The purpose of the gynaecological examination is to understand the health of the vulva, vagina, cervix, uterus, ovaries and fallopian tubes of the pregnant mother to determine whether it is suitable for pregnancy and childbirth. Gynecological examinations often find abnormal problems or diseases that are easily overlooked daily, such as vaginitis, cervicitis and some common gynecological diseases, such as uterine fibroids, cervical lesions, etc., and even rare genital malformations may also be found.
During the examination, pregnant mothers should pay attention to the bladder should be completely empty before the examination; in order not to affect the inspection of vaginal cleanliness, do not clean the vagina before the examination; because the speculum needs to be used to open the vagina, so be sure to relax as much as possible during the examination The doctor in the examination room should put the finger in the rectum. At this time, fully cooperate with the doctor, take a deep breath and do the action of lowering the bowel movement at the same time.
Routine inspection method
- Speculum examination: placing a vaginal speculum, observing the mucosa of the anterior, posterior, and lateral vaginal; the amount, nature, color, and odor of vaginal secretions; observing the size, color, and shape of the cervix, No erosion, polyps, tears, cysts, etc.
- Double-consultation examination: The doctor puts the middle finger and index finger of one hand into the vagina of the examinee, and the other hand is placed above the pubic symphysis and pressurizes the deep part, which is the most important item in the pelvic examination. Knowing the position, size, shape, texture and activity of the uterus, vaginal conditions, can further understand the situation of bilateral fallopian tubes.
- Triad examination: a joint examination of abdomen, vagina and rectum. The purpose was to understand the size of the posterior uterus and to find the posterior wall of the uterus, ligaments and bilateral pelvic lesions.
- vaginal cleanliness: normal adult women will secrete a small amount of white sticky secretions called vaginal discharge. Leucorrhea is a mixture of vaginal mucosal secretions, cervical glands and endometrial secretions, which contain more epithelial cells, vaginal bacteria [to help maintain vaginal pH (pH 4 ~ 4.5)], but also a small amount of white blood cells Occasionally, a small amount of red blood cells. The amount and composition are related to estrogen levels and vary with age and menstrual cycle. When the genital tract develops inflammation or the tumor is secondary to infection, the leucorrhea will undergo abnormal changes in color, quality and quantity. Vaginal secretion examination refers to microscopy of vaginal discharge smear, including the cleanliness of vaginal secretions and the detection of trichomoniasis, fungi, and gonorrhea.
Vaginal cleanliness is an indicator of the presence or absence of inflammation in the vagina and helps to understand the endocrine function of the ovaries. The examination method is to take the vaginal secretions under the microscope and compare the cleanliness with the number of vaginal bacteria, epithelial cells and pus cells. I to II degrees are normal, and III to IV degrees are not clean. Unclean conditions are mostly caused by vaginitis, or caused by pathogens, vaginal mold or vaginal trichomoniasis.
Routine check -- initial prenatal checkup
When you are pregnant, you should go to the hospital as soon as possible to establish a pregnancy health file (manual or card)
The contents of the initial inspection are:
Consultation:
1, the general situation of pregnant women: age, pregnancy (the first few pregnancy), birth times (have been delivered several times), menarche, menstrual cycle, menstrual flow, last menstruation, previous menstruation.
2, whether it is exposed to toxic and hazardous substances, such as: mercury, lead, benzene
3. Have you ever suffered from serious diseases such as hepatitis, tuberculosis, heart, lung, kidney, brain disease, high blood pressure, diabetes, etc., have you ever had surgery?
4. Whether there is a history of genetic disease in the family, a history of twins, a history of cancer
an examination:
1, full physical examination: blood pressure, pulse, height, weight, heart and lung, liver and spleen and other systemic physical examination
2, gynecological examination
3, routine examination of hematuria
4, serological examination: hepatitis A, hepatitis C virus, TORCH (see later), syphilis, AIDS check, alpha-fetoprotein.
5, some people need to do more checks, B ultrasound, ECG, blood glucose check, etc.
Special examination -- genetic diagnosis of villus chromosome examination (see prenatal diagnosis in the second trimester)
Expert Tips : Vaccine
Vaccines available during pregnancy: tetanus vaccine, rabies vaccine, hepatitis B vaccine, and JE vaccine.
Vaccines that are banned during pregnancy: live vaccines. Such as chickenpox, rubella, measles, mumps and other viral attenuated live vaccines and oral polio vaccine, pertussis vaccine. And a larger vaccine for systemic reactions.