Obstetrics and Gynecology - Page 8

Obstetrics and GynecologyGynecology

Hysteroscopy

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Obstetrics and GynecologyGynecology

TCT

TCT, or ThinPrep Cytologic Test, involves using a specialized brush (cytobrush) inserted into the cervical canal and rotated several times to collect cells for examination. It is a diagnostic technique for cervical cancer and precancerous lesions. Compared to traditional cervical cytology, TCT requires less stringent specimen quality and has a higher detection rate for cancer cells. TCT helps in the early detection of precancerous cervical lesions, allowing for timely treatment before they progress to cervical cancer. It is a simple, economical, and practical screening method, but it should only be used as a screening tool and not as a definitive diagnostic basis. This test also cannot precisely locate the tumor, requiring integration with other examinations for a comprehensive assessment. Common TCT Result Interpretations: Normal range or benign cellular changes: This is a normal result; regular screening is sufficient. Atypical squamous cells: This is an abnormal result, highly suggestive of cervical cancer. Further biopsy for definitive diagnosis and treatment is recommended as soon as possible. Atypical glandular cells: This includes atypical glandular cells, adenocarcinoma in situ, and cervical adenocarcinoma. These are also abnormal results, highly suggestive of cervical cancer. Further biopsy for definitive diagnosis and treatment is recommended as soon as possible.

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Obstetrics and GynecologyGynecology

HPV test

HPV is the abbreviation for Human Papillomavirus, which has hundreds of types. It can cause various benign papillomas or warts on human skin and mucous membranes. Some types of HPV infection also carry the risk of causing cervical cancer. HPV testing primarily detects whether a person carries the HPV virus. A doctor collects exfoliated epithelial cells from the cervix or vulva using a small brush or other tools, then places them in a fixative for examination. HPV testing is recommended in the following situations: Superficial inflammation of the vaginal surface, contact bleeding, etc. Frequent symptoms such as increased and foul-smelling vaginal discharge, irregular vaginal bleeding, persistent pain in the sacrococcygeal, gluteal, and thigh regions, and difficulties with urination and defecation. Common Types of HPV Genital HPV includes types such as HPV6, 11, 42, 43, and 44, which often cause benign lesions like external genital warts, including low-grade cervical intraepithelial neoplasia (CIN I). These are considered low-risk types. High-risk HPV includes types such as HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68. These are associated with the development of cervical cancer and high-grade cervical intraepithelial neoplasia (CIN II/III), especially HPV16 and 18. Anything not falling within the above ranges is considered normal. It is important to note that if the test result is high-risk HPV, there is no need to be anxious. An HPV test only determines whether a person is infected with the human papillomavirus and cannot definitively diagnose cervical cancer. Infection with high-risk HPV does not necessarily mean that cervical cancer will develop. If the HPV test result is high-risk positive, further TCT testing and colposcopy are needed to determine the presence of cervical cancer or precancerous lesions.

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Obstetrics and GynecologyGynecology

Colposcopy

Colposcopy is a procedure that uses a special magnifying device to examine the vulva, vagina, and cervix, allowing for the observation of subtle lesions in the vagina and cervix that are not visible to the naked eye. It also enables targeted biopsies of suspicious areas to determine the nature of the lesions. Indications: Abnormal vaginal or cervical cytology Moderate to severe erosion with precancerous lesions on cytology Excessive vaginal discharge or post-coital bleeding Suspicious lesions observed with the naked eye Recurrent vaginitis Personal history or sexual partner with condyloma acuminatum

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Obstetrics and GynecologyGynecology

