
It’s no secret that many women, getting ready for the gynecologist, feel a sense of uncertainty or even fear. For them, stress, because it is a very delicate matter. Some women, because of shyness shy even to talk to your doctor about your problems, but there still has to undergo examination.
The situation is compounded by the fact that the patient does not know or understand what those needs or other research, and doctors once, explain, reassure them, "decrypt" incomprehensible and frightening medical terms.
So, you came to see the gynecologist. The doctor first will talk to you, hear complaints, ask questions that may seem irrelevant, even outrageous, but these "insignificant" trifles, often help the clinician in diagnosis, since many diseases are linked to conditions of life, work, migrated stress, etc. At the reception at the gynecologist is not so shameful. Everything that you tell your doctor to remain in the walls of the cabinet. The data obtained during a conversation, allow the doctor to determine the direction of research, to choose methods of diagnosis. Therefore we must candidly answer the questions, because the success of the mutual cooperation.
After the conversation, usually requires examination. Somatotype, the nature of fatty deposits, the distribution and amount of hair on the body, especially the exterior of a doctor can tell a lot about the problems of the patient. Example of hormonal changes, chronic diseases. This examination is conducted, usually not noticeable to the patient at a time when a woman enters the room, while preparing for the study.
Do not be surprised if the gynecologist ask to show breasts. They are part of the reproductive system and its diseases are the responsibility of not only the doctor mammologist, but also a gynecologist. Study of breast allows the diagnosis of mastitis, suspected cancer, and even determine the cause of infertility.
Survey on Gynecological chair doctor begins with inspection of the external genitalia. Next comes the examination in the mirror. Special tools called mirrors, allows to view the wall of the vagina and cervix. If this reveals any deviation from the norm, there is a need to take fluids genital tract in the study. The easiest and most affordable method, it is used in any women’s clinic and the clinic is a smear on the flora. Special spoons take the discharge from the canal of the cervix, vagina and urethra and cause the glass. Laboratory doctor examines the material under a microscope. Using this method can detect the presence of an inflammatory process (it will measure the number of white blood cells), the state of the epithelium (mucosa), target organ, to identify certain types of infection (fungal, candidiasis, gonorrhea, trichomoniasis, bacterial vaginosis). In some cases, these microscopic smears are not sufficient for diagnosis and therapy, then resorted to the method of polymerase chain reaction (PCR) or immuno-enzyme analysis (ELISA). The capture of material for study by PCR by using miniershika, which is injected into the cervical canal, with the epithelial cells and bacteria contained therein remain on its bristles. The method consists in finding the genetic material of the causative agent of an infectious process. The reliability of PCR is 99%. These methods (PCR, ELISA) used for the diagnosis of specific infections such as chlamydia, mycoplasmosis, ureaplasmosis, gardnerellez, papillomatosis, cytomegalovirus and herpes infections.
Sometimes, often in the identification of viral infection, is required to determine in what form – acute or chronic – disease occurs in the patient. Then determine the blood titer (level) of antibodies to the infection (by ELISA). ELISA method is based on the interaction of antibodies and antigens. Antibodies – a substance produced by the body for protection against pathogenic factors (eg, microbes). Antigens – it ourselves microbes. As antibody, as well as to any class of antibodies detected, can judge the limitations of the process.
In protracted and repetitive processes doctor may prescribe sowing on the flora and sensitivity to antibiotics. The material from the vagina or cervical canal is placed in a nutrient medium on which bacteria grow, and then determine the most effective antibacterial agents.
Since no analysis is not 100% certainty, doctors often prescribe and seeding, and PCR, and ELISA, and smear on the flora at the same time. Obtained on the basis of several studies information is more reliable and helps to make an exact diagnosis.
If you suspect a cervical pathology spend colposcopy – examination of the cervix under a microscope. With this method it is possible to identify cervical erosion, leukoplakia, papilomatoz, cancerous changes. If necessary, under the supervision of colposcopy, a biopsy taken (a small piece of tissue) of the amended section and send the material for histological examination.The fabric is treated with a special way and study under magnification. Histology provides the most accurate information about the state authority. If excluded oncology, for treatment of diseases of the cervix is often used methods that are based on a pathological fracture site, and after healing at this point formed the normal tissue. Such methods include diathermocoagulation ( "moxibustion"), laser effect (destruction of the pathological formation with a laser), cryodestruction ( "freezing" of the affected area), the use of acid solution ( "Solkovagin").
After inspection in the mirrors usually produce two-handed vaginal study. In this study, determine the size, position, state of the uterus, fallopian tubes and ovaries. With vaginal study diagnosed uterine fibroids, inflammation of the appendages, ovarian cysts, ectopic pregnancy, uterine pregnancy may be suspected endometriosis, and so on. If the study cast doubt on the accuracy of diagnosis appoint ultrasonography (U.S.). This method is one of the leading methods of investigation in gynecology. It is effective, harmless, allows to determine the state of internal organs without damaging the integrity of the organism. The method is based on the ability of different tissues in different ways to reflect the ultrasonic waves. When pathological changes in organs, the ability to change. With determine ultrasonic diagnosis of the functional state of the endometrium (uterine lining) and the ovaries, the size and location of bodies, clarify the diagnosis delivered in the previous study. Ultrasound technique is different and depends on the specific situation and diagnostic equipment cabinet. In transabdominal ultrasound investigations were carried out through the anterior abdominal wall during the filling of the bladder. The bladder pushes a loop of intestines, which contributes to better visibility of the uterus and ovaries. When transvaginal study sensor device is introduced into the vagina. This method is more progressive, it offers more opportunities for diagnosis. Sensor is almost directly in contact with the target organ, so there is no need to fill the bladder, the study is not hampered by obesity, adhesive process, the presence of scars on the anterior abdominal wall. But pregnant women at later stages of this method is contraindicated.
