Gynecological Examinations

Gynecological Examinations

1. External Genitalia:

• Includes visible parts from the outside: vulva and vagina.

2. Vaginal pH:

• Normal pH: Slightly acidic (4.2 – 5.4).

• Vaginal environment becomes alkaline when pH > 5.5.

• Vaginal cleanliness depends on the concentration of different types of bacteria, with Doderlein’s bacillus playing a crucial role in vaginal cleanliness assessment.

3. Vaginal Cleanliness Examination:

• Most effective method for cervical cancer screening: Vaginal smear for cancer cells.

• Characteristics of cervical mucus during ovulation: Clear, abundant discharge, thick, stringy.

4. Hysteroscopy:

• Two main purposes: Diagnosis and intervention.

• Best time for hysterosalpingography: After menstruation.

• Path of contrast medium in hysterosalpingography: Uterus => 2 fallopian tubes => uterus afterwards.

• Significance of hysterosalpingography (Cotte):

• Cotte (+): Fallopian tubes are open.

• Cotte (-): Fallopian tubes are blocked.

5. Gynecological Cancer:

• Gynecological cancer with the highest mortality rate: Breast cancer.

• Advantage of breast ultrasound: Detecting cystic lesions.

6. Organs Examined in Gynecology:

• Includes:

• External genitalia

• Uterus

• Breasts

• Hormones: Prolactin, FSH, LH, …

7. Fetal Distress:

• Color of amniotic fluid in fetal distress: Green (with meconium) => White cloudy amniotic fluid like rice water.

8. Amniocentesis:

• Timing of amniocentesis:

• Early stage: Week 16 – 17.

• Late stage: > 24 weeks.

9. hCG Testing:

• hCG/urine quantification: Normal pregnancy.

• Beta hCG/serum quantification: Abnormal pregnancy.

10. AFP/Amniotic Fluid:

• Elevated AFP/amniotic fluid in cases of:

• Primary liver cancer.

• Spina bifida.

11. Fetal Ultrasound:

• Detecting the number of placentas in which stage: First trimester ultrasound (week 13).

• Role of ultrasound in guiding prenatal diagnostic examinations:

• Amniocentesis, cordocentesis.

• Placental biopsy.

12. Obstetric Monitoring:

• 5 key factors in CTG: Baseline variability – fetal heart rate baseline – tachycardia – bradycardia – contractions.

• Obstetric examinations:

• Amniotic fluid analysis, amniocentesis.

• Biochemical testing.

• Ultrasound.

• Obstetric monitoring.

• Purpose of obstetric monitoring: Detecting abnormalities in fetal heart rate & uterine contractions during labor.

13. Fetal Heart Rate Baseline:

• Acceptable range: 120 – 160 bpm.

• Average value: 140 bpm.

14. Baseline Variability:

• Normal value: 5 – 10 bpm.

• Classification of baseline variability:

• 1: < 5 beats/minute.

• 2: 5 – 10 beats/minute.

• 3: 10 – 25 beats/minute.

• 4: > 25 beats/minute.

15. Uterine Contractions:

• Normal frequency of contractions: < 3 contractions/10 minutes.