Gynecological examinations during pregnancy in the antenatal clinic. Examination of a pregnant woman by a gynecologist at different stages of pregnancy Gynecological examination of a pregnant woman

It shows convincing two lines, and you, listening carefully to yourself, find at least five more signs of pregnancy. There are so many joyful, pleasant minutes ahead, and there are so many fantasies in my head. But there is still a lot of trouble ahead, the lion's share of which comes from visiting doctors' offices. Of course, going through numerous studies and tests is not the most pleasant experience. This is especially true for examinations in a gynecological chair.

More than once I have witnessed a conversation between expectant and established mothers on the topic of how many times they had to undergo this examination during pregnancy. Some are proud that this happened just a couple of times, others lament that not even a week passed without this procedure. Where is the golden mean? It’s worth mentioning right away that we will talk about the tradition of monitoring pregnant women in the conditions of the domestic antenatal clinic. Ignorance breeds mistrust. Mistrust breeds fear. This article is an attempt to break this vicious circle and answer the main questions. How, when and why a pregnant woman is examined in a chair.

Getting ready for inspection

Be prepared for the fact that you will undergo an examination on a chair during your first visit to the gynecologist regarding pregnancy. To ensure that the examination brings a minimum of discomfort and maximum information about your condition, prepare for it at home. Make yourself a calendar in advance, on which you mark approximately the days on which you would have menstruated if you had not become pregnant. This is not difficult to do if you have a regular cycle. Do not plan to visit a doctor on these days; they are considered dangerous, critical periods for the development of pregnancy. For the same reason, if nothing bothers you, put everything aside medical examinations and ultrasound before the eighth week from the first day of the last menstruation.

Before leaving the house, take a shower or bath and put on fresh underwear. At the same time, you should not wash yourself especially thoroughly, and even more so, douche, since the doctor must see the condition of the vagina in its normal, “everyday” state. Do not use intimate deodorants or perfumes; they often provoke an allergic reaction, which may be regarded by a doctor as inflammation. Should you shave your perineum before visiting a doctor? Of course, it is not very convenient for a doctor to examine a woman with excess hair on the external genitalia, but if you usually do not do this, then you should not shave, as this can cause severe skin irritation. Empty your bladder. This is necessary so that during the examination it is the sensations of the internal genital organs that are assessed, and not the feeling of a full bladder. The intestines, if possible, should also be empty.
The day before your visit to the doctor, avoid sexual intercourse, as it often remains in the vagina. small quantity seminal fluid, which prevents reliable tests. If you sit in line for a long time to see the gynecologist, don’t be too lazy to go to the ladies’ room when it’s your turn to empty your bladder.

Think about your clothes. The main thing is that you are comfortable, and you can quickly undress from below or free your breasts. Bring socks with you so that when preparing for a gynecological examination, you won’t have to walk to the gynecological chair on the cold floor and your own towel, despite the fact that there will probably be unnecessary pieces of paper in the gynecologist’s office. In order not to burden yourself with thoughts about the conscientiousness of sterilization of examination instruments, purchase a disposable gynecological kit. They are very inexpensive and are sold in most pharmacies. This usually includes a plastic mirror for examining the cervix; it is not as cold as ordinary metal instruments, sterile gloves, special sticks or brushes for collecting material for analysis, and a disposable diaper (instead of a towel).

Usually, you are invited to a gynecological examination after a preliminary conversation, blood pressure measurement, weighing and examination on the couch. If the office has a separate examination room, leave your shoes before entering it. Check with the doctor or midwife where you can undress; you should not place your clothes on a sterile table or radiator; you may stumble upon a not very friendly nurse. Undress slowly, the medical staff will fill in the necessary documents. Put on your socks and place a diaper or towel on the chair so that it reaches the edge, but does not hang over it. Climb up the steps onto the chair itself and lie down on it so that your buttocks are at the very edge. Then place your feet on the supports, the slingshots should be in the popliteal fossa. Do not be shy or embarrassed to ask your gynecologist how to properly sit in a gynecological chair if this design is unfamiliar to you. Place your hands on your chest and try to calm down and relax. You will still have to go through this, the better you relax, the more clear your condition will be to the doctor, the faster the examination will end. Do not try to see everything that the doctor does or help (interfere?) the doctor with your hands, this makes the examination difficult and aggravates the discomfort; it is better to ask the doctor about everything in advance or after the examination.

My light, mirror, tell me...

