How a gynecologist determines early pregnancy. How does a gynecologist determine pregnancy? How is pregnancy determined during the examination

Almost every young family dreams of having a baby. Future mom and dad are anxiously awaiting the onset of pregnancy. And if there is even a ghostly chance of a successful conception, they are in a hurry to confirm the happy news as soon as possible. Many resort to folk methods, study various signs. But why guess when modern medicine makes it easy to diagnose pregnancy even before a missed period? An experienced doctor can easily determine whether a woman is expecting a child or not. What methods do obstetricians use to determine the period? And what manipulations does an examination by a gynecologist during pregnancy include?

At what time does the gynecologist determine pregnancy?

During an examination in the gynecological chair, the obstetrician can determine pregnancy if it occurred no later than 4 weeks ago. The doctor will immediately notice external signs, manifested in a characteristic change in the density, color and shape of the genital organs.

The most reliable and fastest method for determining pregnancy is ultrasound (ultrasound). This diagnostic method allows you to see the fetus inside the uterus quickly and safely. With the help of ultrasound in the early stages, an ectopic pregnancy can be detected, which poses a threat to the life of a woman.

A standard ultrasound machine allows you to diagnose the presence of pregnancy for a period of 4-6 weeks. Using a special vaginal sensor will give the gynecologist the opportunity to detect a fetal egg in the uterus already for a period of 3-4 weeks.

Registering a woman in the antenatal clinic in the first weeks allows the doctor to develop a pregnancy management plan, set the date of its onset as accurately as possible and determine the expected date of birth. And a happy mother will have enough time left to prepare for an important event: the birth of her baby.

Before the delay of menstruation, is it possible to know that conception has occurred?

It will be possible to accurately determine pregnancy after about two weeks after the last ovulation. This can be done in several ways.

Measure basal body temperature (measured immediately after waking up from sleep)

Understanding whether conception has occurred by measuring the lowest temperature reached by the body during rest is quite simple. At the moment the egg is ready for fertilization, as well as some time after conception, the basal temperature is slightly increased and is approximately 37–37.4 degrees.

With the onset of pregnancy, it remains so for several weeks. If conception does not happen, the basal temperature returns to normal within a couple of days after ovulation. Many women even keep a special diary where they note the temperature and dates of ovulation.

A pregnancy test is one of the first diagnostic methods used by expectant mothers at home and by doctors during the initial examination of pregnant women.

Take a pregnancy test

The easiest way to accurately diagnose pregnancy is a test. Modern tests are most reliable and easy to use. It is not necessary to wait a long time for the start of the delay. The test will show a positive result 12 days after conception. Two bright stripes will mean that you will soon become a mother. If the second strip barely appears, it is worth doing the test again a few days later. Most likely, the result will indicate pregnancy.

Take a blood test for the presence of the hCG hormone

An analysis for the presence of the hormone chorionic gonadotropin (hCG) in the blood is prescribed for all women to detect abnormalities during pregnancy. In the early stages, the presence of this hormone in the blood confirms that conception has taken place.

What methods does the doctor use during the examination?

At the appointment, the obstetrician-gynecologist is interested in the well-being of the pregnant woman, finds out the date of the last menstruation, asks about changes in behavior, mood and taste preferences.

The doctor should be told about all the discomfort, hereditary and chronic diseases, bad habits, past pregnancies.

If the patient did not do the test on her own and did not undergo an ultrasound, these procedures can be performed in the gynecologist's office at the first appointment. To obtain a more accurate result, an analysis for hCG can be taken.

The doctor must conduct an examination on a gynecological chair.

vaginal examination

As a result of the onset of pregnancy, the walls of the vagina and the uterine os swell. Their mucous membrane becomes thickened and cool. The tissues are filled with blood. The posterior fornix of the vagina seems to be stretched. The discharge becomes viscous and light, almost transparent.

Vaginal examination with two fingers (determination of pregnancy by touch)

Two fingers of one hand are inserted by the doctor into the patient's vagina, and with the other hand, the obstetrician probes the body of the uterus for enlargement, determines the softness of the isthmus. The gynecologist palpates the appendages. One of them contains a corpus luteum and may be larger.

Bimanual examination to detect signs of pregnancy

Blood analysis

When the hCG hormone is in the blood, the patient can be sure of pregnancy, with some exceptions (the effect on the woman's body of hormone therapy or false conception).

