How does the gynecologist know that you are pregnant? Clinical methods for determining pregnancy

Any married couple planning to conceive, noticing even small signs possible pregnancy, wants to ensure that their attempts are successful as quickly as possible, and new life was born. IN in this case You should not suffer from uncertainty or try to independently confirm the appearance of the baby: it is best to immediately contact antenatal clinic. A qualified obstetrician-gynecologist can reliably determine pregnancy based on some studies and a number of signs.

additionally Early diagnosis of conception is important not only for future parents, but also for the doctor: in the short term, you can accurately determine the number of weeks of the embryo and in the future accurately develop tactics for managing pregnancy and determining the date of birth.

Used to diagnose pregnancy several types of signs:

1. Presumptive;
2. Probable;
3. Reliable.

Presumable signs

Based on these signs, one can only assume the onset of conception, because they can also appear in a number of other pathological conditions:

1. Nausea and vomiting, especially in the morning ;
2. Changes in food preferences, changes in appetite;
3. Intolerance to certain odors;
4. Constant drowsiness;
5. Frequent mood swings, irritability, tearfulness;
6. , tendency to;
7. Breast changes(engorgement, soreness);
8. (appearance of spots on the face, nipples, stomach);
9. Abdominal enlargement(at a later date) .

Considering only presumptive signs, the doctor will not be able to reliably say about the presence of pregnancy, but will conduct additional research to confirm the diagnosis.

Possible signs

The doctor also determines pregnancy using probable signs, in the presence of which we can talk about conception as a very probable event. Much attention is allocated to a gynecological examination, because thanks to it, most of the characteristic features are determined.

Main probable signs:

1. Venous congestion of the genital organs. From the first days after conception, blood flow in the pelvic area increases significantly, which leads to a change appearance genitals. The labia, vaginal walls, and vaginal part of the cervix become swollen and cyanotic, which is easily determined by visual examination and examination in mirrors;
2. Changes in the size, shape and consistency of the uterus. The non-pregnant uterus is normally dense and has specific sizes And pear-shaped. In the presence of pregnancy, it softens, takes on a rounded shape and increases in size as the gestational age increases. Such changes in the uterus appear by 5-6 weeks of pregnancy; before this period, it is extremely difficult to predict conception based only on a bimanual examination;
3. Snegirev's symptom. The uterus becomes easily excitable: during a two-handed examination, it sharply contracts, decreases in size, and becomes denser. After examination, it quickly returns to its normal state;
4. Piskacek's sign. During a gynecological examination, asymmetry of the uterus is determined (one of the horns protrudes more), caused by the attachment of the embryo in the right or left horn. Gradually this sign disappears (usually by 7-8 weeks), and the uterus again takes on a rounded shape;
5. Horwitz-Hegar symptom. In the area of ​​the isthmus of the uterus, severe softening is observed: the tissues become so thin that the doctor practically does not feel them. The sign is typical for 4-6 weeks of pregnancy;
6. Gubarev-Gaus symptom. There is marked mobility of the cervix (presumably caused by softening of the isthmus);
7. Genter's symptom. As a result of softening of the isthmus, the uterus deviates strongly anteriorly, and a comb-like thickening is noted on its anterior surface. This feature not detected in all women;
8. Amenorrhea(absence of menstruation). Many patients believe that this is the most worthy sure sign conception has occurred, but this opinion is fundamentally wrong: menstruation may not begin as a result of a number of reasons far from pregnancy;
9. . With help special test You can determine pregnancy yourself at home. The method is based on determining the increased level of hCG, characteristic of conception, however, errors when performing tests are common, so it is impossible to reliably tell about pregnancy with their help;
10. V laboratory conditions. Define human chorionic gonadotropin can be done using a blood or urine test from 12-14 days after conception. However, it should be borne in mind that this hormone can increase not only due to the appearance of the baby, so rely only on this method it is forbidden.

Reliable signs

information Reliable signs are found only during pregnancy, so based on them we can convincingly talk about conception that has occurred.

