Modern diagnostic methods in gynecology. Methods of examination of gynecological patients

Medical science does not stand still, and today, for the timely detection of various gynecological diseases, physicians, along with traditional, long-tested methods, use a number of the latest methods to get a more accurate idea of ​​the origin, nature of the course and degree of development of gynecological pathologies. In the arsenal of a doctor in our time there are a large number of methods for diagnosing women's diseases, the main of which are:

anamnesis;

assessment of the general condition;

inspection;

laboratory diagnostics;

instrumental diagnostics;

Anamnesis and assessment of general condition

What is an anamnesis? Anamnesis - a set of information that the doctor finds out by questioning the patient. Anamnesis data is obtained at a gynecologist's appointment and is used to select a diagnostic method, as well as to prescribe the necessary therapy. When collecting an anamnesis from women suffering from diseases of the reproductive system, specialists pay attention to the patient's complaints, age, lifestyle and quality of nutrition, the presence of bad habits, living and working conditions. Important for the correct diagnosis are information about previous diseases, the nature of the contraceptive methods used, the number of births and abortions or other operations on the genitals. In the process of collecting the necessary information, the gynecologist receives a general idea of ​​​​the history of the current disease.

What does a general health assessment include? To assess the general condition of the patient, the doctor needs to have information about the presence of mental disorders and metabolic disorders, existing cardiovascular diseases and a predisposition to the occurrence of malignant neoplasms. The gynecologist begins the assessment of the general condition of a woman with an external examination, paying attention to the physique, height and body weight, as well as to the features of the distribution of adipose tissue. During an external examination, special attention is paid to assessing the condition of the skin - their color, the nature of hair growth, increased porosity, and more. At this time, the condition of the mammary glands, lymph nodes is carefully examined, the lungs are auscultated and a thorough palpation of the abdomen is performed.

Communication with the patient is an integral part of the work of any doctor, the ability to correctly ask a question and listen carefully to the answer to it in most cases helps in making an accurate diagnosis. Today, many specialized sites provide an online gynecologist service that will help you get answers to many questions.

How is the inspection carried out? This diagnostic method includes examination of the external and internal genital organs with the help of special tools. In most cases, a gynecologist's examination is performed on a gynecological chair - the patient's legs lie on special supports, and the buttocks are on the edge of the chair. This position allows you to carefully examine the vulva and easily insert instruments into the vagina to diagnose the condition of the internal female organs.

When examining the external genitalia, the gynecologist pays attention to the size of the large and small labia, as well as the condition of the mucous membranes. The size of the clitoris, the nature of the hairline and the condition of the perineum are of no small importance for the diagnosis. At the time of examination of the external genitalia, it is possible to identify the occurrence of inflammation, tumors, warts, scars and fistulas - these pathologies can “tell” a lot to a specialist about the presence of certain diseases in the body, especially of an infectious nature. When examining the external genital organs, the gynecologist will offer the woman to push, which will make it possible to find out if there is a problem with the prolapse of the uterus and vagina.

Why is it necessary to examine the internal genital organs? The gynecologist examines the inner walls of the vagina and cervix using mirrors. These studies are usually carried out before bimanual diagnostics. Examination by mirrors is indicated only for those women who are sexually active. This method helps to recognize the presence of diseases of the cervix (erosion, polyps and other pathologies), during such an examination, smears are taken to detect violations of the microflora and to conduct cytological studies. Examination with mirrors allows, if necessary, to conduct a biopsy of various neoplasms of the vagina and cervix.

What is a bimanual study? Bimanual examination, that is, examination with the help of hands, is carried out after removing the mirrors. This method consists in palpation of the walls and arches of the vagina, as well as the cervix. Bimanual diagnostics allows you to determine volumetric neoplasms and anatomical changes in the internal genital organs of a woman.

Laboratory diagnostics

In practice, laboratory studies are used to detect various pathogens and to identify the degree of oncogenicity of pathological processes. The main methods of laboratory diagnostics today are PCR diagnostics, bacterioscopic and cytological studies.