The human body is almost completely hormone. Many processes are subject to fluctuations in hormone levels. Determine the functional state of the reproductive system allows tests of functional diagnostics. These include measurement of basal temperature in the rectum, which varies depending on the phase of the menstrual cycle and is an indicator of the ovaries.However, the basal temperature does not always provide enough information about the hormonal status of the patient, and there is a need for hormonal studies. The level of some hormones, depending on the phase of the menstrual cycle, so they can take only on certain days. In a number of hormonal disorders is necessary to study the brain for which resort to computed tomography (CT), radiography of the skull. These studies provide insight on the state of the pituitary, which regulates the activity of many endocrine glands, including those that govern the reproductive system.
In addition to infertility investigations hormone levels determine patency of the fallopian tubes. When kimograficheskoy pertubatsii (method of identifying the functional state of the uterus and fallopian tubes) in the uterus, tubes and into the abdominal cavity of injected air or gas and graphically record the reduction of the fallopian tubes. Often requires an additional hysterosalpingography (GSG). In the uterus injected radiopaque substance, and then make an X-ray. When the Fallopian tubes of the substance enters the pipe and poured into the abdominal cavity – it will be seen in the picture. If the pipes are not passable, then the picture will be clear which department pipe struck. This is important in order to solve the problem of surgical treatment. If impassable final section tubes, then this situation can be corrected with surgery. It is now widely used laparoscopic surgery (in this case do, as a rule, three small puncture, which assume a video camera and instruments), such an operation is less traumatic and postoperative period was easy. If the pipe is not passable in the near to the uterus department, then eliminate this defect with the operation impossible. Such women offer ekstakorporalnoe fertilization (IVF), ie fertilization in vitro. In acute situations, in the differential diagnosis between ectopic pregnancy, ovarian appopleksiey (torn capsule of the ovary), and appendicitis – perform diagnostic laparoscopy, ie through a puncture in the abdominal wall introducing a video camera and examined the innards. If you find a pathological process producing operation. With GSG also diagnosed endometriosis of the uterus (adenomyosis), uterine cancer, uterine anomalies in the structure, isthmic-cervical insufficiency.
To identify intrauterine pathologic processes using hysteroscopy. It is introduced into the uterus manipulator with a video camera. With this method, you can see the canal of the cervix and uterus. This allows in some cases to avoid scraping, which is a traumatic procedure, or take a biopsy with only a suspicious area. Under the supervision of hysteroscopy may divide the intra-seam that prevent pregnancy, and even remove uterine myoma, which grows inside the cavity.
Women who had a history of miscarriages, non-developing pregnancy, birth of children with Disabilities, etc., displaying medical genetic research.
All pregnant women in establishing the fact of pregnancy necessarily measure the size of the pelvis special device tazomerom. It is very important information because narrowing pelvis birth vaginal possible and necessary cesarean section. Pronounced narrowing of the anomalies of the pelvis, suspected inadequate size of the pelvis and fetal head, a history of injuries of the pelvis, spend rentgenopelviometriyu, ie measurement of the pelvis through the X-ray image. Apply this technique at the end of pregnancy, when he was no longer dangerous to the fetus.Throughout the pregnancy, measured the height of the bottom of the uterus and abdominal circumference – it gives an indication of how to grow fruit, whether the size of the term of pregnancy. With this data you can calculate the estimated fetal weight.
A method by which to evaluate the condition of the fetus is cardiotocography. At the mother’s abdomen is placed sensors that detect fetal cardiac activity, its movement, uterine contractions.The device records the data in the form of the curve on which the judge on the state of the baby.
Pregnant women are advised on the age of 16 – 21 week of pregnancy to explore such an indicator as alpha-fetoprotein, which is an indicator of the nervous system of the fetus. To analyze the blood of the mother or take amniotic fluid. To study okolloplodnyh water resort that is suspected to any deviations in the fetus (genetic disorders, etc.), this involves an operation amniocentesis (amniocentesis).
Naturally, the problem of the relationship of patients to the gynecological examination is not solved a single article. But perhaps, after reading it, you’ll be able to talk with your doctor, better aware of the core problem. Dealing with a competent patient easier and communication is more productive. Hopefully, you will be going to the doctor, not only when a problem arises with health, but also as a prophylactic measure once every six months or a year. The full survey should take if you are thinking about the baby while you can avoid many problems in the future.The fact that the disease is easier to prevent than to treat everyone knows, but not all follow the truth.
Popularity: unranked [?]