Reliable signs:

1. Fetal movement: at 18-20 weeks in primigravidas, at 16-18 weeks in multi-pregnant women;
2. Determining the fetal heartbeat using a stethoscope(after 20 weeks);
3. Identification of fetal parts by external obstetric study (from the second trimester);
4. Ultrasonography. Most early way when the gynecologist determines pregnancy reliably: from 3 weeks of pregnancy using a vaginal sensor and a little help when performing an abdominal ultrasound (3.5-4 weeks). The heartbeat of the embryo can be detected as early as 5-6 weeks.

Anya Tomorrow I have an annual medical examination in connection with work and there I will need to go to the gynecologist, and I suspect that I am pregnant, since my periods are late. In principle, I’m glad, because we’ve been wanting a child for a long time and I don’t do the test on purpose. I wonder how a gynecologist determines pregnancy?

A delay in menstruation does not always indicate pregnancy, so you should not rush to conclusions. However, in most cases, this is a sure sign that you are thinking about your interesting position. As for determining the fact of conception, much depends on how much time has passed since the fertilization of the egg. Of course, we cannot discount professional experience specialist, how he relates to his responsibilities. If we ignore minor nuances, a gynecologist through examination can determine pregnancy approximately in the fourth or fifth week from the day of conception. The doctor pays attention to the color of the vagina and cervix, since it changes somewhat with the onset of pregnancy. The labia acquire a barely noticeable bluish tint and, as a result of venous congestion, become cool. The posterior vault of the vagina changes its retraction to the opposite inflating, acquiring a shape similar to a kind of sail. The consistency of the liquid that is released from the cervical canal, it becomes characterized by ductility and transparency. The walls of the uterine cavity also increase in size, becoming softer. For the experienced eye of a gynecologist, these nuances are decisive.

Of course, we are talking about an extremely detailed vaginal examination, during which the doctor often inserts one or two fingers into the vagina, trying to feel the softness of the uterus, determine changes in its volume and enlargement of the appendages. We can talk about such an examination scenario to a greater extent when neither the gynecologist nor the woman suspects the fact of conception. If you come to a specialist with a statement about an alleged pregnancy, an ultrasound will be immediately performed, the results of which, together with observations during a visual examination, will give rise to one or another professional conclusion. Moreover, ultrasonography the body makes it possible to detect the presence of an embryo at an earlier date than can be done through visual inspection. It is likely that you will also be prescribed a blood test for human chorionic gonadotropin, which shows reliable result in almost 100% of cases.

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There are many ways to determine pregnancy. One of them is an examination by a gynecologist. But how reliable is it and when is the best time to make an appointment with a specialist?

Signs of pregnancy and methods for determining it

Pregnancy occurs only 7–10 days after conception, since during this time the fertilized egg reaches the uterus. Several signs may indicate that a woman is pregnant.

From a medical point of view, signs can be divided into three groups: presumptive, probable and reliable.

The first include symptoms based precisely on the woman’s feelings

• nausea (it is important that the expectant mother can vomit not only in the morning, as is commonly believed, but also in the afternoon or evening);
• mood swings and psycho-emotional state;
• drowsiness and fatigue;
• increased sensitivity to odors (may be one of the causes of nausea);
• change taste preferences and increased appetite.

Possible symptoms include external manifestations successful conception and are based on changes in a woman’s body that both she and the doctor can notice.

1. Delayed menstruation.
2. Changes in the usual course of menstruation.
3. Swelling of the breasts and nipples.
4. Increased discharge and basal temperature.
5. Feeling of heaviness in the pelvis and uterus.
6. Increase in the size of the uterus (especially during the period 4–8 weeks).
7. Changes in the color, shape and size of the labia.
8. Positive test results (preferably three) and increased level HCG in the blood.

To the third group of signs interesting situation include those that indisputably indicate the appearance of a fetus in the womb. In the first weeks, this is ultrasound data.
New sensations and probable symptoms may signal pregnancy

Since inspection is not in a reliable way to determine pregnancy, in some countries the patient is immediately sent for an ultrasound. In Russia, this procedure is carried out in the vast majority of cases, but by law a woman has the right to refuse this manipulation. In addition, on many women's forums there are heated debates about how safe examinations are. From experience I can say that everything depends on the doctor’s experience: if the gynecologist is careful, there will be no harm to the fetus or mother.

At what time can a gynecologist detect pregnancy?