The study begins with an examination of the external genitalia: the doctor assesses the condition of the skin and mucous membrane of the perineum, labia majora and minora, clitoris and external opening of the urethra. At the same time, the inner surfaces of the thighs are also examined, which makes it possible to identify varicose veins, the presence of areas of pigmentation or rash elements. The anus area must be examined, which allows you to immediately identify the presence of hemorrhoids, fissures and some other disorders.

Then the doctor proceeds to examine in the mirrors. This type of examination is aimed primarily at identifying any diseases of the vagina or condition of the cervix. There are two types of mirrors: casement and spoon-shaped. The flap speculum is inserted in a closed form, then the flaps are opened, and the cervix becomes accessible for inspection. The walls of the vagina are examined as the speculum is gradually removed from the vagina. When examining with spoon-shaped mirrors, first move the rear (lower) mirror, place it on the back wall of the vagina and lightly press on the perineum; then, parallel to it, an anterior (upper) speculum is inserted, which lifts the anterior wall of the vagina. Inserting the speculum is the most unpleasant part of the examination. In order to make it less painful, it is better to relax and press on the mirror, opening towards it when you feel that it has touched you. Then it will go in by itself, and you won’t even notice it. After inserting the speculum, a light is directed onto the cervix and examined. During pregnancy, the cervix is ​​bluish, this is one of the signs of pregnancy. This research method can also identify diseases of the cervix and vagina (inflammation, erosion, polyp, cancer). When examining the cervix, pay attention to the presence of redness (spots) on the outer surface of the cervix. This is what they say" erosion" Many diseases can be hidden under this sign, but only examining the cervix using a special microscope - a “colposcope” - will help make an accurate diagnosis. It is possible that the doctor will perform a colposcopy immediately if his office is equipped with this device or will schedule another day. In addition, they look at the condition of the external pharynx (the opening of the cervical canal). Appearance this hole, even without further examination, helps to establish a diagnosis of threatened interruption even in a very short period of time. In addition, the condition of the external pharynx determines isthmic-cervical insufficiency. In this case, the canal is slightly open, the shape of the pharynx is often irregular due to cervical ruptures in previous births.

Special attention is paid to the nature of the discharge from the cervix. If the discharge is streaked with blood, this always indicates a possible threat of miscarriage. If the discharge is cloudy or has an unusual odor, this indicates an infection.

What's for analysis?

The first test that is always done when registering during pregnancy is flora smear. Using a special spoon, the doctor “scoops” the substance from the cervical canal, vagina, urethra and applies it to the glass. The extracted material is examined in the laboratory under a microscope. This method can identify the inflammatory process (by the number of leukocytes), detect some types of infection (fungal, candidiasis, gonorrhea, trichomoniasis, bacterial vaginosis).
The flora smear is repeated 3-4 times during pregnancy, even if it was absolutely normal. And this is no coincidence, because often during pregnancy, infections “wake up” that have not made themselves felt for a long time. For example, candidiasis (thrush) occurs 2-3 times more often in pregnant women than in others. During this period, the woman’s body is reconstructed, the level of female sex hormones increases. The vaginal environment becomes more acidic, which is very “to the taste” of candida.
At the same time, hormonal changes in the body lead to a local decrease in cellular immunity and leukocyte activity, which also contributes to increased proliferation of the fungus in the genital tract of the expectant mother. The longer the pregnancy, the higher the number of microorganisms, so it is in the last trimester that candidiasis worries expectant mothers especially often. The aggressive environment that forms in the vagina of a pregnant woman with candidiasis, especially with isthmic-cervical insufficiency, can “melt” the lower pole of the amniotic sac and lead to rupture of amniotic fluid, which means miscarriage or premature birth.

Second mandatory analysis- This cytological examination. Cytological examination examines the structural features of the cells of the surface and canal of the cervix. A smear for cytological examination is taken with a special instrument - a spatula or brush. This analysis is very important for identifying various cancers at the earliest stages. And during pregnancy, it is simply necessary, because pregnancy aggravates the course of these diseases. Often another cytological smear is taken from the vaginal vault. This analysis allows you to assess the hormonal status of a woman, predict the threat of miscarriage or disturbances in the uteroplacental blood flow.

