Examination outside pregnancy
Last reviewed: 23.04.2024
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Examination of women with miscarriage begins with a general examination, pay attention to the growth and body weight, the nature of the build, the severity of secondary sexual characteristics, the presence and nature of obesity, hirsutism, the presence of streaks on the skin (striae).
When evaluating a physique, it is advisable to use a morphogram. With a small growth, asthenic physique, there can be manifestations of general and genital infantilism. Signs of virilization (well-developed musculature, broad shoulders, narrow hips, hirsutism) are characteristic for manifestations of hyperandrogenism of the adrenal genesis. General obesity, chilliness, dry skin, lethargy - are characteristic of hypothyroidism, etc. The nature of the build will help assess hormonal and metabolic disorders.
Survey conducted on the organs and systems. Extragenital diseases, a condition of a liver, cardiovascular system, kidneys are revealed. Particular attention should be paid to the psychoemotional state. For women with habitual miscarriages, chronic stress, emotional stress, which is usually associated with a feeling of inferiority arising from the inability to communicate the child, are characteristic.
Gynecological examination should include examination of the external genitalia, examination with mirrors and a two-hand vaginal examination. It is necessary to pay attention to the nature of the hair, the severity of the arches, the condition of the walls of the vagina. Particular attention should be paid to the examination of the cervix. The presence of cicatrical changes, the gaping of the cervical canal indicate the possibility of development of ischemic-cervical insufficiency. A short small cervix is observed when the uterus is hypoplastic. It should be noted the manifestations of infectious damage to the cervix, vagina, vulva - the presence of kandil, ectopia, leukoplakia, cervicitis,
When palpating the uterus determine the size of the uterus, the ratio of the length of the uterus and cervix, the position of the uterus. A small hypoplastic uterus, a long thin cervix of the uterus is observed in genital infantilism. A small uterus, a short small cervix can be due to malformations of the uterus, as well as the presence of a septum in the vagina. The enlargement of the uterus can be in the presence of myomatous nodes, adenomyosis.
When examining the appendages of the uterus, there is an increase in the ovaries, swelling of the ovaries, adhesion in the small pelvis.