Today, women have less and less space for doubts - there are tests that can quickly determine the presence / absence of pregnancy. But even after the tests (which, by the way, are erroneous), women go to see a gynecologist to make sure of their "interesting position." From what period and by what signs obstetricians can determine pregnancy during examination, and whether they can be wrong, this article will tell.
Doctor's options are limited
A home test, available at any pharmacy and even at the supermarket checkout, has a great advantage over a medical examination at the earliest possible date. The test immediately after the delay, and sometimes even before it, will show a second strip, reacting to a special hormone - hCG, which is produced by the chorionic villi after the embryo is implanted in the uterus (this usually happens a week after ovulation).
The doctor cannot catch traces of hCG, and on a standard examination on a chair he will not see anything special that would indicate an "interesting position" - the uterus is still of normal size, not enlarged, because the size of the baby by the beginning of the delay is less than a millimeter. That is why you should not run to a gynecologist with a clearly positive pregnancy test before the delay or in the first days after it - the doctor, alas, will not see anything except your joy and the "striped" test.
A visit to the doctor should be timed to the time when ultrasound diagnostics can confirm the fact of pregnancy. Before and immediately after the delay, the ultrasound doctor is unlikely to see anything in the patient's uterus.
The ovum begins to be visualized at the 5th week of pregnancy, and at the 6th week of the embryo the heart begins to beat, and this can also be heard and seen. Usually by this time, the first physiological signs appear, which will allow the doctor, if necessary, to confirm the fact of an "interesting position" during examination.
Doctor's terms
The first incomprehensible thing that women usually face when they come to an appointment with their "striped tests" after a delay is completely different terms from the doctor's mouth. The doctor, without examining anything, simply asks when the last menstruation was, and with the help of a round obstetric calendar calculates the obstetric term - it is usually more than real, which confuses future mothers.
The fact is that conception is possible only during ovulation, and which of the sexual acts led to the birth of a new life, and whether ovulation was timely, no one can know. Therefore, it is customary in the obstetric environment to measure the term according to obstetric standards. Doctors consider the timing as follows: the first day of your last menstrual period is the first day of your pregnancy.
That is, by the first day of the delay, the woman has already 4 weeks of pregnancy, and if she comes to the appointment after a week of absence of menstruation, then this is already 5 weeks. This should not be embarrassing - this method of calculating pregnancy is generally accepted throughout the world.
Symptoms and Signs Important to the Doctor
After making the calculations, the doctor will assume that the woman may be pregnant, but such a diagnosis will not appear on the card until the specialist is convinced of this personally. All signs of pregnancy are divided:
- on the alleged;
- possible;
- objective (they are also reliable).
In the early stages, a woman usually has a huge number of alleged signs and symptoms, especially if she dreams of a child - in this state, and bloating, and insomnia, and the desire to eat pickled cucumber, the woman interprets only from the position of pregnancy, in fact, replacing reality with the desired. Therefore, doctors are skeptical about such complaints of patients as:
- sick in the morning;
- tastes and smells have changed;
- headache (back, lower back);
- want to sleep (do not want to sleep at all);
- mood changes and you want to cry (laugh, swear, beat someone);
- chest pains, nipples have become very sensitive;
- urination became frequent.
Of course, the specialist will listen to the patient, but he needs more convincing evidence, for example, possible and reliable signs of pregnancy. It:
- increased blood circulation and blood filling of the vagina and uterine walls, an increase in the size of the uterus;
- slight swelling of the labia majora (a sign of fullness of the vulva);
- lack of menstruation;
- confirmed elevated levels of hCG based on laboratory blood test results;
- confirmation of the presence of the ovum in the uterus according to ultrasound diagnostics.
As already stated, up to 5 weeks, it is very difficult to examine the embryo in the uterus even by a highly qualified doctor using a high-resolution apparatus. Therefore, a medical statement of the fact of your pregnancy is possible on the basis of an ultrasound scan and a blood test for hCG only from 5 weeks... Before that, the maximum that the doctor can notice is the presence of a corpus luteum in the ovary, a thickened layer of the endometrium.