IN recent years In the vast majority of antenatal clinics, pregnant women are screened for sexually transmitted infections ( STI). Most often, these tests are taken not on the first visit, but during a repeat examination in the chair. The analysis is taken from the cervical and urethra on several glasses or in a test tube, depending on the method of diagnosing infections. If your antenatal clinic is not able to do such a test, check with your doctor where it can be done and at what stage of pregnancy it is safe. STIs must be treated, as primary placental insufficiency can form, which indirectly leads to fetal hypoxia. Thus, the child may die from lack of oxygen while still in the mother’s stomach.

Smart hands

The mirror can finally be taken out. You need to push and open up while removing it, then it will go away easily and painlessly. After examination using speculum, a two-manual vaginal examination is usually performed to determine the size, position and condition of the uterus, fallopian tubes, and ovaries. First, the doctor spreads the labia majora, and then carefully inserts the index and middle fingers of the right hand into the vagina. The doctor places his left hand on your stomach. Your hands lie on your chest, you do not look at the doctor, breathe deeply and calmly. First, the condition of the vagina is assessed: the width of the lumen and the extensibility of the walls, the presence of scars, tumors, septa, and other pathological conditions that can affect the course of pregnancy and childbirth.

Then the doctor finds the cervix and determines its shape, size, consistency, and location. So, during a normal pregnancy, the cervix is ​​tilted back, its length is more than two centimeters, it feels dense to the touch, and the canal is not passable for a finger. When there is a threat of miscarriage, the cervix shortens, softens, moves toward the center, and the canal opens. It should be noted that an experienced doctor only needs to touch the cervix to evaluate it. The doctor will not specifically examine the patency of the cervical canal during a premature pregnancy, so as not to provoke a miscarriage or premature birth. A simple touch to the cervix does not provoke a miscarriage; during normal sexual intercourse, the “load” on this organ is tens of times higher than during examination. Information about the condition of the cervix obtained by the doctor during the first examination is a sample for subsequent comparison. After all, every woman is individual. And what for one is a clear sign threats of interruption, for another - the norm.

Next, the uterus is palpated. The size of the uterus most often exactly corresponds to the gestational age, but it may be greater if a woman suffers from uterine fibroids, is carrying her third or fourth pregnancy, is expecting twins, or less due to a combination of pregnancy and some gynecological diseases. In addition to size, the doctor pays attention to the consistency and shape of the uterus. The uterus during pregnancy is softer than a non-pregnant one; the part of the uterus close to the cervix (the so-called isthmus) becomes especially soft. Irregularities on the uterus may be a sign of abnormal development of the uterus or the presence of fibroids. For a short period of time, the uterus is mobile and occupies a middle position in the pelvis. If its mobility is limited or it is deviated to the side, then this is most often associated with adhesions or inflammatory disease of the uterine appendages.

After examining the uterus, the doctor will definitely check the appendages - the ovaries and fallopian tubes. In the early stages, this is especially important to exclude ectopic pregnancy. Examination during an ectopic pregnancy is sharply painful. In addition to ectopic pregnancy, an enlargement of one of the ovaries is often determined due to corpus luteum(education that provides hormonal support for pregnancy early). This condition requires repeated examination and observation.

At the end of the study, the inner surface of the sacrum, symphysis and lateral walls of the pelvis is felt. Palpation of the pelvis allows one to identify deformation of its bones and make a diagnosis of anatomical narrowing of the pelvis. This information will become especially necessary during childbirth.

How often?

Pregnancy is a long process, and your condition may change significantly over time. Therefore, the study must be repeated periodically. For example, isthmic-cervical insufficiency can be recognized in time only if, during regular visits to the antenatal clinic, the doctor examines the woman in a chair. This condition is painless and may not affect your well-being in any way. With it, the cervix gradually shortens and opens slightly, the lower pole of the fertilized egg becomes infected, the membranes lose their strength, and rupture occurs amniotic fluid and miscarriage. If you have been informed of such a diagnosis, do not be alarmed, the main thing is to take action in time. Pathology of the cervical canal is “removed” both surgically and conservatively. Your doctor will determine which method is right for you. Typically, to monitor the condition of the cervix and analyze a smear for flora, the study is carried out at 20, 28, 32, 36 weeks of pregnancy. This is if nothing worries you, and the initial examination did not reveal any pathology. The doctor must see you if you complain of abdominal pain or a change in the nature of the discharge. In addition, after completing the course of treatment there should also be a follow-up examination.