Ultrasound (ultrasound)

With the help of ultrasound, pregnancy can be diagnosed as early as 21 days. Such a study is mandatory in the early stages. He is prescribed to make sure everything is in order and confirm the diagnosis of pregnancy.

The results of an ultrasound examination can be seen already for a period of 5-6 weeks.

signs

To diagnose pregnancy, doctors use three groups of signs.

Conjectural.
Probable.
accurate or reliable.

Based on presumptive signs, the doctor only assumes that the patient is pregnant. They bear this name, because they can manifest themselves in the body for other reasons.

Suggested signs:

Frequent morning vomiting or nausea during the day.
New taste preferences, increase or lack of appetite.
Dislike for certain smells.
Constant desire to sleep.
Increased sentimentality and sudden mood swings.
Frequent urination, infrequent stools.
Breast enlargement or tenderness.
Changes in skin color in the nipple area, the appearance of spots.
Increase in the size of the abdomen.

The presence of only presumptive signs is not enough to reliably determine pregnancy. Therefore, the woman undergoes a series of additional examinations.

The probable signs of pregnancy are called so, because on their basis the obstetrician-gynecologist with a high degree of probability confirms the onset of conception.

Among them are a few:

Congestion of the walls of the uterus and vagina. From the first days of pregnancy, the volume of blood in the body increases significantly, the genitals thicken and fill.
An increase in the size and change in the shape of the body of the uterus. The longer the gestation period, the larger the uterus becomes. It increases exponentially. Its tissues become soft and pliable. The uterus changes already in the third month of pregnancy.
Identification of a specific symptom. A probable pregnancy can be considered if symptoms known to medicine are detected: Snegirev (the uterus is easily reduced from external influences), Piskachek (asymmetric shape of the uterus in the early stages), Horvitz-Gegara (softening of the isthmus of the uterus), Gubareva-Gaus (the cervix is mobile), Gentera ( some women have a thickening on the body of the uterus).
Prolonged absence of menstruation.
Positive pregnancy test result.
The presence of the hCG hormone in the blood. The result is determined in the laboratory.

Accurate or reliable signs identified by the doctor establish and state the onset of pregnancy. But they can be seen at a later date.
Noticeable movements of the fetus inside the uterus, starting around 18-20 weeks of pregnancy. These include undeniable evidence of pregnancy.

Listening to the doctor's heartbeat of the child.
Determination of body parts of the child during manual and visual examination.

Can a doctor miss pregnancy?

If a woman came for a routine examination to her gynecologist, then the doctor may not see signs of pregnancy only when conception has occurred quite recently. If the purpose of the visit to the doctor is precisely the confirmation of pregnancy, then the doctor uses all the diagnostic methods available in his arsenal to obtain a reliable result.

In cases where less than 5 weeks have passed since conception, during a routine examination in a gynecological chair, there is a chance that pregnancy will not be noticed. Therefore, if there is the slightest doubt, the doctor prescribes additional examinations, which were mentioned earlier: a blood test, test or ultrasound.

How is the term considered in obstetric practice?

When examined in the gynecologist's chair, the doctor will determine the approximate gestational age at 5 weeks. These days, the uterus is enlarged and takes on a rounded shape. With the increase in the term, the uterus also grows.
After another 7 weeks, its bottom is already in the area of \u200b\u200bthe woman's pubis.
In the second month of pregnancy, it reaches the size of a woman's fist.
By three months, the size of the uterus resembles the average male fist.
In the second trimester, the uterus is clearly palpable through the wall of the abdomen. From this moment, the gynecologist can determine the period by the height of the location of the bottom of the uterus above the pubis relative to the navel and the xiphoid process. For example, at 16 weeks, the bottom of the uterus is located approximately 6 cm above the pubis, at 20 weeks it rises by 20 cm, at 28 weeks the distance increases by another 5 cm, at 32 weeks it is 30 cm, and already at 36 weeks it is at level 35 cm.
In the last week of pregnancy, the circumference of the abdomen increases significantly, the size of the baby's head changes.

How else can you determine the expected date of birth?

Currently, several methods are used to calculate the gestational age. Even special computational formulas have been deduced. Fetal height (or length) and head size are used as variables.