If a woman suspects pregnancy, she can’t wait to quickly confirm or refute her assumption. However, you should not rush and make an appointment with a gynecologist for an examination before your period is missed. This is explained by the fact that even an experienced specialist is not able to notice external signs of an interesting position until 4–6 weeks of pregnancy.

Since fertilization does not occur immediately, as a result, changes associated with hormonal changes occur much later.

How is the inspection carried out?

After a woman has felt the symptoms of an interesting situation and done a test (preferably several), she needs to make an appointment with a gynecologist. This visit in case of possible pregnancy is mandatory: if the examination result is positive, it is necessary. It is advisable to visit a doctor two weeks after the expected start of your period. If pregnancy is not confirmed, and, for example, tests indicate the opposite, there may be diseases that need to be identified, and here you cannot do without consulting a specialist. At the beginning of the appointment, the doctor collects the patient’s medical history: the gynecologist will be interested in the date, regularity and duration of the cycle, expected date of conception, test result (it is better to take the test with you), symptoms and possible complaints. It is better to prepare the answers to these questions in advance so as not to get confused and save time at the appointment.

Next, the actual inspection begins. First, the gynecologist evaluates the condition of the woman’s skin and breasts: redness of the integument and enlargement of the mammary glands, sensitivity of the nipples speak in favor of successful fertilization.

Afterwards the patient is invited to a chair. First of all, the doctor assesses the condition of the labia: if they become bluish, swollen and cool (that is, there is venous congestion), the likelihood of pregnancy is very high. The next stage is examination using gynecological speculum.

Here the specialist pays attention to the condition of the cervix and vaginal vault and evaluates the nature of the discharge. During pregnancy, the cervix also swells and becomes blue tint, and the discharge becomes viscous and transparent. In addition, the doctor takes a smear for flora.

The final stage of the examination is a two-manual examination of the pelvic organs. The doctor inserts two fingers of one hand into the vagina and palpates the lower abdomen with the other hand. This way you can estimate the size of the uterus and ovaries, which also increase due to the production of yellow body the hormone progesterone.

After the examination, the gynecologist sends the woman for an ultrasound and a hCG test to make a final diagnosis.

Ectopic pregnancy

Ectopic pregnancy is very dangerous pathology, which threatens organ rupture. At first it has the same symptoms as a normal pregnancy, so it can be quite difficult to recognize it. However later woman will experience pain, accompanied by heavy bleeding and a sharp deterioration in condition (fever, vomiting, chills, dizziness and fainting).

• Depending on where the embryo is attached, symptoms of pathology can be felt at different times: in the narrow part fallopian tube
• - 5–6 weeks;
• in the wide part - no earlier than 8 weeks;
• in the peritoneum or on the ovary - at the end of the first month;

on the cervix - a woman may not feel any symptoms at all. When outside intrauterine pregnancy

the embryo can attach to the fallopian tube, causing the organ to rupture It is possible to assume an ectopic pregnancy both based on the test results and in the blood (then the woman is at risk). In the first case, the strip indicating successful fertilization will be quite pale, and in the second, the level of the hormone will be lower than expected during pregnancy. However, only a doctor can make an accurate diagnosis.

Whether the doctor will be able to notice the pathology during the examination largely depends on where exactly the fetus is located. If the attachment occurs in the fallopian tube, the patient will feel pain when palpating the appendages. Plus, the size of the uterus will not correspond to the expected period.

However, only based on the results of the examination, the gynecologist will not be able to make an accurate diagnosis. Therefore, the woman is sent for an ultrasound, which can reveal pathology.

When I went to the gynecologist about a possible pregnancy, the doctor diagnosed me with an ectopic pregnancy only because during the examination in the chair I screamed when pressure was applied to the appendages. No assurances that I was feeling normal, there was no bleeding, and it was painful due to the carelessness of the specialist, did not help: the gynecologist insisted on urgent hospitalization. As a result, I got a referral for an ultrasound, which showed normal pregnancy for a period of 4 weeks.

Multiple pregnancy

Diagnose multiple pregnancy you can already with four weeks due to the increased size of the uterus. This assumption can be confirmed already at the first ultrasound at 11–16 weeks.

Can a doctor miss pregnancy?