Why do you need PCR diagnostics? PCR diagnostics is a method that allows you to determine the presence of the disease, even if a small amount of pathogen DNA molecules is present in the smear. This method helps to identify the occurrence in the body of such dangerous viral infections as various types of hepatitis, HIV, herpes, papillomavirus, chlamydia, mycoplasmosis, gonorrhea and others. These PCR infections are extremely dangerous for human health and life, so it is very important to determine their presence at an early stage, and PCR diagnostics will become an indispensable tool for this.

What is the essence of bacterioscopic and cytological studies? Bacterioscopic studies are used to diagnose various inflammatory diseases. Their results help to accurately determine the etiology of the inflammatory process. Bacterioscopy determines the degree of purity of the vagina, therefore, douching and treatment of the vagina with drugs is prohibited before it. This method consists in the fact that a swab is taken from the urethra, the posterior fornix of the vagina and the cervical canal with a specially designed instrument and sent to the laboratory for research. Bacterioscopic examination is indicated before any gynecological operations.

Cytological studies are aimed at detecting the occurrence of oncological diseases in the early stages of development. To do this, smears are taken from the surface of the cervix or cervical canal. To conduct such studies, you can also use the material obtained by taking a puncture from bulk neoplasms. The development of the pathological process in this case is recognized by the morphological features of the structure of cells, by the ratio of individual groups and the location of cellular elements in the test preparation.

Laboratory data enable the gynecologist to determine the cause of the development of any pathological process and prescribe a treatment suitable for each specific case. The online gynecologist service will help you understand the results of the tests and seek help from a specialist in time. Research in gynecology in our time is aimed primarily at preventing the occurrence of diseases of the female genital organs, so a timely visit to a specialist and periodic gynecological examinations will save you from health problems in the future.

Instrumental diagnostics

The main methods of instrumental diagnostics today are: colposcopy of the cervix, ultrasound, computed (CT) and magnetic resonance imaging (MRI).

What is a colposcopy? Such a research method as colposcopy is used today quite widely and is characterized by high diagnostic efficiency. This method allows you to assess the condition of the vulva, the walls of the vagina and the surface of the cervix using a special device - a colposcope, which gives an increase in the object by 30-50 times. Colposcopy of the cervix allows you to identify precancerous conditions in the early stages of development, makes it possible to choose the right site for a biopsy, helps to control the treatment process.

Now in practice, two methods of this instrumental examination are used: simple and extended colposcopy. A simple one allows you to determine the main parameters of the state of the cervix - its size, color, relief of the mucous membrane, as well as the state of the mucous epithelium. Extended colposcopy differs from simple one in that before examination, the cervix is ​​treated with a 3% solution of acetic acid, which causes short-term swelling of the epithelium and a decrease in blood flow. This makes it possible to see pathologically altered cells and clearly define areas for biopsy.

What is the essence of ultrasound, CT and MRI? These diagnostic methods are non-invasive, so they can be used to detect pathologies, regardless of the patient's condition. Ultrasound today is most often used to monitor the intrauterine development of the fetus, as well as for the early diagnosis of diseases of the uterus, its appendages and the detection of abnormal development of the internal genital organs.

Gynecological examination is an objective assessment of the health of a woman of any age. The meaning of the survey is invested in visual inspection, sampling for analysis, and instrumental research. Each patient should undergo preventive examination 1-2 times a year. If the patient's history contains any chronic diseases of the pelvic organs, suspicions of STIs, then visits to the gynecologist should be made at least 1 time in 3 months. This will quickly prevent the development of exacerbations and identify other pathologies at the very beginning of development.

Types of diagnostic examination

The tactics of examining a patient completely depends on her age, status, and the final goal of the study. All research methods in gynecology are classified in several areas and ways to achieve diagnostic goals. There are rectal, rectovaginal, vaginal (bimanual) examination with and without a mirror.

Usually gynecologists use several types of examinations at once for more reliable information. An examination of the genital organs is performed using an examination with gynecological instruments and is necessary to compile a holistic clinical picture. The color of the skin and mucous membranes, the condition of the skin, the presence of rashes or irritation, hair growth, the nature of the discharge, and the smell are taken into account.

Examine the contours of the anatomical structures, exclude the presence of pathologies or tumor-like formations by palpation of the outer walls of the vagina from the side of the peritoneum and from the inside with a finger. The gynecologist takes into account the condition of the perineum, perianal region and urethral canal. Some types of inspections include:

The smaller size of the uterus may indicate its infantility or the course of menopause. An increase in the size of the uterus is possible during pregnancy or tumors. The shape of the uterus during pregnancy has a spherical appearance, and with neoplasms - pathologically altered contours.