The most popular is the Jordania method, which involves the use of the formula X \u003d C + L, where X is the number of weeks of pregnancy, C acts as the diameter of the child's head, L equals the child's height.
A more complex calculation method was formed by Dr. Skulsky. In his calculation formula, X \u003d (L x 2) -5/5. In this case, X means the months of pregnancy, L is the growth of the fetus, 5 are indicators of the thickness of the uterine wall and the coefficient for calculation.
In any pharmacy, you can purchase a new generation of rapid tests that can set a deadline up to a week even at the earliest period.

The most accurate modern way to calculate the gestational age is ultrasound. By measuring the parameters of the uterus and the size of the fetus, it is possible to set the term with the least error.

Video "Conception, pregnancy, term determination"

In the absence of health problems for the expectant mother, the best time to see a doctor comes after two weeks of delay. Then the probability that the fact of conception will go unnoticed will be reduced to zero. If your baby is planned and long-awaited, pay special attention to the choice of a gynecologist who will manage the pregnancy and an obstetrician who will help your baby be born.

Every woman would like to know how a gynecologist determines pregnancy, because then one could easily find out about the presence of an “interesting situation” without any problems. In addition to elementary folk ways to determine a new life, there are many medical methods.

Uzi palpation test
pdr define belly
where to go for a fertilization appointment
ovum folk blood

The essence of the method

The routine gynecological exam involves a complex process of examining the genitals.

Initially, before the examination, the doctor must thoroughly wash his hands with a disinfectant.
Next, he begins to examine the external genital organs, then the walls of the vagina.
By pressing, he determines whether the patient has pain from such actions, and also checks if the walls have fallen.
Then, having examined the vulva, the specialist proceeds to check the internal organs. For such a process, he uses special gynecological mirrors, which allow you to thoroughly examine the organs for the presence of diseases and various lesions of the uterus. Obvious symptoms of uterine damage will be scars, tears.
Then he conducts a study of secretions for color, smell, quantity.
The doctor takes some of the secretions for microflora analysis.
After examining the mirrors, the gynecologist proceeds to conduct a manual examination. It is this examination that helps the gynecologist determine pregnancy. By touch, he studies the state of the uterus, ovaries. The doctor can easily determine inflammation of the appendages, uterine fibroids, as well as the presence of cysts on the ovaries. The gynecologist determines pregnancy.
After a detailed examination of the uterus, the specialist examines the appendages to identify changes in the structure or existing formations. This is how a gynecologist can determine the presence of pregnancy.

The process of communicating with a specialist

If a woman has suspicions that she has become pregnant, namely, a lot of facts have appeared, then she needs to make her first visit to the gynecologist because of the determination of a possible pregnancy.

Communication with a gynecologist

Symptoms to look out for:

delayed menstruation;
chest pain;
increase in breast volume;
nausea;
fainting;
drowsiness;
fatigue;
the appearance of stiffness of the nipples;
toxicosis;
abrupt change of mood.

At the reception, you will need to tell about all the nuances of your well-being. The doctor will be able to do a full study of the "interesting situation" only after 3 weeks. Signs will be darkened nipples, an enlarged uterus, a blue tint of the uterus.

Up to 3 weeks, no specialist will be able to determine the presence of a fetus due to the existing factors of the pregnancy process. The best determinant can only be the result of a blood test for hCG. It is impossible to determine pregnancy before a delay by a gynecologist. This is due to the fact that the uterus does not yet have an enlarged size, and the egg is in a state of searching for a place of attachment.

Symptoms to watch out for

After such an appointment with a specialist, a woman should be registered for pregnancy and undergo a full examination by a doctor. At this stage, a card is started indicating all the data, including the possible date of fertilization for a timely examination. It is worth noting that at too early a gynecologist may not notice a possible pregnancy.

Methods for determining the term of childbirth

Currently, there are many methods for determining the timing of the upcoming birth.

The calculation is carried out according to the Negel formula, that is, three months must be subtracted from the first day of the delay and a week added. The resulting date will be your due date.
In addition to this method, there is another calculation formula: 280 calendar days are added to the date of the first day of the last cycle of menstruation. However, such calculations are not entirely correct. This is explained by the fact that each woman's menstrual cycles are different, and for some they are irregular. Also, the erroneous calculations are allowed due to the fact that the sperm cell lives for several days, therefore, fertilization can occur later than the moment of sexual intercourse.
There is a way to get information on the first movement of the fetus. The formula is simple: the first movement is about half the term, that is, it occurs somewhere in the twentieth week of pregnancy for those who give birth for the first time and the 18th week for repeated births. However, there are some departures: the first movements depend on the structure of the body and the woman's body, since a thin girl will feel the movement much earlier. It is also possible to confuse the movement with gas formation in the intestines.

