Picture: Huang Jie| Written by: Aunt Weng| Editor in charge: Ling Lan
Hello everyone, my name is Aunt Weng, an obstetrician and gynecologist.
Welcome to the latest issue of “Berry has the answer”. The 4 questions in this issue are all related to gynecological examinations, and most girls are very concerned about it. But I am ashamed to ask other people’s gynecological examination details, I hope my answer can solve the confusion lingering in your little brains.
In this issue you will see:
Can a gynecological ultrasound detect cervical cancer?
Can I get HPV from a vaginal ultrasound?
Is there any difference between transabdominal ultrasound and yin ultrasound?
Is there a population limit for gynecological examinations?
The screening methods for cervical cancer and precancerous lesions include cervical cytology (also known as TCT) and HPV-DNA testing. The combination of the two is a commonly used screening method in clinical practice.
Both examination methods are performed in gynecological examinations. Use a special brush and rotate the cervix several times to obtain specimens and place them in their respective in the specimen bottle for inspection.
The former mainly observes whether there are abnormal changes in cell morphology, while the latter uses genetic testing technology to determine whether it is infected with HPV virus and the specific subtype of infection.
Whether it is TCT or HPV, it is only a means of screening. If there is an abnormality, such as abnormal TCT cervical cell morphology or HPV has high-risk types 16 and 18, yin is required. Endoscopy+biopsy pathology was further confirmed.
Ultrasound is usually not used as a screening method because ultrasound cannot detect early lesions in time, and the observed masses are often lesions to a certain extent, or even It can only be found when there is lymph node metastasis.
So if you encounter a hospital or a doctor or a physical examination agency that recommends using a yin endoscope, ultrasound or other fancy items to check for cervical cancer, you must be alert to whether you have stepped on the pit.
The diagnosis and treatment process of normal cervical cancer should be TCT + HPV screening, then the pathology of the yin tract endoscopy is clear, and finally the treatment is performed according to the degree of the lesion.
Regular physical examination institutions do TCT or HPV, and most of them are sent to public hospital laboratories or third-party testing institutions, which is also believed.
This question should be a question for many people. After all, the probe of the ultrasound has to enter the body, and cross-infection is a special concern of many people.
According to “Basic Requirements for Nosocomial Infection Management in Primary Medical Institutions”: Ultrasound probes (into the skin, mucous membranes, yin tract, rectum and other body cavities) must be disinfected or isolated for one person Ultrasonic probes should be thoroughly cleaned and disinfected after each shift inspection.
This means that each patient needs to sterilize the probe or use a new diaphragm (ie condom) before examination.
The correct use of condoms is recognized for the prevention of sexually transmitted diseases. The online saying that “condoms are not 100% safe” does not mean that there are “loopholes” in condoms , allowing viruses and bacteria to penetrate, but considering that the wearing method may be irregular, which may lead to contraceptive failure.
Therefore, the safety of the condom on the ultrasound probe is still guaranteed, but in my actual work, I occasionally encounter something very embarrassing for the doctor, that is, the condom on the probe. Accidental rupture, which may be related to the roughness of the lower body hair, or the dry yin duct, or the quality of the condom.
So I personally think that Health care workers can eliminate the ultrasound probe one by one, plus condoms, such double insurance will be safer, even if it is true To catch an accident like a condom rupture, the probe is sterilized, which also reduces the risk of cross-infection.
Transabdominal ultrasonography and yin tract ultrasonography are commonly used in obstetrics and gynecology. The two methods of ultrasonography have their own advantages and disadvantages, and the requirements for the subjects are slightly different.
Abdominal ultrasound generally requires recumbent or semi-recumbent position, and requires a full bladder (ie holding back) >), there is a clear contrast between the urine-filled bladder and the uterus in the ultrasound image, and the contours of the uterus and ovaries can be clearly displayed under the contrast of the fluid.
Generally, transabdominal ultrasound is suitable for women who are not sexually active, or the inspection scope is larger than the scope of the yin tract probe, such as Fetuses in the second and third trimesters or giant fibroids in gynecology.
Transyin ultrasoundno need to hold back, instead you need to empty your bladder and then take off your underwear, in bladder lithotomy position examine.
Because there is only a thin layer of yin duct wall between the yin duct probe and the uterus and ovaries, the clarity is better, and the measurement of the size of the follicle or mass is also more accurate Some can also be used for obese or those with thick abdominal fat to reduce ultrasound errors due to abdominal wall thickness.
Gynecological examinations in the traditional sense include external and external genitalia and pelvic organ examinations.
Examination of external genitalia requires observation of hair distribution, skin, lips, perineal body, pedicle, urethral orifice, vestibule, and orifice of yin, whether there are developmental abnormalities, skin lesions (such as skin discoloration) , ulcers, plaques, wart-like changes, skin breaks from scratching), lumps, and evidence of trauma or infection.
Internal genitalia, including yin tract, cervix, uterus, fallopian tube, ovary, and internal genitalia, require speculum placement and a doctor’s bimanual examination.
The gynecological examination is not limited to a specific population, but the specific items during the examination may vary according to the specific situation of the individual examined.
For example, when a young girl has abnormal secretions or genital itching, the doctor will not place a speculum to collect the secretions and observe the mucous membrane of the yin tract, but observe the mucous membranes and skin of the genitalia, and leave the yin canal orifice. Test secretions.
The requirements for post-pregnancy gynecological examinations, Preconception and Pregnancy Care (2018) are as follows:For all couples planning to conceive, a comprehensive examination is required in the first 3 months of pregnancy Physical examination, including gynecological examination, if not examined 3 months before pregnancy, can be supplemented in time during the first examination during the first trimester (6 to 14 weeks of pregnancy).
There are no mandatory requirements in the regulations for the second and third trimesters of pregnancy, but there are some special circumstances, such as 25-28 weeks pregnant women who need to have cervical secretions to check fetal fibronectin, or have secretions during pregnancy Abnormalities, yin tract bleeding, etc., from the perspective of disease treatment, gynecological examination is still required, but it is different from the non-pregnant state. At this time, the examination of the fallopian tubes and ovaries may not be affected by the enlargement of the uterus. Too accurate.
Of course, some pregnant women cannot undergo gynecological examinations. For example, those with suspected placenta previa generally do not undergo gynecological examinations. Therefore, Gynecological examinations during pregnancy need to be carried out by doctors according to the actual situation. Decide.
For postmenopausal conditions, regular gynecological examinations are also recommended. Menopause is just a state of amenorrhea caused by ovarian failure. The estrogen and progesterone in the body are reduced to the lowest level, but the It does not mean that you will not suffer from gynecological diseases, so you should pay attention to check even after menopause.
The examination items for postmenopausal women are the same as those of women of childbearing age, the difference is that due to the decrease of estrogen in the body, the atrophy of the vulva and yin mucosa oftenneed to use a small speculum in postmenopausal women to reduce discomfort during the exam.
Okay, the above is the answer to this issue, I hope it will help you.
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