How gynecologists check pregnancy

Determination of pregnancy

For most women, the absence of the period is the first sign of pregnancy (Pregnancy). However, it is not a sure sign of pregnancy, as very few women have an exactly regular cycle. Exam stress, air travel or a cold are enough for many women to get the rule off the rails.

Often women notice other early signs of pregnancy, e. B. a pulling in the breasts or their size increase. But even these are not reliable signs.

To the 09j01secure Pregnancy signs include:

  • Detection of the embryo in its amniotic sac by ultrasound from the 5th Week of pregnancy (SSW)
  • Evidence of the child's heart activity in the ultrasound from the 7th week of pregnancy
  • 99% of the time also the positive reaction of an over-the-counter pregnancy test. This measures the hormone beta-HCG produced by the placenta (placenta) in the mother's urine. However, since there are also HCG-producing tumors (bladder moles), HCG detection is not an absolutely certain sign of pregnancy.

Pregnancy test. Every woman can work with one practically and quickly pregnancy test from the drugstore or pharmacy to find out whether she is pregnant or not. However, the test only works on the day of the absence of menstrual bleeding; However, if you have an irregular cycle, you should wait 1–3 days so as not to have to repeat the test. The test detects the pregnancy hormone beta-HCG in the urine. It is advisable to do the test in the morning after waking up, as the urine and the beta-HCG it contains are particularly concentrated. If you are pregnant, this hormone is produced by the placenta. The reliability of the urine test is very high today - it is around 99%.

If you want to be certain very quickly, you can have the blood checked by the gynecologist. An increase in beta-HCG can be detected in the blood as early as eleven days after fertilization, i.e. before the menstrual period has stopped.

Immediately to the gynecologist for a positive pregnancy test? Some women feel insecure or feel that they need to be fully examined immediately for possible risks of their pregnancy. However, the fact is: the gynecologist can only assess the pregnancy two or three weeks after the absence of the menstrual period, but then with the ultrasound very well, in particular, the exclusion of an ectopic pregnancy can be sure.

The first gynecological examination

This begins with the first visit to the gynecologist Prenatal care. For the first four months, it calls for a visit to the gynecologist every four weeks, for the following three months every three weeks, for the next two months every two weeks and for the last, tenth month, every week. The first investigation includes:

  • Inquiring about general and gynecological pre-existing illnesses as well as the course of previous pregnancies.
  • The calculation of the expected due date according to the Naegele rule. Most gynecologists use a small turntable to read the due date after setting the date of the last menstrual period.
  • The initial consultation on nutrition, general stress and childbirth (e.g. antenatal courses, maternity wards), possibly also information on genetic counseling.
  • Laboratory examinations: Urine examinations to record an increased excretion of sugar in the urine (indication of gestational diabetes) and a urinary tract infection; a blood test to determine the blood group and the Rhesus factor as well as the hemoglobin value to rule out anemia; Antibody determination in the blood for syphilis, rubella, hepatitis B and possibly also HIV / AIDS (an HIV test is only carried out with the express consent of the pregnant woman) or toxoplasmosis (as a self-payment service).
  • Physical examination with determination of body weight, blood pressure measurement (as high blood pressure can endanger mother and child), vaginal examination to assess the position of the uterus in the pelvis and to check the cervix, including a smear to check for chlamydia, palpation of the chest, examination of the legs on water retention and varicose veins.

An ultrasound is also performed, usually through the vagina (vaginally). Vaginal ultrasound is a little more uncomfortable for most women than ultrasound through the abdominal wall, but it produces much better images. In addition, the urinary bladder must be used for vaginal ultrasound Not be filled - in contrast to the ultrasound through the abdominal wall, in which about an hour before the examination you have to drink a lot without going to the toilet.

The findings of the prenatal care are in the Mother pass registered. If there is a high-risk pregnancy with an increased risk for the mother or child, additional examinations are carried out. Even if the pregnancy is healthy, the pregnant woman should not postpone or cancel an appointment.

Apart from the ultrasound, this screening program has remained roughly the same since it was introduced by health insurers in the 1960s. Pregnant women and their doctors hope that all these examinations will benefit mother and child. But it is also a fact that there are no systematic studies on the usefulness of this system in Germany. Data from individual federal states on the health of newborns show that the number of infant deaths during pregnancy has not decreased measurably over the past 20 years, despite close care. Maternal mortality halved every ten years in the 20th century, but without the introduction of preventive medical check-ups having noticeably accelerated this process. The question of how often a pregnant woman should see a doctor without recognizable risks has by no means been definitively answered.

Special text: Calculation of the expected due date

Continue reading:

Authors

Dr. med. Katja Flieger, Dr. med. Arne Schäffler in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). | last changed on at 12:09