Gynecological examination

Gynecological examination refers to the examination of the vulva, vagina, cervix, uterus, fallopian tubes, ovaries, parametrial tissues, and the inner wall of the pelvic cavity, which can provide an early diagnosis for some gynecological diseases. It mainly includes general examination, abdominal examination, and pelvic examination, with pelvic examination being unique to gynecology. General Examination Includes measuring body temperature, pulse, respiration, and blood pressure, and if necessary, height and weight. Other examinations are similar to other internal medicine physical examinations. Abdominal Examination Includes inspection, palpation, percussion, and auscultation of the abdomen. Pelvic Examination Vulvar examination: Observe the vulvar hair, skin, mucous membranes, etc., for any abnormalities. Vaginal examination: Check if the vaginal mucosa surface is smooth, if its texture is normal, if there are any bleeding spots, and if the character and odor of vaginal secretions are normal. Cervical examination: Observe the cervix for any masses, ulcers, erosions, polyps, if the cervical size is normal, if the surface is smooth, if the texture is too hard, and if there is any uterine prolapse. Bimanual examination: After lubricating the fingers of one hand, the doctor gently inserts two or one finger into the vagina along the posterior wall through the vaginal opening, while the other hand cooperates with the examination on the abdomen. The main purpose is to check for abnormalities in the vagina, cervix, uterus, adnexa, uterine ligaments, and parametrial connective tissue. Rectovaginal examination: A combined examination of the abdomen, vagina, and rectum, supplementing the bimanual examination. It can assess the size of a retroverted and retroflexed uterus; the presence of lesions on the posterior uterine wall, rectouterine pouch, or uterosacral ligaments, especially the extent of cancer infiltration, as well as lesions in the rectovaginal septum, anterior sacrum, or within the rectum. Rectal-abdominal examination: Suitable for patients without a history of sexual activity, vaginal atresia, or other reasons making bimanual examination unsuitable. Other Examinations Pelvic and vaginal B-ultrasound: Can detect early lesions such as uterine fibroids and ovarian cysts. Colposcopy: Cannot directly diagnose cancer but can assist in biopsy for cervical cancer screening. Hysteroscopy: Can simultaneously assess the condition of the endometrium and the patency of the fallopian tubes. Laparoscopy: This examination is very expensive but highly accurate. It is not suitable for initial visits, but when repeated examinations fail to find a cause, laparoscopy can assess pelvic adhesions and simultaneously perform a fallopian tube patency test, though it requires anesthesia and hospitalization. Fallopian tube patency test (hydrotubation): Can determine if there is a blockage in the fallopian tubes. Hormone tests: Including estrogen, progesterone, androgens, follicle-stimulating hormone, luteinizing hormone, prolactin, testosterone, human chorionic gonadotropin, etc. Blood samples need to be drawn between day 2 and 5 of menstruation.

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Obstetrics and GynecologyGynecology

Prenatal check-up

Prenatal care refers to regular check-ups for pregnant women and their fetuses throughout pregnancy to prevent and detect complications early and reduce their adverse effects. Currently, domestic guidelines recommend prenatal check-ups at the following gestational weeks: 6-13 weeks +6, 14-19 weeks +6, 20-24 weeks, 25-28 weeks, 29-32 weeks, 33-36 weeks, and 37-41 weeks. A total of 7-11 visits are recommended. For those with high-risk factors, the number of visits should be increased as appropriate.

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Obstetrics and GynecologyGynecology

Rudimentary uterine horn pregnancy

Rudimentary uterine horn pregnancy refers to the implantation of a fertilized egg in the uterine horn at the junction of the uterus and the fallopian tube opening, where the embryo develops towards the uterine cavity rather than in the interstitial part of the fallopian tube. It is a relatively rare type of pregnancy in a special uterine location. The main symptoms include amenorrhea, abdominal pain, vaginal bleeding, and asymmetrical uterine enlargement.

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Obstetrics and GynecologyGynecology

Uterine hypertrophy

Uterine hypertrophy, or uniform enlargement of the uterus, is a condition characterized by thickening of the uterine muscle layer due to inflammation, pathogen infection, and other causes. It may be accompanied by uterine bleeding and cervical erosion. This condition is common in multiparous women and primarily manifests as menstrual irregularities, increased vaginal discharge, bloody vaginal discharge, lower back and abdominal pain, and abnormal urination and defecation.

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Obstetrics and GynecologyGynecology

Retroverted uterus

Uterine retroversion is a common clinical uterine position abnormality. If the longitudinal axis of the uterus remains unchanged, but the entire uterus tilts backward, causing the cervix to point upward, it is defined as uterine retroversion. Most patients with this condition are asymptomatic. However, patients whose uterine retroversion is caused by gynecological diseases may experience varying degrees of lower back pain, lumbosacral discomfort, dull pain in the lower abdomen, and anal prolapse sensation.

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