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Examination outside of pregnancy
Last reviewed: 23.04.2024
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Examination of women with miscarriage begins with a general examination, paying attention to height and body weight, body type, severity of secondary sexual characteristics, presence and nature of obesity, hirsutism, presence of stretch marks on the skin (striae).
When assessing the physique, it is advisable to use a morphogram. With a small stature, asthenic physique, manifestations of general and genital infantilism may occur. Signs of virilization (well-developed muscles, broad shoulders, narrow hips, hirsutism) are characteristic of manifestations of hyperandrogenism of adrenal genesis. General obesity, chilliness, dry skin, lethargy - are characteristic of hypothyroidism, etc. The nature of the physique will help to assess hormonal and metabolic disorders.
The examination is carried out on organs and systems. Extragenital diseases, the state of the liver, cardiovascular system, and kidneys are identified. Particular attention should be paid to the psycho-emotional state. Women with habitual miscarriage are characterized by states of chronic stress, emotional tension, which, as a rule, is associated with a feeling of inferiority that arises from the inability to carry a child to term.
A gynecological examination should include an examination of the external genitalia, examination with speculums, and a bimanual vaginal examination. It is necessary to pay attention to the nature of hair growth, the severity of the vaults, and the condition of the vaginal walls. Particular attention should be paid to the examination of the cervix. The presence of cicatricial changes and gaping of the cervical canal indicate the possibility of developing isthmic-cervical insufficiency. A short small cervix is observed with uterine hypoplasia. It is necessary to note the manifestations of infectious lesions of the cervix, vagina, vulva - the presence of condylomas, ectopia, leukoplakia, cervicitis, etc.
When palpating the uterus, the size of the uterus, the ratio of the length of the uterus and the cervix, and the position of the uterus are determined. A small hypoplastic uterus, a long thin cervix are 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. An enlarged uterus can be due to myomatous nodes, adenomyosis.
When examining the uterine appendages, enlarged ovaries, ovarian tumors, and adhesions in the pelvis are detected.
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