Every woman knows about the need to visit a gynecologist at least once a year (more often if there are any symptoms that cause concern). But in fact, there are very few women who adhere to this rule! But if you are pregnant, then you absolutely need to visit this specialist, despite all your fears and “dislike” for this doctor! Remember that we are talking about your health small miracle, and of course about yours too.

Preparing for your appointment

Let's look at what features examination by a gynecologist during pregnancy. Let's start with preparing for a visit to the doctor. There are several rules that a woman going to an antenatal clinic (GC) must adhere to:

1. Be sure to empty your bowels and bladder! Thanks to this, you will not feel discomfort or pain during the examination, and the gynecologist will not have any difficulty conducting a palpation examination.
2. The day before visiting a doctor, you should avoid vaginal sexual intercourse, since a small amount of sperm or lubricant may remain in the vagina, which will distort the test results (smears).
3. When going to the residential complex, take a refreshing shower (it is not advisable to take a bath) and put on clean underwear. It is strictly not recommended to thoroughly wash and douche before taking smears for flora, since the test result will not show the true picture of your vaginal environment. You should also not use intimate deodorants.

Take with you a disposable gynecological kit (preferably with glasses and mirrors). True, if you go to a paid clinic, then such a need will not arise - as a rule, in such institutions everything is provided on site.

In addition to everything, it is very important to prepare yourself psychologically for an appointment with a gynecologist! You must understand that such a visit cannot be avoided in any case, and that all the questions asked by the doctor are not mere curiosity, but serve as the main source for recreating the overall picture of your health. Based on the data received, the doctor will decide whether you need to prescribe or consult with highly specialized specialists. Also, subject to your frank communication, the doctor will be able to answer all your questions.

Progress of the examination

To conduct a gynecological examination, a woman is asked to sit in a special gynecological chair with her legs on the footrests. Before the examination, the doctor thoroughly washes his hands with a disinfectant and puts on sterile latex gloves.

A gynecological examination begins with an examination of the woman’s vulva (external genitalia). Next, the condition of the vaginal walls is determined, it is determined whether there is pain when pressing on them and whether the walls are drooping.

After examining the external genital organs, the gynecologist proceeds to examine internal organs. The main method for diagnosing the condition of the internal genital organs is their examination using gynecological speculum. This examination has the main goal of identifying (or absence of) vaginal diseases or lesions of the cervix. During an examination using mirrors, the gynecologist assesses the condition of the vaginal walls, examines the cervix (determines whether there are scars, erosions, tears on it), identifies whether the woman has endometriosis (overgrowth of the uterine endometrium), and also studies the nature of vaginal discharge ( their quantity, color, smell). During such an examination, the doctor takes samples of vaginal material (so-called smears) to conduct a study on the nature of the vaginal microflora, for a cytological examination of cervical discharge (in order to identify cells indicating cancer).

After examination with mirrors, the gynecologist will conduct a palpation (manual) examination of the vagina. This diagnostic method will determine the size, position, structure and general condition of the uterus, ovaries and fallopian (fallopian) tubes. Thanks to palpation, one can suspect inflammation of the appendages (adnexitis), uterine fibroids, cysts on the ovaries (PCOS, polycystic ovary syndrome) in a woman, and also determine whether it is uterine or ectopic pregnancy. It should be noted that important indicator palpation of the uterus reveals its soreness. Normally, the uterus is absolutely painless and the woman will not feel any discomfort during examination. Soreness of the uterus manifests itself in various disorders, such as various inflammations (including chronic ones), fibroids and some others. After palpating the uterus, the doctor will conduct a manual examination of its appendages in order to identify any deviations from the normal structure and identify neoplasms, such as adhesions or ovarian tumors. This will complete the vaginal examination by the gynecologist.

Gynecological examination during pregnancy

For the entire pregnancy, starting from the moment of your registration, a gynecological (vaginal) examination and examination by a gynecologist you will be asked several times:

1. At the time of the first visit to the gynecologist (usually this coincides with registration);
2. At the 30th week of pregnancy, before taking maternity leave, smears are taken for vaginal flora, cytology and sensitivity to antibiotics;
3. At the 38th – 40th week of pregnancy in order to determine the readiness of the cervix for the upcoming birth.

An additional gynecological examination may be necessary if the development of infectious diseases is suspected, the symptoms of which may be discomfort in the genital tract, pathological vaginal discharge, itching and rashes on the genitals. Also a direct indication for examination by a gynecologist during pregnancy is the appearance of bleeding and slight bloody discharge from the woman’s genital tract.

