation from an ethical point of view, then it is better to postpone the scheduled examination for “clean” days. It’s another matter if menstruation is necessary as a physiological component required for manipulation. So, a visit to a female doctor during menstruation is prescribed:

• at installation of an intrauterine device. The second day of menstruation is considered a favorable day for attaching the IUD. In this phase, the cervix opens slightly, which is necessary for the introduction of a foreign body. Also, the uterus itself reacts less painfully to the spiral, since its cells are regenerated.
• if a woman undergoing IVF program, where a short protocol requires an internal vaginal ultrasound on the second day of menstruation.

In addition to direct prescriptions, you should get checked during your period if you have the following symptoms:

• weakness and dizziness, this may indicate the onset of bleeding;
• the discharge has an unpleasant (smelly) odor, has changed its color and composition (comes out in pieces);
• the appearance of severe itching accompanied by rashes. This is how herpes or a fungus may manifest itself, the treatment of which should not wait until after your period;
• The discharge does not stop after the end of menstruation.

At what age do virgins go to the gynecologist for the first time?

Every accomplished woman probably remembers her first appointment with a gynecologist. How embarrassing and scary it was, and even this chair... But that’s not about that now. A girl, even if she is a virgin, needs to visit a gynecologist for the first time at the age of 14–15. This is necessary not only to prevent the development of gynecological diseases, but also to control normal sexual development (maturation).

It is not necessary to go to the clinic to see a regular gynecologist. The first visit to a gynecologist before the age of 16 can be made together with the mother to a pediatric gynecologist. This doctor is more tactful with still young patients and the girl will not be afraid to visit the gynecological office in the future, since the first experience of visiting a doctor will leave a normal impression.

Is it necessary for a virgin to go to the gynecologist?

There is a misconception that virgins have nothing to do in the gynecologist's office. This opinion, unfortunately, has led more than one young lady to serious gynecological diseases in severe form. As already noted, the first examination by a gynecologist is recommended at 14–15 years of age. It is at this age that it is possible to correct all kinds of anomalies in the development of the reproductive system of girls. There are cases when virgins seek counseling for the first time at the age of 19–20, hoping for their “purity,” but the moment is already lost.

For example, if the uterus is underdeveloped at 14 years old, the organ can be stimulated with hormones and “grow” it to the required size, and at 19 years old such therapy will give a 50/50 chance of cure and a young virgin may remain infertile.

That's why A visit to a gynecologist is also necessary for virgins. If the fear is caused by the procedure itself, then it doesn't hurt, and the doctor takes a smear and examines the vagina without damaging the hymen.

I'm afraid to go to the gynecologist: what should I do if I'm ashamed and scared to go to the gynecologist?

The main task of a gynecologist is to examine for the presence of diseases. In their presence, find out, make the correct diagnosis and prescribe appropriate treatment. Almost no woman is excited about going to a gynecologist. Some are afraid of the chair, others are afraid of the introduction of instruments. There are also those who are afraid to hear a terrible diagnosis, and therefore do not go to the appointment. But we should not forget that the gynecologist is your friend, thanks to whose actions you can avoid the development of all kinds of gynecological problems.

If you have a fear of visiting a gynecological office, then prepare yourself so that it is research is necessary for your health and the examination procedure is not an execution, but an integral part of the process of caring for women's health.

Many women who were previously afraid and embarrassed to visit a gynecologist have overcome this problem. The solution was to visit the same treating professional, who was liked not only as a specialist, but also as a person. Now a visit to the gynecologist is perceived as a visit to a friend or a specialist in your health.

What to take with you to an appointment with a gynecologist?

If you are going for an examination for the first time, take your documents with you (passport, medical card). As for the inspection itself, you will need sterile gloves, towel and diaper to place on the gynecological chair. The doctor has all the necessary tools.

Modern medicine also suggests purchasing a special gynecological examination package. It includes:

• disposable diaper;
• sterile gloves;
• a plastic disposable vaginal speculum (if you do not bring a bag, they will check you with a metal speculum that has been sterilized);
• glass slide onto which biological material is applied.

This is the standard package. There are other options that include: Volkmann spoon, Ayer spatula. Before visiting a gynecologist, be sure to carry out hygiene procedures.

Video: Why go to the gynecologist?

Many representatives of the fairer sex who have reached reproductive age and are planning to become mothers have wondered about possible confirmation of pregnancy. Most often, people are interested in how long it can be determined that conception has occurred. It is no coincidence that interest in this is caused; the sooner a woman finds out about her situation, the more she will monitor her own health, and this will allow her to carry out the entire pregnancy as correctly and safely as possible.

At what period can a gynecologist determine pregnancy?

The most obvious sign of pregnancy for expectant mothers is the onset of delayed menstruation. But its occurrence does not always indicate successful conception. In order to clearly answer the question about fertilization, it is recommended to go to see a doctor at an antenatal clinic.

The gynecologist conducts an examination and makes a verdict. Depending on the qualifications of the doctor and the method he uses, the period at which it is realistic to determine the presence of an embryo is three or four weeks. If a woman takes a blood test for hCG (a hormone produced by the embryonic membrane), the result can be noticeable even ten days after fertilization.

A doctor can examine a woman in a gynecological chair to determine whether she is pregnant. In this way, you can determine the presence of an embryo if the period is at least four weeks. At this time, the color of the vagina and cervix changes, the walls of the uterine cavity soften and its size increases. But it should be understood that even at this time, only an experienced, qualified obstetrician-gynecologist can see signs indicating that a woman is pregnant.

In most cases, examination determines pregnancy, which has reached seven weeks. This method is not the most reliable for detecting the fact of conception. There is an opinion that a doctor’s examination of a woman whose pregnancy does not exceed ten weeks can provoke embryo rejection, since during this period it is fused with the uterus, and the effect on the abdomen and internal genital organs can lead to undesirable consequences.

In order to be sure that you can prepare to become a mother, there are other, much safer laboratory methods of examination.

How does a doctor determine pregnancy?

In order to correctly determine the fact of conception, the obstetrician-gynecologist first asks the woman about her health, changes in perception, mood, taste preferences, sensations in the mammary glands and other changes in her usual life. These signs may appear even before menstrual delay occurs.

After the interview and entering the necessary information into the exchange card, the doctor can begin to examine the woman in a special chair. He evaluates the condition of the mammary glands and external genitalia, especially the labia. If a woman is pregnant, the labia swell, become cool, and have slight swelling and a bluish tint.

Then, using a gynecological speculum, the woman’s internal organs are examined. The uterus changes in size, shape, and density if a new life is born in it. The doctor also examines the condition of the cervix and vagina. By palpating with your fingers, the gynecologist assesses the size of the uterus and the condition of the appendages.

At the discretion of the doctor, he may not conduct a manual examination, but immediately give a referral for a vaginal ultrasound. This method of detecting pregnancy does not pose a threat to either the woman or the unborn baby. It is much more reliable than the usual ultrasound. With its help, you can determine an ectopic pregnancy, the position of the fertilized egg, prevent a possible failure and assess the general condition of the reproductive system. The advantage of the procedure is painlessness, simplicity, when the examination does not require any additional preparation.

In addition to an ultrasound examination, you may need to donate blood to increase the level of hCG, a hormone that begins to be intensively produced in the body from the early stages of pregnancy. At the first stages of development of the fertilized egg, there is a risk of not noticing its presence through ultrasound. And the result of a blood test will definitely confirm or deny the presence of pregnancy.