Calculation of the term of childbirth by the Negel formula

How is the period of "interesting situation" determined?

When examining the genital organs, the doctor can not only state that the woman has become pregnant, but also give an approximate date.

It is worth knowing how a gynecologist determines pregnancy and its duration. It all depends on the size of the uterus:

for example, up to a month, the size will be equal to the volume of a chicken egg;
at 8 weeks - the size will be equal to a goose egg;
after 12 weeks, it is impossible to determine the period by the size of the uterus due to the physiological characteristics of the unborn baby.

There are several more ways to determine, for example, using ultrasound or when calculating the height of the fundus of the uterus. For example, such techniques begin to be used from the second trimester:

if 8 weeks, then the uterus is in the redistribution of the small pelvis, while the height is 9 cm;
at 10 weeks, the growth of the uterus is planned, the height is 11 cm;
16 weeks indicates the presence of the uterus between the pubis and the navel, the height ranges from 14 to 18 cm;
from 21 weeks, the size begins to increase relative to the period of 1 week / 1 cm, respectively, and it is located at a distance of 2 fingers from the navel.

Definition on ultrasound of the term "interesting position"

Determination of ectopic fetal development

If we talk about whether a gynecologist can determine an ectopic pregnancy, then it should be noted that its presence can only be determined with the help of ultrasound. With manual inspection in the early stages, it is impossible to notice the deviation.

Every girl needs to remember that for the first appointment with a gynecologist during pregnancy, you need to take.

Passport.
Socks.
A diaper or towel.

Based on the foregoing, a gynecologist can determine pregnancy only at a later date. It is impossible to determine the presence of a fetus early.

The cost of the first and subsequent examinations by a gynecologist during pregnancy are different. Consider examples of prices in the table.

Summing up, it should be noted that at the first symptoms indicating a possible pregnancy, you should immediately consult a doctor in order to prevent some deviations.

Pay attention to our article, there is a fantastic video.

: Borovikova Olga

gynecologist, ultrasound doctor, geneticist

Many representatives of the weaker sex, who have reached reproductive age and plan to become mothers, wondered about the possible confirmation of pregnancy. Most often, they are interested in how long it is possible to determine that conception has occurred. Interest in this is not accidental, the sooner a woman finds out about her situation, the more she will monitor her own health, and this will allow her to endure the entire pregnancy as correctly and safely as possible.

At what time can a gynecologist determine pregnancy?

The most obvious sign of pregnancy for expectant mothers is the onset of a delay in menstruation. But not always its onset indicates a successful conception. In order to unequivocally answer the question about fertilization, it is recommended to go to the doctor's office at the antenatal clinic.

The gynecologist conducts an examination and issues a verdict. Depending on the qualifications of the doctor and the method used by him, the period at which it is realistic to determine the presence of an embryo is three or four weeks. If a woman takes a blood test for hCG (a hormone that is produced by the embryonic membrane), then the result can be noticeable even ten days after fertilization.

A doctor can examine a woman on a gynecological chair to establish the reliability of pregnancy. In this way, the presence of an embryo can be determined if the period is at least four weeks. At this time, the color of the vagina and cervix changes, the walls of the uterine cavity soften and its size increases. But it should be understood that even at this time, only an experienced qualified obstetrician-gynecologist can see signs indicating that a woman is in position.

In most cases, pregnancy is determined by examination, the period of which has reached seven weeks. This method is not the most reliable for detecting the fact of conception. It is believed that a doctor’s examination of a woman whose gestational age does not exceed ten weeks can provoke the rejection of the embryo, since during this period it is fused with the uterus, and exposure to the stomach and internal genital organs can lead to undesirable consequences.

In order to be sure that you can prepare to become a mother, there are other, much safer laboratory methods of examination.

How does a doctor determine pregnancy?

In order to correctly determine the fact of conception, an obstetrician-gynecologist first asks a woman about her well-being, about changes in perception, mood, taste preferences, sensations in the mammary glands and other changes in her usual life. These signs may appear even before the onset of a menstrual delay.

After questioning and entering the necessary information into the exchange card, the doctor can proceed to examine the woman in a special chair. He assesses the condition of the mammary glands and external genitalia, especially the labia. If a woman is pregnant, then the labia swell, become cool, there is a slight swelling and a bluish tint.