Gynecological examination during childbirth

As mentioned above, at 38–40 weeks a woman undergoes a gynecological examination to determine the condition of the cervix and its degree of maturity, thereby determining how ready the body is for the onset of labor. The cervix is ​​considered ready for childbirth when it becomes soft, it shortens (its length does not exceed 2 cm), a finger quietly enters the cervical canal, the cervix is ​​located in the area of ​​the center of the small pelvis (that is, centered).

A vaginal examination performed during childbirth allows you to accurately determine which part of the body (head or pelvis) the baby is moving along the maternal birth canal, and also allows you to observe the dynamics of changes in the condition of the birth canal itself and the process of dilatation of the cervix. A prerequisite for such an examination is to prevent pathogenic bacteria from entering the vagina and uterus, so as not to cause postpartum complications.

Two more points that can be clarified during a gynecological examination during childbirth are the state of the amniotic sac (its integrity, water content and quantity) and the degree of smoothness (no changes, shortening, smoothness) of the cervix and the indicator (in centimeters) of dilation uterine pharynx (full dilatation is from 10 to 13 centimeters) and the condition of its edges (thickness - thick or thin - and structure - dense or soft).

A gynecological examination of the vagina is performed several times during childbirth:

• upon admission of a woman in labor to the maternity ward (or maternity hospital), and then every three to four hours of labor;
• after discharge (discharge) of amniotic fluid (as well as after puncture of the amniotic sac);
• when a woman experiences pushing (pushing resembles the urge to have a bowel movement);
• if any abnormalities occur during childbirth (such as weakness of labor - may be necessary; bleeding - may be necessary C-section; deterioration of the condition of the mother or child - a perineal incision (or episiotomy) may be necessary to speed up the birth of the baby; etc.).

Immediately after the final stage of labor - the birth of the placenta - the cervix is ​​examined using special instruments - spoon-shaped mirrors. When these mirrors are inserted, the woman in labor may experience some discomfort. When examining the cervix, its integrity is established (if necessary, sutures are applied), then the same is done with the vagina and perineum. If it is necessary to restore tissue integrity, anesthesia is required (local or general anesthesia, at the discretion of the doctor).

In conclusion, I would like to say that a well-executed inspection with an experienced and highly qualified gynecologist - the procedure is safe and painless! Therefore, if you completely trust the doctor you choose, a gynecological examination should not leave you with any unpleasant memories!

If you suspect you are pregnant, the very first thing you need to do is go to a gynecologist, because a timely visit to a gynecologist will save you and your baby from many problems and complications. An examination by a gynecologist in the early stages of pregnancy is a responsible undertaking, and it must be taken with complete seriousness, especially if the visit to the doctor will be your first.

So, the first visit to the antenatal doctor should take place before 12 weeks, and if you are wondering how a gynecologist determines pregnancy in the early stages, then it will be an ultrasound. This procedure will either confirm the pregnancy or deny it. An ultrasound is also necessary to rule out the possibility of an ectopic pregnancy.

Read in this article

First inspection

The first examination by a gynecologist in the early stages of pregnancy will begin with an examination. The doctor will determine whether she is hypertonic, whether you have a cyst or ovarian fibroids. You will also be sent for urine and blood tests.

More difficult challenges await women who have chronic illnesses, such as heart and kidney defects. Those at risk are those suffering from heart pathologies and kidney dysfunction, because during pregnancy the load on these organs increases.

There is an opinion that examination in a chair in the early stages of pregnancy can be very, very harmful, but this is nothing more than a stereotype. If you find a good doctor who takes a careful look, this will in no way harm the pregnancy. In view of this, there is no need to go to an unfamiliar doctor while pregnant. It's better to go to the doctor you know well. There are many insensitive doctors who can hurt the patient and cause her great stress.

An examination by a gynecologist in the very early stages of pregnancy will include many questions, including about the health, age, and heredity of the father of the unborn child. The doctor will be especially interested in whether the baby's father has chronic diseases, such as diabetes or heart disease. The doctor will probably be interested in whether you and your father have a future child. bad habits, where you work, what kind of housing you have and your level of material wealth. He will also ask about the onset of sexual activity, your first period, and your lifestyle. All this will not be idle curiosity, but absolutely necessary data that will allow you to predict the course of pregnancy and prevent some complications.