It is important to support a gynecological examination with laboratory results and instrumental examination data.

It is important to correctly convey the goals that are achieved during the study, for example, the exclusion of diseases, preparation for pregnancy, routine preventive examination, and so on.

Indications for examination and necessary tests

It is not always necessary to look for special reasons to visit a gynecologist, but many women usually neglect preventive examinations and go to the doctor already upon the discovery of symptoms of a disease or upon ascertaining the fact of pregnancy. The following conditions may serve as additional indications for examination:

Before the examination, the doctor visually assesses the patient's figure, the amount of hair in intimate places, and the hormonal status. It is important to remember that you need to answer the doctor's questions honestly, because this is part of the diagnostic measures and will provide an opportunity to get a more accurate clinical picture. For example, it is necessary to answer questions about sexual life, the nature of menstruation, about a partner, about the presence of serious diseases in history (for example, STIs).

During the examination, the following methods of examination of gynecological patients can be applied:

If serious pathologies are detected, minimally invasive research methods and surgical intervention can be prescribed:

Only one analysis or procedure is not enough to make a diagnosis. To identify gynecological diseases or pathological pregnancy, a comprehensive examination is carried out, the general clinical history of the patient is carefully studied.

Features of the diagnosis of STIs and bacteriological examination

A gynecological examination for STIs has some peculiarities, so it is very important to seek help immediately after questionable sexual intercourse. STIs are sexually transmitted infections, that is, infection occurs during sexual intercourse.

All sexually transmitted infections are classified into:

• infections caused by microbes(syphilis or gonorrhea);
• infections caused by protozoan microorganisms(trichomoniasis);
• hepatitis (B, C) or HIV.

Scabies, pubic pediculosis are common diseases transmitted through sexual contact.

A timely visit to the doctor will allow you to diagnose the disease and prevent its progression. The smear examination will be more effective when the infection has just joined. As other research methods, tests for sowing, a detailed biochemical blood test are used. For the diagnosis of STIs, it is important to apply all diagnostic methods in combination. Treatment for STIs should be given to both partners. Only a comprehensive gynecological examination can accurately predict the course and success of the entire therapeutic treatment.

Bacteriological research involves growing bacteria in special conditions to study their resistance to certain drugs. The most common method of bacteriological research is bacterioscopy. To study the non-fixed bacterial microflora, two methods are used:

• flattened drop(finding of bacteria between glasses);
• hanging drop.

It is important to remember that unfixed bacteria are extremely contagious. A smear is used for bacterioscopy of fixed bacteria. The most common method of fixing the drug is heating it with a gas burner or using fixing compounds. In the laboratory, fixed bacteria are always stained.

Preparing for the inspection: rules and regulations

Before visiting a gynecologist, it is important to follow all the necessary measures and conduct proper preparation. All these simple rules will allow you to determine the gynecological problem as accurately as possible, get full information from the test results, and help the doctor prescribe adequate treatment. Before preparing for the visit, it is important to do the following:

A complete gynecological examination includes the disclosure of complete information about the status of one's life, about the number of sexual partners. During the reception, you should not hide facts that may be important for making a diagnosis. You need to trust the doctor in order to fully discuss the existing problem, establish an accurate diagnosis, and exclude relapses of the disease. Removing the psychological barrier should also become the rule for visiting the gynecological office.

3. General and special methods of examination of gynecological patients.

General research methods include:

1. External gynecological examination- when examining the external genital organs, the degree and nature of the hairline (by female or male type), the development of the labia minora and labia majora, the condition of the perineum, the presence of pathological processes (inflammation, tumors, ulceration, warts, pathological discharge) are taken into account. Pay attention to the gaping of the genital slit, whether there is a prolapse or prolapse of the vagina and uterus (when straining), a pathological condition in the anus (varicose veins, fissures, condylomas, discharge of blood and pus from the rectum). The vulva and the entrance to the vagina are examined, taking into account their color, the nature of the secretion, the presence of pathological processes (inflammation, cysts, ulcerations), the condition of the external opening of the urethra and the excretory ducts of the Bartholin glands, the hymen.