Then, with the help of a gynecological mirror, an examination of the internal organs of a woman is carried out. The uterus changes in size, shape, density, if a new life is born in it. The doctor also examines the condition of the cervix and vagina. When probing with fingers, the gynecologist evaluates the size of the uterus and the condition of the appendages.

At the discretion of the doctor, he may not conduct a manual examination, but immediately give a referral for a vaginal ultrasound. This method of detecting pregnancy does not pose a threat to either the woman or the unborn baby. It is much more reliable than the usual ultrasound. With it, you can determine the ectopic pregnancy, the position of the fetal egg, prevent a possible breakdown and assess the general condition of the reproductive system. The advantage of the procedure is painlessness, simplicity, when the examination does not require any additional preparation.

In addition to an ultrasound examination, you may need to donate blood to increase the level of hCG, a hormone that begins to be intensively produced in the body from early pregnancy. At the beginning of the development of the fetal egg, there is a risk of not noticing its presence through ultrasound. And the result of a blood test will already accurately confirm or refute the presence of pregnancy.

Young women who go to the gynecologist about the onset of pregnancy discuss a variety of topics related to pregnancy during the appointment, but still some questions may not be heard for various reasons.

But every unasked question and every unanswered answer is the anxiety and doubt of the future mother, which should be avoided. What are the most common concerns of young women who are expecting their first child?

Can a gynecologist see / not see pregnancy and ectopic pregnancy during examination

To understand whether a gynecologist can not notice a pregnancy or an ectopic pregnancy, it is necessary to have an idea of how exactly and by what signs he determines the onset of pregnancy.

The first sign that the doctor pays attention to already during an external examination is swelling of the genital organs. The labia, both small and large, become quite dense due to increased blood circulation and due to the influx of venous blood (the so-called venous plethora). Even if a woman does not notice this (and this is exactly what happens most often), then the doctor determines this without any difficulty.

The next sign of the onset of pregnancy is the changed color of the internal genital organs, that is, the walls of the vagina. During pregnancy, both the external pharynx of the vagina (the entrance to the vagina) and its walls acquire a dark red color, which sometimes becomes almost purple, that is, it becomes cyanotic. A change in the color of the mucous membranes of the female genital organs after the onset of pregnancy is the norm.

Then the doctor proceeds to examine the internal female genital organs, which are located in the vagina, that is, the uterus, appendages (fallopian, or fallopian tubes) and ovaries.

As for the uterus, its size during pregnancy is constantly increasing, which is quite easy to establish with a manual examination. The shape of the uterus also changes, which is also easily established by palpation during a two-handed internal examination. The appendages (fallopian tubes) and ovaries may also be enlarged. Often one ovary is larger than the other, because it contains the so-called corpus luteum, which provides the necessary at the beginning of pregnancy.

It is important that during pregnancy, the body of the uterus and the cervix lose their elasticity and become softer, which is easy to determine during a manual examination.

The mucus that is secreted from the cervical canal, after the onset of pregnancy, becomes transparent and more viscous (viscous).

Among other things, the doctor during the examination necessarily checks the condition of the posterior vaginal fornix - before pregnancy, the posterior vaginal fornix really has the shape of a deep and retracted fornix, and with the onset of pregnancy it becomes even.

A very informative sign of pregnancy is the changes that occur with the mammary glands of a woman, that is, with her breasts. After the onset of pregnancy, the breast, under the influence of hormones, begins to prepare for lactation and more milk ducts form in it, and adipose tissue begins to be replaced by glandular tissue. It is also important that the breast increases in size and the density of the tissues of this organ changes.

Attention! Pregnancy during a gynecological examination can be determined no earlier than the fifth week.

For an earlier determination of the onset of pregnancy, an ultrasound examination (ultrasound) is necessary. Ultrasound, using a transvaginal probe inserted into the vagina, can detect pregnancy after the third week, although some highly trained doctors can see nascent life earlier. If ultrasound is performed using a conventional abdominal sensor, that is, through the anterior abdominal wall, then reliable results can be obtained at the fifth week or a little later (especially if the woman is overweight).

Attention! When determining the timing for ultrasound, it should be taken into account that a delay in menstrual bleeding for a period of five to six days corresponds to approximately three weeks from the time of conception. Thus, transvaginal ultrasound can determine the onset of pregnancy as early as the fifth or sixth day of delayed menstrual bleeding.