Do not hesitate to answer all questions in detail and accurately, because your life and health with your baby are on the map. You should also be sure to ask your doctor all the questions you are interested in, no matter how stupid or ridiculous they may seem to you. The more you know about pregnancy, the easier and more comfortable it will be.

After your appointment, you will be absolutely prescribed a course that will saturate your body with all the necessary elements and make adjustments. In addition, you will be referred for a number of tests.

Weight and height measurement

Typically, a gynecological examination in early pregnancy includes measuring height and weight. If a woman has an asthenic build, then her metabolism will be fast. Women of this type have narrow hips and chest, long and thin muscles. An asthenic body type involves a fairly large weight gain.

The narmosthenic type of build is characterized by an average rate of metabolic processes. Women of this build are allowed to gain up to 9 kg throughout pregnancy. Such women will have broad shoulders, small rib cage, waist, shoulders and hips are approximately the same width.

If a woman has a hypersthenic type of build, then she will be prone to being overweight. Such women usually have a round face, wide hips, extra pounds. It is better for them to gain no more than 7 kg during the entire pregnancy. Using a special pelvic meter, the doctor will measure the size of your waist and pelvis.

What tests need to be done

Ideally, all necessary tests and examinations should be done at the pregnancy planning stage. However, if for some reason you did not do them, then, if you find yourself in an interesting situation, you should immediately go to the clinic. Based on the test results, the doctor will assess your health level, and, if necessary, appropriate measures will be taken in a timely manner.

• Before going for an examination in the early stages of pregnancy, you should do this. This is the most common analysis. During pregnancy, it will have to be done almost every 2 weeks. And if there are any serious health problems, then more often.
• If signs of pregnancy are obvious during examination, it is also worth taking a blood test from a vein. This is done in order to establish the absence of sexually transmitted diseases, as well as to determine the blood type and Rh factor.
• If signs of pregnancy are noticeable in gynecology, then it’s time to donate blood from your finger. This is done in order to determine the level of hemoglobin, which is an oxygen carrier. If the hemoglobin level is critically low, this can have a detrimental effect on your condition and the condition of the child. In addition, a finger prick blood test will show the presence of antibodies to rubella and other TORCH infections in the blood.

You will also need to go:

• to the lore;
• neurologist;
• ophthalmologist;
• therapist.

These events are purely formal, however, absolutely necessary. You will have to undergo a standard medical examination three times: at the beginning, middle and end of pregnancy.

What to take with you to your first visit to the doctor

The first examination by a gynecologist in the very early stages of pregnancy will be an exciting event, even if visiting a gynecologist is not new to you.

The first thing you need to put in your purse is your insurance policy and passport. Of course, it is worth taking with you the results of tests and examinations, as well as extracts from your medical history. All this useful information is usually collected in a medical record stored in a clinic at the place of residence or at home. Once you are registered, you will be issued a new card.

It’s good to take a towel or diaper with you to lay on the chair. Socks will be needed to avoid walking barefoot on the floor.

Pregnant women often become absent-minded, so a notebook and pen where you can write down the doctor's recommendations will not be superfluous.

For inspection at medical institutions In the early stages of pregnancy, some women come with their own disposable gynecological kit and gloves, which are sold at the pharmacy. But there is no need for this, because gynecological offices today are equipped with everything necessary.

How is the first visit going?

Many women are interested in whether the gynecologist sees early pregnancy. As a rule, the answer to this question will be in the affirmative.

The first examination by a doctor in early pregnancy will take place in a chair. The doctor will look using his hands and a mirror. If pregnancy is diagnosed, there will be no more chairside examinations. Subsequently, the doctor will only palpate the abdomen on the couch without penetrating the vagina. During the appointment, the gynecologist will take a smear on the flora and determine the condition of the vagina, uterus, and appendages.

If it is difficult for a doctor to determine pregnancy in the early stages in a chair, then you will have to do an ultrasound, which will allow you to accurately diagnose the interesting position or its absence.

Is it possible to identify an interesting situation in the early stages?

It is clear that women are usually interested in whether a gynecologist can determine pregnancy in the early stages. The situation varies. A very experienced doctor can diagnose it by changes in the color of the vaginal mucosa. In addition, in pregnant women, the uterus contracts when palpated. Even in the early stages it is already greatly increased in size. However, at 4-5 weeks or less, only a doctor with extensive experience and talent can diagnose pregnancy. Usually it is determined manually no earlier than 6-7 weeks.

So, whether a gynecologist sees an early pregnancy will directly depend on his professionalism and work experience.