2. Examination with gynecological mirrors- produced after examination of the external genital organs. Entering the mirror into the vagina, examine the mucous membrane of the vagina and cervix. At the same time, attention is paid to the color of the mucous membrane, the nature of the secret, the size and shape of the cervix, the condition of the external pharynx, the presence of pathological processes in the cervix and vagina (inflammation, trauma, ulceration, fistulas).

Technique for examining the cervix with a vaginal speculum: with the left hand, large and small labia are parted, the entrance to the vagina is widely exposed, then, the rear mirror (spoon-shaped) is inserted according to the direction of the vagina (front from above - backwards down), the rear mirror is located on the back wall of the vagina I slightly pushes back the perineum; then, parallel to it, an anterior mirror is inserted (a flat lifter is used), with which the anterior wall of the vagina is raised upwards. If it is necessary to increase access to the cervix, flat plate mirrors are inserted into the lateral fornix of the vagina. For inspection, in addition to spoon-shaped mirrors (Simpson) and flat lifts, folding mirrors (cylindrical, Cusco) are used, which are inserted to the vaginal vaults in a closed form, then the valves are opened and the cervix becomes available for inspection; the walls of the vagina are examined, gradually, removing the mirror from the vagina.

3. Vaginal examination- determine the state of the pelvic floor, feel the location of the Bartholin glands, feel the urethra from the anterior wall of the vagina. The condition of the vagina is determined: volume, folding of the mucosa, extensibility, the presence of pathological processes (infiltrates, scars, stenoses, tumors, malformations). The features of the vaginal fornix (depth, mobility, soreness) are revealed. Next, the vaginal part of the cervix is ​​examined: size (hypertrophy, hyperplasia), shape (conical, cylindrical, deformed by scars, tumors, warts), surface (smooth, bumpy), consistency (normal, softened, dense), position relative to the pelvic axis (directed anterior, posterior, left, right), the state of the external pharynx (closed or open, round shape, transverse slit, gaping), cervical mobility (excessively mobile, immobile, limitedly mobile), the presence of gaps is noted.

4. Bimanual (vaginal-abdominal, bimanual) examination- the main method for recognizing diseases of the uterus, appendages, pelvic peritoneum and fiber. Carried out after removing the mirrors. The index and middle fingers of one hand, dressed in a glove, are inserted into the vagina, the other hand is placed on the anterior abdominal wall. First, the uterus is examined, with palpation, its position, size, shape, consistency, mobility, and pain are determined. After completing the examination of the uterus, examine the appendages. The fingers of the outer and inner hands are gradually moved from the corners of the uterus to the side walls. Normal tubes are usually not palpable, healthy ovaries can be found with sufficient experience of the examiner, they are determined on the side of the uterus in the form of small oblong formations. Unchanged ligaments of the uterus are usually not detected, with inflammation, tumors, you can feel the round, main and sacro-uterine ligaments. Then pathological processes in the area of ​​the pelvic peritoneum and fiber (infiltrates, scars, adhesions) are revealed.

Technique of vaginal and bimanual (vaginal-abdominal-mural, two-handed) examination: the middle finger of the right hand is inserted into the vagina, with which the perineum is slightly pulled backwards, then the index finger of the right hand is inserted and both fingers are advanced along the axis of the vagina until it stops (front to top-down and back), while the thumb is directed to the symphysis, and the little finger and the ring fingers are pressed against the palm, the back of their main phalanges rests against the perineum. Palpate the area of ​​the pelvic floor, the location of the Bartholin glands, palpate the urethra, determine the condition of the vagina, examine the vaginal part of the cervix. Then they proceed to a two-handed study, for which the left hand is placed above the pubis. The right hand is transferred to the anterior fornix, slightly pushing the cervix backwards. Palpate the body of the uterus with the fingers of both hands. Having completed the examination of the uterus, proceed to the examination of the appendages. The fingers of the hands are gradually moved from the corners of the uterus to the side walls of the pelvis: the fingers of the right hand are transferred to the corresponding posterolateral vault, and the fingers of the left hand to the iliac region. Moving the hands towards each other until they touch at the sacroiliac joint, they are mixed anteriorly and such movements are repeated two or three times until the area from the corner of the uterus to the side wall of the pelvis is explored.