As mentioned earlier, if a woman comes before 4–6 weeks, the doctor may not see external signs pregnancy and not detect it during examination. In this case, when positive test The specialist will prescribe a blood test for hCG to the patient.

How is gestational age determined?

It is easiest to determine the gestational age of a woman with a stable cycle. Moreover, the lucky woman can even be given a preliminary date of birth: from the first day of the last menstruation, the doctor subtracts three months and adds seven days. If your periods are irregular or the woman does not remember the start date of her last cycle, the doctor may resort to other methods.

If future mom If you consult a doctor before the 8th week, the gestational age can be determined quite accurately by examination by the size of the uterus: by 4 weeks the organ becomes the size of a chicken egg, by the eighth week - the size of an average apple. However, this method is unreliable, since in some cases (for example, with fibroids) the size will be larger than expected.

But the most accurate way to determine the gestational age is with the help of an ultrasound. During the study, the specialist looks at the size of the fetus (it is believed that during this period the embryos are approximately the same). The first ultrasound is scheduled at 12–16 weeks, but if necessary, it can be done earlier.

You can also find out the number of weeks by hCG level in blood. The amount of the hormone increases every 2–2 days up to 8 weeks inclusive, which allows you to calculate the gestational age.

Do I need to immediately register with the housing complex?

Of course, each woman decides for herself when to register and whether to register at all, but experts strongly recommend doing this as early as possible.

From what was said above, it is clear: the sooner you contact a gynecologist, the more likely, firstly, determine exact date pregnancy, and secondly, to identify possible complications.

In addition, a specialist will be able to help adjust nutrition so that both the fetus and mother receive all the necessary vitamins and microelements. It is also necessary to determine whether the expectant mother is at risk and can give birth on her own. Finally, women who register before 12 weeks are entitled to a guaranteed - albeit very small - payment, about 600 rubles.

Bleeding after examination by a gynecologist

Unfortunately, it often happens that blood may bleed after an examination. If there is little scarlet discharge and it stops quickly, there is a high probability that the doctor inadvertently damaged tissue or blood vessels when using a mirror or scraping off material for analysis. But if the blood continues to flow for a long time, and at the same time the state of health worsens, this can become a serious threat to the woman and the fetus. Any girl who suspects she is pregnant should visit a gynecologist to confirm or refute her suspicions. Many changes in female body , whether related or not related to pregnancy, can be found out by taking certain types of tests and undergoing various methods examinations. But first of all it is better to get a consultation experienced doctor

, which can determine whether there is actually a pregnancy. It must be remembered that in order to make a reliable diagnosis, it is better to run to the doctor with any characteristic symptoms not immediately, but after some time. Even without analysis, using the method gynecological examination

and visual changes in a woman’s body, a diagnosis of pregnancy can be made. Sometimes, even on pregnancy (approximately the third or fourth week), the doctor can determine it during examination. The thing is that sperm need about a day to reach their goal - an egg. Then, the already fertilized egg moves through the fallopian tubes around seven calendar days. The next stage is that this egg reaches the body of the uterus and an embryo is formed. After the second seven days, the embryo attaches to the walls of the uterus, and it is at this time that the female reproductive organ itself begins to change. These changes can be determined by a number of changes: the uterus acquires a softer state, the cervix changes in color, namely, it becomes colored in blue-violet tones. These signs can help a specialist establish pregnancy even before a delay.

Of course, the uterus increases in size. All these features are taken into account by the gynecologist during the examination.

You need to be aware that without additional tests and examinations in the early stages of pregnancy, a gynecologist can give an accurate answer to the question about the presence of pregnancy, but not always.

How a gynecologist determines pregnancy - calculating the gestational age

How does a gynecologist determine pregnancy? Examination on a gynecological chair

In the early weeks it is possible to determine the true duration of pregnancy. The conclusion depends on the size of the enlarged uterus. For example, at four weeks its volume is similar to the size of a chicken egg, and at eight weeks the uterus increases to the size of a goose egg. An experienced gynecologist will be able to determine the actual gestational age through examination through the vagina.

After eight weeks of pregnancy, taking into account only the increased size of the uterus, it will be extremely difficult to determine the correct gestational age. This depends on the fact that in the second trimester, in two pregnant women with the same period, the size of the reproductive organ can and will differ.