If you are wondering how a gynecologist determines pregnancy in the early stages, then for the most part he does this based on the general condition of the body, and ultrasound and tests confirm or refute his diagnosis.

The fastest and in an efficient way Diagnosis will be carried out by urine analysis, which must contain an increased amount of gonadotropin hormones.

How to determine an interesting position yourself

You can identify an interesting situation before or after the delay yourself. Its signs may be:

• increased;
• and nipples;
• positive test results;
• pain in the lower abdomen and its enlargement;
• absence of menstruation;
• a large amount of colorless discharge.

The first visit to a female doctor in an interesting situation is in many ways purely formal, especially if the gynecological signs of pregnancy are already obvious. However, it is in the initial stages that various deviations and inflammatory processes can occur, which can be completely invisible. The sooner health problems are identified, the better, of course. Therefore, you should not worry or be nervous. As soon as you think you are pregnant, immediately run to a antenatal doctor to protect yourself and your baby in the future and become a happy mother.

One morning, waking up with nausea or noticing atypical gastronomic preferences, a woman, of course, begins to suspect something is “off” - a possible pregnancy. But since representatives of the fair sex are famous for their excessive impressionability and “talent” for wishful thinking, one of the right ways confirm or refute assumptions - go to an appointment with a gynecologist.

Determining pregnancy in the early stages

By the way, the well-known morning sickness, tearfulness, moodiness, and salty cravings cannot be reliable signs of pregnancy. We can say that these are possible (but not at all obligatory) companions of a woman’s new state, when the new life. But the following will help determine exactly what conception has occurred:

• pregnancy test;
.

A competent specialist is able to recognize an existing pregnancy at a very short time (about 4-5 weeks from the date of the last menstruation), but here’s how he does it - below.

How is the first examination by a gynecologist during pregnancy?

Many of us are wary of doctors and are downright afraid, but a gynecologist is the specialist that any woman, and especially expectant mother, should not be ignored. Therefore, for any problems with women's health and if you suspect an interesting situation, you should not postpone a visit to the gynecological office.

Important: when visiting a antenatal clinic for the first time in for a long time do not forget to take with you the required package of documents (passport, compulsory medical insurance policy and SNILS), as well as a disposable diaper and a disposable sterile set of gynecological instruments. If you are visiting the residential complex for the first time, they will give you a card at the reception desk, and only then they will direct you to the doctor’s office.

So let's say you're at a doctor's appointment. What's next? The specialist will definitely ask about the purpose of your visit, listen to all your complaints and suspicions, collect anamnesis (number of sexual partners, duration of sexual activity, number of pregnancies and surgical abortions, whether there were births and which of them ended successfully, whether there are chronic diseases, etc. ). Then the doctor will ask you to go to the chair.

It is a very common belief that in the early stages of pregnancy, a gynecological examination can cause complications, since the very fragile fertilized egg can be damaged during the manipulations of a specialist. There is no clear opinion on this matter; some gynecologists advise to abstain and themselves dissuade from examination in a chair, offering other diagnostic methods.

But let’s say this: an experienced and qualified specialist can not only determine the presence of a fertilized egg in the uterus in a very short period of time, but also conduct a high-quality examination without any complications in the future. By the way, sexual intercourse during pregnancy has a much greater impact on the cervix and the organ as a whole than the doctor’s manipulations during examination.

What does the doctor do during an examination in the chair:

takes samples for research for the presence of sexually transmitted infections and possible pathological changes in the reproductive system (flora smear and cytological smear);

• assesses the nature of vaginal discharge;
• assesses the condition of the external genitalia and anus;
• examines the condition of the vagina and cervix using gynecological instruments;
• performs palpation (palpation) of the uterus to assess possible changes.

After the examination, the specialist can confirm or refute suspicions of pregnancy or prescribe additional tests. If the period is long enough to reliably determine the fertilized egg in the uterus and its approximate “age,” then the gynecologist will begin the procedure, create a personal one, prescribe a series of tests and a routine examination of a number of specialists.

Visiting specialists is a mandatory step when registering. A complete examination of the expectant mother will allow her to detect health problems in time and take the necessary measures. If a woman planned a pregnancy and prepared for it in advance (cured existing diseases, solved the problem of chronic diseases, got her teeth in order, etc.) or is relatively healthy, then, as a rule, no problems arise during the examination. The whole procedure happens quite quickly.