5. Rectal (rectal) and rectal-abdominal studies - used in girls and girls, with atresia, aplasia, vaginal stenosis; in addition to a bimanual examination in case of tumors of the genital organs, in inflammatory diseases, in the presence of discharge from the rectum, fistulas, cracks, abrasions, etc. The examination is carried out with the 2nd finger of the right hand, which must be lubricated with petroleum jelly. In the study, the cervix, sacro-uterine ligaments, and pelvic tissue are easily reached and felt. The outer hand (rectal-abdominal examination) examines the body of the uterus and appendages.

6. Recto-vaginal examination - it is used in the presence of pathological processes in the wall of the vagina, rectum, in the surrounding tissue. The index finger is inserted into the vagina, the middle finger into the rectum. In this case, infiltrates, tumors and other changes are easily determined.

Special Methods

Functional diagnostic tests are used to determine the activity of the ovaries and characterize the estrogen saturation of the body:

I. Examination of cervical mucus- the method is based on the fact that during the normal menstrual cycle, the physicochemical properties of mucus are subject to changes: by the time of ovulation, its quantity increases and viscosity decreases under the action of certain mucus enzymes, the activity of which increases by this period.

1. Symptom "pupil"- expansion of the external pharynx with mucus of the cervical canal. The symptom is associated with a change in the amount of mucus depending on the hormonal saturation of the body. The symptom becomes positive from 5-7 days of the cycle. Assessed on a three-point system: 1 point (+): the presence of a small dark dot (early folliculin phase); 2 points (++): 0.2-0.25 cm (middle follicular phase); 3 points (+++): 0.3-0.35 cm (ovulation). After ovulation, the "pupil" symptom gradually weakens and disappears by the 20-23rd day of the menstrual cycle.

2. Symptom "fern"- crystallization of cervical mucus under the influence of estrogen. Evaluated on a three-point system: 1 point (+) - the appearance of small crystals (early folliculin phase, with little estrogen secretion); 2 points (++) - a clear pattern of crystals (middle folliculin phase with moderate estrogen secretion); 3 points (+++) - strongly pronounced crystallization in the form of a sheet (maximum estrogen production during ovulation). The symptom is negative in the luteal phase of the cycle.

3. Symptom of tension "cervical mucus"- mucus stretching more than 6 cm with a forceps inserted into the cervical canal. The slime is stretched into a thread, the length of which is measured in centimeters. The test is evaluated on a three-point system: 1 point (+) - thread length up to 6 cm (low estrogenic stimulation); 2 points (++) - 8-10 cm (moderate estrogenic stimulation); 3 points (+++) - 15-20 cm (maximum estrogen production). In the luteal phase of the cycle, the tension of the mucus decreases

II. Colpocytological study of cellular composition vaginal smears - based on cyclic changes in the vaginal epithelium.

1. The reaction of the vaginal smear:

a - basal, parabasal cells, leukocytes are determined in the smear - a sharp estrogen deficiency;

b - parabasal cells and single intermediate cells in a smear - pronounced hypofunction of the ovaries;

c - in the smear, intermediate cells and single superficial ones - moderate ovarian hypofunction (present in the normal menstrual cycle in the follicular and luteal phases, with the exception of the periovulatory period);

d - in the smear there are superficial cells, single intermediate ones, among the superficial ones - cells with wrinkled nuclei - good estrogen saturation, determined in the periovulatory period.

2. Maturity index- percentage of superficial, intermediate and parabasal cells. It is written as three numbers, of which the first is the percentage of parabasal cells, the second is intermediate and the third is superficial cells. 0/20/80 - periovulatory period, the maximum level of estrogens and surface cells; 0/70/30 - early folliculin phase.

3. Karyopyknotic index (KPI)- percentage of surface cells with pycnotic nuclei to cells with vesicular (non-pycnotic) nuclei. KPI at the beginning of the follicular phase is 25-30% by the time of ovulation - 60-70%, in the luteal phase it decreases to 25%.