Attention! On ultrasound, the diagnosis of "Ectopic pregnancy" is not made - in this case, the doctor only reports the likelihood of pathology.

Without a gynecological examination, the onset of pregnancy can be determined by the results of a blood test for the content of the hormone hCG (human chorionic gonadotropin produced by the chorion - the fetal membrane that precedes the placenta).

It should be remembered that a blood test is more accurate and more informative than a urine test, and also that its information content is much higher than the information content of a home test for express analysis, even if it is the most modern one. The fact is that the content of chorionic gonadotropin in the blood is much higher than in the urine.

The result of an analysis for the content of hCG in the blood can be false only after hormone therapy or with a hydatidiform drift (a non-viable product of conception, which may not even contain an embryo).

Attention! To confirm the onset of pregnancy, an ultrasound examination (ultrasound) is mandatory.

Of course, every woman who listens to the signals of her body may suspect that she is pregnant, because under the influence of hormones, serious changes in her body begin in the early stages. A pregnant woman will be helped to identify the following symptoms and signs:

In the predicted period, menstrual bleeding does not begin;
The mammary glands become very sensitive (unpleasant pulling sensations and even pain may appear), and their size increases;
There is a general weakness, dizziness becomes frequent for no apparent reason, in the morning it begins to feel sick, which together are signs of early;
Taste preferences change very sharply - favorite foods and drinks are annoying and can even cause disgust;
Emotional instability appears, frequent mood swings are noted;
Urination may become more frequent.

Of course, many of these signs can be symptoms of a disease, so only a gynecologist can make an accurate diagnosis in the early stages of pregnancy.

If a woman has a suspicion that she is pregnant, then she needs to visit a gynecologist to talk about her observations and about her changed state of health. Even at very early dates (about three weeks), an experienced doctor can determine pregnancy, taking into account several objective signs:

The chest becomes painful on palpation, and the nipples darken;
With a two-handed internal examination, it can be determined that the uterus softened and began to increase;
The cervix has acquired a bluish tint;
The external genital organs, including the labia, changed their consistency and color due to venous plethora.

Attention! A gynecological examination in early pregnancy is very important, because it allows you to make sure that the pregnancy is developing correctly, that is, the fetal egg is located in the uterus. If the fetal egg remains in the fallopian tube, that is, the pregnancy is ectopic, then it must be interrupted, since the prognosis in this case is only negative - an ectopic pregnancy can pose a serious danger to the health and life of a pregnant woman.

Early pregnancy and ectopic pregnancy cannot be missed or seen by a gynecologist, because he uses several methods of gynecological examination that complement each other.

During a gynecological examination, the doctor assesses the condition of the nipples, the condition of the external genital organs and the condition of the internal genital organs. During an internal examination, the doctor palpates the uterus, ovaries and fallopian tubes. With such an examination, it is possible to determine exactly where the fetal egg was implanted (fixed and began to develop), that is, a normal uterine pregnancy began to develop or.

Even with uterine pregnancy in the ovaries and in the tubes, sometimes the doctor may find some seals, which may be a corpus luteum or corpus luteum cysts that do not require treatment. But seals can also be pathological in nature, which can be found out during an ultrasound examination.

The next method for determining early pregnancy is prescribed after a gynecological examination - this is an ultrasound examination of the pelvic organs, or ultrasound of the pelvic organs. During ultrasound, the fact of pregnancy is confirmed almost unmistakably. In addition, it is accurately determined what kind of pregnancy develops - uterine or ectopic (determination of the localization of pregnancy).

An ultrasound determines the size of the fetal egg, so the gestational age is determined quite accurately. If an ultrasound is performed using a vaginal probe, then pregnancy can be established three weeks after the probable conception, or even a few days earlier.

Even earlier than on ultrasound, pregnancy can be established using a blood test for the presence of the human chorionic gonadotropin hormone (hCG), which is produced by the chorion (the outer layer of the fetal membrane) and can be determined a few days after the probable fertilization of the egg and conception. Chorionic gonadotropin is concentrated in the blood and urine of a pregnant woman, so rapid tests for determining pregnancy at home use the same principle, although the concentration of hCG in the blood is higher.

Attention! Already in the early stages of its development, pregnancy is confirmed in three ways - a gynecological examination, ultrasound and a blood test for the presence of human chorionic gonadotropin.

It is very important that the presence of hCG in the blood is an absolutely accurate sign of pregnancy, since under no other circumstances is this hormone produced by the body. Thus, it is impossible to miss and not notice pregnancy even at the earliest stages.