How a gynecologist determines pregnancy using ultrasound diagnostics

First, as already mentioned, the doctor conducts an examination on a gynecological chair. Then, to be 100% sure, he writes out a referral for an ultrasound.

This study can be carried out with an intravaginal sensor, or perhaps by applying a gel to the surface of the abdomen. Thus, all information about the condition of organs and the fetus, deviations or compliance with standards is displayed on the screen. At an early stage, you can already hear the fetal heartbeat. This is how the fetal development process is monitored. early stages, is everything okay with the fertilized egg?

After pregnancy is confirmed, the expectant mother is required to undergo a series of tests. These are various blood tests to obtain information about the condition hormonal levels, indicating normal course pregnancy, general analysis blood. This is also a general urine test, a urine test for the hormone gonadotropin. This hormone helps stimulate the glands of the genital organs.

How a gynecologist determines pregnancy - taking a blood test

This method involves taking a blood test to female hormone pregnancy hCG- human chorionic gonadotropin. Blood sampling is possible seven days after the date of the last sexual intercourse where conception was possible. But it is better to carry out this procedure when there is already a delay of three or five days. In the body of a non-pregnant woman, the level of this hormone is several times lower than in a woman preparing to become a mother. A pregnancy test works approximately on the same principle, only urine is used instead of blood, and the reliability percentage is lower.

This hormonal analysis is taken strictly on an empty stomach by collecting venous blood if the woman is taking any medications, then you need to inform your gynecologist about this.

How does a gynecologist determine pregnancy based on the last menstruation?

This is the method that obstetricians use in their medical practice. It consists of counting the number of weeks between the first day menstrual cycle and date gynecological examination. This is the gestational age.

Knowing the start date of the last menstruation, it is easy to determine the date of the expected birth; the so-called Nägel formula is used. From the first day of the last menstruation, subtract three months and add seven days.

This calculation method is easy to use, but not accurate enough. It is about two weeks longer than the present date.

Main signs indicating pregnancy

Here are a number of specific signs indicating a possible pregnancy, which should prompt a visit to the gynecologist:

• How can one not miss it and distinguish such important point in a woman's life? It’s worth listening to your body more closely and analyzing whether the changes in female body with the main signs of pregnancy.
• The most important and first sign that should make you think is the absence of menstruation.
• But quite often, the absence of menstruation may simply indicate disruptions in the female body, which are both hormonal and stressful in nature.
• Toxicosis - as a consequence of pregnancy. Often the nausea starts in the morning, and you can feel sick in a stuffy room.

• Distortion of odors and tastes.
• Manifestation increased appetite or its absence altogether.
• There are sudden mood changes, fatigue is present and you really want to sleep.

• You may feel pain in the lower abdomen, but you should pay close attention to this symptom so as not to miss the possibility of miscarriage.
• The mammary glands increase in volume.

How does a doctor determine an ectopic pregnancy?

At ectopic pregnancy in the early stages, the woman does not feel anything “suspicious”, the symptoms completely or partially coincide with the signs of progression normal pregnancy. Only by measuring basal temperature you can see that it is slightly higher. When the doctor sends you to test the level of the hCG hormone, he will definitely notice that the level of this hormone does not coincide with the duration of pregnancy, this is one of the signs of an ectopic pregnancy. If the doctor suspects an ectopic pregnancy, he should refer you for an ultrasound, an examination with a transvaginal probe. This can also be caused by a woman’s complaints of pain in the area of ​​one of the ovaries.

If the diagnosis is confirmed, it is necessary to carry out urgent surgical intervention. It is much better when such a pregnancy is detected in advance, then the fallopian tube can be preserved. If such a pregnancy lasts more than five or six weeks, the fallopian tube ruptures and it becomes impossible to save it. Here we are talking about preserving life by stopping bleeding.

No woman is immune from ectopic pregnancy, but it is worth noting that this phenomenon occurs due to existing chronic inflammatory processes in the female genital organs. Therefore, to prevent these, you need to visit your gynecologist more often.

Therefore, if you find a number of signs in yourself that indicate pregnancy, and a pregnancy test shows positive result, then you should visit a consultation with a competent specialist who will dispel your doubts.