III. Measurement of basal temperature- the test is based on the hyperthermic effect of progesterone. The latter has a direct effect on the thermoregulation center located in the hypothalamus. Therefore, with an increase in progesterone secretion in the second half of the normal menstrual cycle, an increase in basal temperature by 0.4-0.8 0 C is noted. In the follicular phase, the basal temperature is below 37 0 C, the ovulation period drops to 36.2 0 - 36.3 0 C , after ovulation rises to 37.1 0 - 37.3 0 C, rarely up to 37.6 0 C and keeps on subfebrile numbers in the luteal phase (at least 10-12 days), immediately before menstruation drops to the original numbers. According to the basal temperature, one can judge the duration of the phases of the cycle, their usefulness, the presence or absence of ovulation.

IV. Histological examination of endometrial scrapings. The method is based on the appearance of characteristic changes in the endometrium under the influence of ovarian steroid hormones. Estrogens cause proliferation, and progesterone - secretory transformations.

Normally, in the secretion phase, the glands are enlarged, have a polypoid shape, a compact and spongy layer is visible. The cytoplasm in the cells of the glandular epithelium is light, the nucleus is pale. A secret is visible in the lumen of the glands. With hypofunction of the corpus luteum, the glands are slightly tortuous, with narrow gaps. With an anovulatory menstrual cycle, the endometrial glands are narrow or somewhat dilated, straight or tortuous. The glandular epithelium is cylindrical, high, the nuclei are large, located basally or at different levels. Atrophic endometrium is characterized by the predominance of stroma, sometimes single glands are visible. Scraping is extremely sparse

V. Blood test. It is based on the fact that the composition of the formed elements changes in accordance with the phases of the menstrual cycle. In the late folliculin phase, the number of leukocytes, platelets and erythrocytes increases. By the beginning of menstruation, the number of these elements is minimal. The method is less reliable due to large individual fluctuations.

VI. Skin allergy test. Based on the appearance of an allergic reaction in response to the introduction of hormonal drugs (estrogen, progesterone). At the injection site of hormonal preparations, a papule is formed, the size of which increases with an increase in the level of estrogen or progesterone. At the same time, along with an increase in the size of the papule, a local allergic reaction occurs: redness of the papule, itching. If the cycle is anovulatory, there is no change in the papule to the introduction of estrogens. A change in the papule with the introduction of progesterone during the period of the expected maximum function of the corpus luteum (late luteal phase) indicates that ovulation has occurred and a satisfactory function of the corpus luteum. The test is carried out over several menstrual cycles.

Hormonal-functional tests are used for topical and differential diagnostics of endocrine diseases both horizontally (ovaries-adrenal glands-thyroid gland) and vertically (uterus - ovaries - pituitary gland - hypothalamus - neurotransmitter mechanisms).

a) test with progesterone- used for amenorrhea of ​​any etiology to exclude the uterine form; it is considered positive if 2-4 days after 6-8 days of intramuscular administration of progesterone or 8-10 days after a single injection of oxyprogesterone capronate, the patient develops a menstrual-like reaction. A positive test excludes the uterine form of amenorrhea and indicates a deficiency of progesterone. A negative test can be with uterine amenorrhea or with estrogen deficiency.

b) test with estrogens and progesterone- is carried out to exclude (confirm) the uterine or ovarian form of amenorrhea. The patient is administered one of the estrogen preparations intramuscularly (estradiol benzoate, folliculin) or orally (ethynyl estradiol) for 10-14 days, then progesterone, as in the progesterone test. The onset of a menstrual-like reaction indicates a pronounced deficiency of endogenous estrogen, a negative result indicates the uterine form of amenorrhea.

c) test with dexamethasone- used to determine the nature of hyperandrogenism in women with signs of virilization, based on the inhibition of ACTH secretion. Before and after the test, the content of 17-KS is determined. A decrease in the level of 17-KS after the test by 50-75% indicates an adrenal source of androgens (positive test), by 25-30% - an ovarian origin of androgens (negative test).

d) test with clomiphene- is indicated for a disease accompanied by anovulation, more often against the background of oligo- or amenorrhea. The test is carried out after menstruation or a menstrual-like reaction. Clomiphene citrate is prescribed from 5 to 9 days from the onset of a menstrual-like reaction, its effect is felt through the hypothalamus. A negative test with clomiphene (no increase in the concentration of estradiol, gonadotropins in the blood plasma, monophasic basal temperature, absence of a menstrual-like reaction) indicates a hypothalamic-pituitary disorder.

e) test with luliberin- carried out with a negative test with clomiphene. 100 mg of a synthetic analogue of luliberin is administered intravenously. Prior to the start of drug administration and 15, 30, 60 and 120 minutes after administration, blood is taken from the cubital vein through a permanent catheter to determine the content of LH. With a positive test, by the 60th minute, the LH content rises to numbers corresponding to ovulation, which indicates the preserved function of the anterior pituitary gland and impaired function of the hypothalamic structures.