As for an ectopic pregnancy, which can be suspected on the basis of some indirect signs, it is absolutely confirmed or denied by an ultrasound examination that determines the location (location) of the pregnancy.

How a gynecologist determines the gestational age during examination

Knowing the gestational age is not only curious, but also important, since it will depend on how accurately the period is determined, how accurately the date of birth and, accordingly, the start of maternity leave (the so-called maternity leave) is determined. In addition, it is very important to know the gestational age in order to monitor the development of pregnancy - whether the fetus grows and develops correctly, whether it lags behind in development.

It must be understood that gynecologists distinguish between the obstetric gestational age and the true gestational age, which differ by two weeks.

The obstetric gestational age is determined from the first day of the last menstrual bleeding. This countdown of pregnancy is explained by the fact that the onset of menstrual bleeding, or menstruation, coincides with the beginning of the maturation of a new egg.

It is the egg that began to mature with the onset of menstrual bleeding, when the remnants of an unfertilized egg are removed from the body, that the male germ cell (spermatozoon) can fertilize, resulting in a zygote that will very quickly turn into an embryo, in order to then be implanted in the mucous membrane of the uterine wall and give rise to the development of the fetal egg. But after 12 weeks of pregnancy, the embryo is already called a fetus.

Obstetric pregnancy, which is considered from the first day of the last menstruation, or from the first day of development of the egg, which was then fertilized, lasts 10 lunar months, or 280 calendar days, or 40 calendar weeks. However, we should not forget that the period of intrauterine development of the fetus can be different and range from 37 to 42 weeks, which may be due to genetic causes or other factors, which are also individual in each case.

The true gestational age is counted from ovulation and conception, which can presumably occur two weeks after the start of the last menstruation, therefore, in order to determine the true gestational age, two weeks must be subtracted from the obstetric gestational age.

Of course, the gynecologist takes into account information about the timing of the onset of the last menstrual bleeding, the duration and regularity of the menstrual cycle, however, during a gynecological examination, the doctor is based on objective data.

The easiest way to determine the gestational age is during a gynecological two-handed examination in the early stages of pregnancy, that is, from four to eight weeks. The doctor determines the duration of pregnancy based on the size of the uterus, which he palpates (feeling).

If the pregnancy is four weeks, then the size of the uterus can be compared to the size of a chicken egg, and at eight weeks of pregnancy, the uterus is already comparable in size to a goose egg.

Experienced gynecologists are able, during a manual examination, to determine the gestational age with an accuracy of one day, if we are talking about early terms. However, after the 12th week of pregnancy, and sometimes even earlier, it will be difficult to determine the gestational age during a gynecological examination, since the development of the embryo is very individual, and by the time the embryo is already called a fetus (and this happens after the 12th week of pregnancy), the size of the fetus can vary significantly at the same developmental period.

Thus, during a gynecological examination, the doctor will most accurately determine the gestational age from four to eight weeks.

How is the gestational age determined by the results of ultrasound (ultrasound)

When determining the gestational age based on the results of an ultrasound examination, the qualifications of the doctor are also important (the more experienced the doctor, the more accurately he interprets the results of the study and determines the gestational age), and the expected gestational age.

The most accurate are the ultrasound data obtained before the 12th week - during this period, the gestational age is determined by the size of the fetal egg and the average indicators of its internal diameter.

At later dates, that is, in the second and third trimester, the gestational age is determined on the basis of the data obtained on the size of the circumference of the fetal head, on the size of the circumference of the tummy of the developing fetus, as well as on the average diameter of the chest of the fetus and its tummy. The most informative and reliable are the data that are obtained as a result of measuring the fetal head.

Attention! The longer the gestational age, the greater the error in determining the gestational age using ultrasound data (ultrasound).

The high probability of such an error is explained by the fact that the development of the fetus in each case is very individual, especially after the completion of the formation of the main organs and systems by the end of the first trimester. As you know, by the end of the gestational age, the size of the fetus (its length and weight) can vary significantly.

Attention! The main task of determining the exact gestational age is to clarify the due date, but there is no absolutely reliable way to determine the due date.

With any determination of the gestational age, an error is possible, especially if the gestational age is determined for the first time after eight weeks. Therefore, it is very important to visit a doctor earlier and determine the terms of pregnancy earlier, which will be the most accurate.