How does a doctor determine pregnancy during examination?

An examination on a chair allows the specialist to obtain almost complete information about the changes in a woman’s body due to pregnancy. Almost immediately after the attachment of the fertilized egg (implantation), multiple processes are launched that adjust the mother’s body to the new “mission”. Some changes may be noticeable during a gynecological examination.

What does the doctor pay attention to:

• condition of the external genitalia. The vulva of a pregnant woman, due to increased blood flow, acquires a blue-violet tint and appears somewhat swollen;
• vagina and cervix also undergo changes with the onset of pregnancy. The neck softens and becomes mobile when subjected to mechanical action;
• the most obvious changes affect the uterus, which becomes soft, pliable, takes on a spherical shape, the walls of the uterus are filled with blood, and it itself is defined as increased in size. During a manual examination, a specialist may notice an asymmetry of the organ due to the location of the fertilized egg on one side, and already from 8 weeks to obstetric period the uterus may respond to manipulation with small contractions.

However, an examination by a gynecologist in early pregnancy may not bring any results if the woman came to the appointment too early, for example, before the delay. Since all changes in the mother’s body occur after implantation of the fertilized egg (this is approximately 7-10 days after conception), when visiting a gynecologist’s office until this point, even the most experienced doctor will not be able to recognize the presence of pregnancy in a woman.

By the way, gynecologists are skeptical about positive pregnancy test results and consider this an unreliable sign, which can cause confusion among patients. But, nevertheless, if you have recent test strips with a positive result (even if the second strip is barely visible), take them with you and show your doctor.

This mistrust of rapid tests is understandable.

Firstly, The test does not always show a positive result because you are pregnant. The hCG marker to which the test strips are sensitive can be produced by some tumors. Therefore, if there are no other reliable signs of pregnancy, the specialist will prescribe other tests to make an accurate diagnosis.

Secondly, sometimes that same female “talent” plays a role in seeing what is not really there: some women who dream of a child can “see” a phantom second stripe (barely noticeable, according to them), which in fact does not exist. And this happens.

Additional research methods

In some cases, a number of additional studies may be required to confirm pregnancy, because the gynecologist is not always able to identify pregnancy, especially if the period is still very short. In this case, they rush to help the doctor:

• ultrasound examination;
• biochemical blood test for human chorionic gonadotropin.

Contrary to popular belief, early ultrasound is absolutely safe for both the expectant mother and the developing embryo. In the first 2-3 weeks after conception, an ultrasound sensor will not be able to detect the baby in the uterine cavity due to its tiny size, but structural changes in the organ will be visible, which may be one of the signs of a woman’s new position.

An ultrasound specialist will be able to easily determine the fertilized egg in the uterus at 5-6 weeks of obstetric time. Also this study to the expectant mother will have to go through at least three more times: during mandatory ultrasound screenings in each of the three trimesters.

Another way to find out about pregnancy even before a missed period is with a blood test for hCG. It can be done independently in a private laboratory if desired, or by referral from a gynecologist in the same private or public laboratory at an antenatal clinic.

Frequency of examinations and visits to the doctor during pregnancy

As soon as a woman registers, she becomes a regular visitor to the antenatal clinic. This is mainly due to the need to provide inspection results narrow specialists to the doctor leading the pregnancy, passing the necessary tests and periodically assessing the condition of the expectant mother.

But a gynecological examination during pregnancy during a regular visit to a specialist’s office is by no means a mandatory procedure. During the entire period of bearing the baby, the woman sits on the examination chair several times (no more than 3-4), provided that the pregnancy is proceeding normally. Naturally, if the need arises, this will have to be done more often to control the baby’s condition.

The frequency of visits to the gynecologist’s office increases as your tummy grows: if until the end of the second trimester you are welcome to see you about once a month, then when you go on maternity leave, the frequency of visits will increase to once a week. You need to “check in” weekly with your pregnancy doctor some time before giving birth, starting from the 36th week of gestation.

4. Does every specialist appointment end with an examination on the chair?

No, if a pregnant woman visits a doctor on time and does not have any abnormalities, then the gynecologist sees her no more than 3-4 times in the entire 9 months.

A gynecological manual examination cannot be called a pleasant procedure: the woman feels some physical discomfort, feels shy and feels constrained (especially if the doctor is a man). If you take this calmly and prepare in advance (take a hygienic shower, take necessary tools and a diaper), then the inspection process should not cause negative emotions.