Gynecological diagnostics at the European level

Modern European medicine attaches great importance to regular health monitoring and prevention. It helps to prevent diseases and improve the quality of life at any age.

Gynecological diagnostics should normally be carried out not only in the presence of symptoms of any disorders, but also regularly, twice a year, in the check-up format. This approach to women's health helps to prolong youth and avoid many serious problems, because often dangerous gynecological diseases are asymptomatic.

And of course, it is especially important to immediately contact the Clinic for a gynecological examination in case of symptoms such as:

• discomfort or pain in the lower abdomen and in the genital area;
• discharge unusual in quantity, color, or consistency;
• any menstrual irregularities;
• itching, burning, the appearance of erosions, cracks, spots on the mucous membrane;
• discomfort and discomfort during or after intercourse.

The role of gynecological diagnostics is wider than is commonly believed

Diagnostics in gynecology, of course, plays an important role. A disease diagnosed in time is easier to cure and does not entail serious consequences. This is especially important because the health of the female genital area actually affects all the main aspects of a woman's life: it directly affects the appearance, self-confidence, determines the ability to conceive and successfully bear a healthy child.

However, the role of gynecological diagnostics is not limited to this. Modern diagnostics in gynecology, among other things, makes it possible to identify or exclude possible contraindications to a number of cosmetic, aesthetic and medical procedures, which increases their effectiveness and safety, and helps to avoid risks. In particular, in GMTCLINIC, gynecological diagnostics can be prescribed by a doctor before undergoing a course of body shaping procedures. In addition, diagnostics in the field of gynecology and endocrinology helps to identify some of the factors that affect aging and determine how to reduce their influence.

Diagnostics in gynecology at GMTCLINIC. A full range of. High quality.

At the Clinic of German Medical Technologies, you will be offered consultation and expert diagnostics by experienced specialists in the field of gynecology and endocrinology, as well as access to the most modern diagnostic methods using the best diagnostic equipment and laboratory diagnostic capabilities.

One of the main methods of gynecological diagnostics are informative and safe ultrasound examinations. Ultrasound diagnostics in gynecology, including during pregnancy, is carried out at the Clinic of German Medical Technologies using high-precision ultrasound devices of the latest generation PHILIPS brand. Due to the high sensitivity of the device and the qualifications of ultrasound specialists, the information content of this type of examination in GMTCLINIC is maximum!

As part of instrumental diagnostics in gynecology, GMTCLINIC performs simple colposcopy and advanced video colposcopy - a painless examination of the vagina, cervix, cervical canal using a special video colposcope device. Among other things, this technique makes it possible to exclude oncological diseases, which are especially dangerous precisely in connection with untimely diagnosis, since they are asymptomatic.

In the Clinic of German Medical Technologies, a wide range of laboratory diagnostics in gynecology is also carried out. The clinic cooperates with reputable laboratories in Moscow and guarantees the utmost accuracy and efficiency. In the Clinic, you can take all the tests necessary for diagnosis in gynecology - from a smear for flora and oncocytology, to Schiller's test and cervical biopsy. Express diagnostics and treatment of sexually transmitted diseases are also carried out.

Professional, accurate and prompt diagnostics in gynecology requires modern equipment and experienced specialists. The clinic of German Medical Technologies offers you the highest level of diagnostics that meets strict European standards. Make an appointment with a gynecologist at GMTCLINIC for diagnosis if you have any symptoms that bother you or undergo regular preventive examinations. We guarantee the accuracy, efficiency, comfort and anonymity of any research. With us you can be sure that your health is in reliable and professional hands.

Price list

Diagnosis of sexual diseases and health conditions of a woman provides the gynecologist with information that can be used to make a clinical diagnosis much more accurately, if necessary, develop a logical tactic for further examination and prescribe adequate, correct treatment.