It is very important to obtain information about the gestational age from different sources (gynecological examination and ultrasound data) in order to be able to compare them.

However, when determining the possible date of delivery, it should be remembered that normal labor can begin from the 38th to the 42nd week of pregnancy.

How is the gestational age determined by the first movement of the fetus

One of the ways to determine the gestational age is the first movements of the fetus that the pregnant woman feels.

As a rule, women who are carrying their first child begin to feel movements at twenty weeks. If this is the second child, then the expectant mother may feel a stir for a period of eighteen weeks.

A gynecologist who monitors the development of pregnancy must record the date of the first movement in the medical record, because this will allow you to clarify the gestational age and the expected date of birth:

To determine the expected date of the first birth, twenty more weeks (approximately four and a half months) are added to the date when the pregnant woman felt the first movement of the fetus - the result should be forty weeks.
To determine the estimated date of the second birth, twenty-two weeks (approximately five months) are added to the date when the pregnant woman felt the first movement of the fetus, forty weeks should be the result.

However, this method cannot be considered completely reliable, since different women feel the first movement at different times: some expectant mothers begin to feel movements as early as the 17th week (especially if the woman is thin), and some only at the 22nd.

Doctors are quite skeptical about the feeling of early movements, since this may be a reaction of the body to the work of the intestines and to increased gas formation.

Attention! The gestational age can be determined in different ways, but there are no completely reliable methods. Most accurately, the gestational age can be determined with a two-handed gynecological examination and with ultrasound (ultrasound) for up to eight weeks. After the 12th week, the reliability of the data decreases due to the individual characteristics of the development of the fetus.

Can bleeding begin after a gynecological examination, and what measures should be taken in this case?

Bloody discharge after a gynecological examination is quite possible, but most often they are explained by quite obvious reasons.

We should not forget that the speculum is a tool with a hard surface that can injure the vaginal mucosa. During pregnancy, the mucous membrane becomes more sensitive to any influences, so spotting can occur even with the slightest contact. Such secretions are not dangerous, and to cope with them, you just need to lie down a bit.

The cause of injury to the vaginal mucosa can involuntarily become the patient herself, who during the examination could not relax properly (especially the pelvic muscles) or made an involuntary movement (twitched), as a result of which the mucous membrane could be injured. Such bleeding is always short-term and completely harmless.

The cause of spotting may be the manipulation necessary in order to make a smear. Even light scraping from the surface of the mucous membrane can sometimes cause spotting, especially during pregnancy, when the mucous membrane becomes especially sensitive.

Sometimes spotting appears due to the onset of menstrual bleeding, which happens during a delay if a woman went to see a gynecologist. Obviously, such bleeding does not pose any danger.

Sometimes spotting appears as a result of examination in the presence of certain diseases of the female reproductive system:

The cause of bleeding or spotting can be endometriosis, which can be accompanied by pain;
Bloody discharge can be triggered by the presence of polyps in the area of the cervical canal, since polyps with such localization are very easy to injure even with the most careful gynecological examination;
There is a high probability of spotting after a gynecological examination in the presence of endometrial hyperplasia, because even a minimal mechanical effect on the thickened mucosa can injure and damage it;
Another cause of spotting after a gynecological examination is cervical erosion, in which the inflamed epithelial tissue can bleed on its own, without any intervention;
The cause of bleeding after a gynecological examination may be a miscarriage, or spontaneous abortion, at a very early stage, when the fetal egg cannot yet be determined in any way. As a rule, such a miscarriage after a gynecological examination is not associated with the examination itself, but with gynecological problems that a woman has and became more active after an outside intervention;
Sometimes the cause of bloody discharge after a gynecological examination may be a malignant tumor, which did not manifest itself in any way, but after medical manipulations began to separate a certain number of cells;
The mucous membrane of the vagina becomes more vulnerable as a result of any infectious disease that is sexually transmitted. Many inflammations of a bacterial nature cause discharge, including discharge with blood impurities. Therefore, when planning a pregnancy, it is very important to diagnose all possible diseases in a timely manner and cure them in time;
Bloody discharge can appear as a result of uterine fibroids and other benign tumors.

Attention! If bleeding began as a result of minor mechanical damage to the vaginal mucosa during a gynecological examination, then it is of a moderate nature and quickly stops.

Attention! If the bleeding that began after a gynecological examination does not stop within a few hours and lasts more than a day, then you should immediately consult a doctor.