Hormonal changes in the female body in the early stages of pregnancy gradually lead to changes at the physiological level, and then the doctor can already see the fact of pregnancy when examining the chair. This usually occurs no earlier than 6-7 weeks of pregnancy.
Many women believe that a gynecological examination in the early stages of pregnancy can harm the baby and lead to a miscarriage. It's a delusion. A delicate and qualified specialist will not do anything that can even theoretically harm, and small pinkish discharge after examination is not a threat of miscarriage, as worried women write on thematic forums, and microtrauma of the vessels of the vagina after the introduction of instruments (the vagina, under the influence of progesterone, begins to be supplied with more blood, and the vessels become more fragile). Such microtraumas pose no danger to either the expectant mother or her baby.
Today, many gynecological offices are equipped with an ultrasound diagnostic scanner, and therefore there are no significant difficulties in determining the gestational age in the early stages, to establish whether it is uterine or ectopic, does not arise already at the first visit a week after the start of the delay.
Vaginal examination - how accurate are the results?
During a vaginal examination on a chair for a short period of time, no changes are found, and the only objective sign of a possible pregnancy is the absence of menstruation. But menstruation may be absent not only due to pregnancy - hormonal disorders, some neoplasms and tumors, as well as inflammatory diseases are often manifested by amenorrhea. And at an early stage, the only thing that the doctor can do is to exclude possible pathologies by conducting a standard gynecological examination.
After 2-3 weeks after the start of the delay, the gynecologist will already quite easily establish the pregnancy by physiological changes: the labia look edematous, due to the increased blood circulation of the genitals, they may look somewhat bluish.
Examination of the cervix and vagina is carried out using special mirrors. With swelling and displacement of the center of the cervix, the likelihood that a woman is pregnant is high.
Bimanual palpation of the uterus with an existing pregnancy shows that the walls of the genital female organ are softened, the body of the uterus itself is enlarged, the shapes are spherical. Non-pregnant women are characterized by a dense consistency of the walls of the uterus, its pear-shaped shape. The sign of Rusin is assessed - if a woman is pregnant, the cervix is more mobile and easily moves closer to the walls of the uterus when palpating, since the isthmus softens under the action of the pregnancy hormone progesterone.
The ability of the pregnant uterus to respond to touch with a reciprocal contraction and compaction is the so-called obstetric sign of Snegirev, it is not determined in the early stages. Such a sign in expectant mothers during examination is found from about 8 weeks of pregnancy.
The softening of the cervix, which is common to all pregnant women, is called Goodell's sign. This is how progesterone acts on the cervix. But softening does not at all mean that the fetus is under threat - a thick plug of cervical mucus has formed inside the cervical canal, thickened under the action of progesterone again. She will not allow microbes or viruses, as well as other uninvited "guests" to enter the uterine cavity.
At 7–8 weeks, some asymmetry of the female reproductive organ is determined. The embryo is attached in one corner of the uterus, and it is he who begins to bulge somewhat. This sign is called Piskachek sign by obstetricians-gynecologists.
The likelihood of medical error
A doctor is, first of all, a person, and like any person, he has every right not to notice pregnancy during examination, if a woman turned to him with this request too early. That is why many experts refuse to examine a woman who came to an appointment with a striped test earlier than 6-7 weeks after the last month. This means that the specialist will conduct an explanatory conversation about probable and reliable signs and will make an appointment with the woman at a later date. That is why you shouldn't rush. You need to apply two weeks after the start of the delay. This will help reduce the likelihood of specialist error in diagnosing pregnancy.
But it is also not worthwhile to delay the treatment too much, so as not to miss the diagnosis of some pathologies that are important to detect at the earliest possible date, for example, an ectopic or frozen pregnancy.
If any doubts arise about the condition of a woman, the doctor does not make diagnoses based on the results of a vaginal examination: he necessarily conducts an ultrasound examination, prescribes a blood test for hCG, and only then an informed decision is made about further actions.