Inspection

Examination of the patient by a gynecologist is one of the most important methods for assessing the state of her health. During the examination, the doctor conducts a gynecological examination: bimanual examination, examination in the mirrors, examination through the rectum, which allows obtaining objective data necessary for making the correct diagnosis. In parallel, an anamnesis of life and disease is collected.

Laboratory diagnostics (tests)

Along with general laboratory examinations: general blood and urine tests, a biochemical blood test, a blood test for group and Rh factor, a coagulogram (determination of blood clotting) in gynecology, there are also specific tests, which include: analysis for the TORCH complex (detection in antibodies to rubella, herpes, toxoplasma, cytomegalovirus and chlamydia), hormonal screening, microbiological diagnostic methods, enzyme immunoassay, polymerase chain reaction, pregnancy test, blood test for tumor markers.

Detection of the concentration of hormones in the blood (hormonal screening)

This diagnostic method allows you to identify endocrine pathologies. Hormonal screening allows you to reliably assess the nature of the basal secretion of steroid and tropic hormones in the blood of a woman. At the same time, the degree of hormone activity is studied at different phases of the menstrual cycle (prolactin, gonadotropic hormones (LH, FSH), testosterone, estradiol, cortisol, thyroid hormones (T3, T4) and many others are studied).

Microbiological diagnostic methods

Microbiological research allows to identify microorganisms in the female genital tract and thus to establish the etiological cause of the disease or pathological condition. This method allows diagnosing infectious and inflammatory diseases of the female genital area. With the microbiological diagnostic method, bacteriological cultures are preliminarily made: a smear from the vagina, cervix, urine or blood is sown on a nutrient medium and colonies of microorganisms are grown, which are then examined under a microscope. This method also allows you to identify the sensitivity of a particular pathogen to antibiotics and correctly, taking into account the sensitivity of the microorganism, to select an antimicrobial drug for the treatment of the disease. Microbiological examination is the cheapest diagnostic method, but does not always give accurate, objective results.

ELISA or enzyme immunoassay

ELISA blood test is a more accurate (compared to the microbiological method) research method. This diagnostic method, in addition to identifying the etiology of the pathogen, also allows you to identify the stage of the pathological process (acute, subacute, chronic, reinfection, subsidence of the pathological process, the consequences of the inflammation process).

Polymerase chain reaction - PCR (or DNA diagnostic method)

PCR is the most accurate reliable method for diagnosing infectious and inflammatory diseases (however, it is also the most expensive). When carrying out this reaction, a fragment of the DNA of the microorganism is removed from the biological material (vaginal swab, urine, blood). PCR has a high degree of diagnostic accuracy and detects a wide range of pathogens (protozoa, bacteria, fungi, viruses).

Pregnancy test

Used to diagnose pregnancy. It is based on the detection in the urine of a pregnant woman of chorionic gonadotropin, which is produced by the embryo from the first weeks of pregnancy.

Blood test for the presence of tumor markers

This analysis is non-specific, it is prescribed in cases of suspected presence of ovarian cysts, malignant neoplasms of the female genital area, therefore, it requires repeated repetition and additional diagnostic methods.

Instrumental diagnostic methods

ultrasound

This method uses the principle of reflection of an ultrasonic signal from the boundary of body media with different density and structure. Using ultrasound, you can diagnose diseases of the abdominal cavity, pelvic cavity, mammary glands, as well as diagnose uterine neoplasms (ultrasound using a vaginal probe).

Hysterosalpingography

Hysterosalpingography can be ultrasound and X-ray. The study is carried out in order to diagnose the patency of the uterus and fallopian tubes.

basal body temperature chart

A curve that is built on the basis of daily measured temperature indicators in the rectum. A basal temperature chart is necessary to determine ovulation (diagnosis of infertility).

Hysteroscopy

Assessment of the state of the uterine cavity using a special optical device - a hysteroscope. Hysteroscopy is performed to diagnose diseases of the cervix and the uterus itself and for the purpose of treatment (removal of a polyp, a site of hyperplasia of the endometrium of the uterus).

Colposcopy is an examination of the vagina using a special binocular device equipped with lighting equipment - a colposcope.

MRI of the Turkish saddle or CT (computed tomography)

Produced for the purpose of diagnosing the pathology of the pituitary gland (with menstrual irregularities).