A visit to an obstetrician-gynecologist in the absence of complaints should be at least once a year. Each examination with the specialist is structured. It consists of history and objective examination. 1. Gynecological anamnesis The purpose of the anamnesis is the collection of data for accurate diagnosis of the disease, clarification of past and accompanying ones. Each examination begins with a passport part: name, age, marital status, address, profession, then moves on to the patient’s complaints. The history of accompanying and past diseases should clarify any family burden, operations, chronic or sexually transmitted diseases relevant to the present condition. A specific part of the gynecological history is obtaining information about menstruation, sex life and reproductive health of the woman. It inquires about the date of the last regular menstruation, duration, cyclicity and strength of the bleeding. Past pregnancies, their course, sterility, abortions are specified. Gathering this type of information requires tact, discretion on the part of the physician, and mutual trust. 2. Objective gynecological examination It begins after the completion of the anamnesis and includes several methods: inspection, palpation, percussion and auscultation. During the examination based on antopometric data and physiological features, the patient’s constitution, security, tone, color of the skin and mucous membranes, hair, swelling, pathological secretions are determined. The examination of the patient continues after taking a supine position on a gynecological chair, with hands on the chest, maximally relaxed muscles and emptied pelvic organs – bladder and rectum. 3. Abdominal examination The examination determines its shape and level, its participation in breathing, presence of cicatrixes, pigmentation, type of hair, condition of the muscles and navel. Abdominal enlargement may be due to pregnancy, and shortness of breath may be a sign of disease changes. Through palpation, shape, size, border, consistency and mobility of organs and formations are determined. Percussion provides information about organ boundaries or volume-occupying processes. Auscultation serves to detect intestinal obstruction and pregnancy. 4. Examination of the external genitalia The examination of the external genitalia should be performed with the naked eye. A colposcope may also be used. Attention is paid to size and shape, inflammatory changes, sores and condylomas, secretions and swellings. The color of the vestibule of the vagina is important. Livid color is indicative of pregnancy or a stagnant process in the pelvis. In a forensic medical case, the state of the hymen is assessed and its integrity, abrasions and tears are described. The anal opening is also examined for pathological changes – ringworm, condylomas, tumor changes, leakage of blood, pus and other secretions. 5. Examination of the vagina and cervix It is carried out with special instruments – speculums. Before insertion, they must be sterilized,warmed and moistened. If better visualization is needed, obstetric valves are used. In patients with preserved hymen, rigid or flexible endoscopic instruments – vaginoscopes – are used. During the examination, an anatomical and physiological assessment of the vagina and cervix is ​​made, if necessary, material is taken for microbiological, cytological or histological examination. NEWS_MORE_BOX 6. Gynecological palpation – douching It is performed with both hands. An individual pair of sterile gloves is used for each patient. Depending on access, it is divided into several types. Vaginal-abdominal palpation is most often used. With her, one hand – external, opens the labia, and the other – internal, previously prepared in a gynecological position, penetrates the vagina. The gynecological position of the hand consists of flexion of the fourth and fifth fingers, maximum extension of the first and second, and maximum abduction of the thumb. The size of the cervix – normal-, hypo- or hyperplastic, its position and consistency – compacted or softened – is evaluated by the douching. The external opening of the cervix is ​​also evaluated – normally it is closed, but in case of abortion, pregnancy, polyps, it is possible that it is partially open. Examination only through the vagina is not enough. For this, the palpation is supported by the outer hand, which through the abdominal wall presses the organs to be examined to the inner hand. The uterus, fallopian tubes and ovaries, ligaments are examined sequentially. Normally, the uterus is equidistant from the symphysis and sacrum and equidistant from the side walls of the pelvis. When it is flushed, the relationship between the axes of the uterine body and the cervix is ​​also determined – flexio. In the absence of pathology, the fallopian tubes are not palpable. When the hand is removed from the vagina, its walls, pelvic floor, perineum, labia and urethra are evaluated. In addition to the vagino-abdominal technique, several more are known. In the recto-abdominal palpation, the inner hand is palpated, placed in the rectum. It is preferred in women with preserved hymen, in stenoses and anomalies of the vagina. Another technique is the vagino-recto-abdominal, in which the index finger is introduced into the vagina, the middle finger into the rectum, and the outer hand exerts pressure on the abdominal wall.and the other – internal, previously prepared in a gynecological position, penetrates the vagina. The gynecological position of the hand consists of flexion of the fourth and fifth fingers, maximum extension of the first and second, and maximum abduction of the thumb. The size of the cervix – normo-, hypo- or hyperplastic, its position and consistency – compacted or softened – is evaluated by the douching. The external opening of the cervix is ​​also evaluated – normally it is closed, but in case of abortion, pregnancy, polyps, it is possible that it is partially open. Examination only through the vagina is not enough. For this, the palpation is supported by the outer hand, which through the abdominal wall presses the organs to be examined to the inner hand. The uterus, fallopian tubes and ovaries, ligaments are examined sequentially. Normally, the uterus is equidistant from the symphysis and sacrum and equidistant from the side walls of the pelvis. When it is flushed, the relationship between the axes of the uterine body and the cervix is ​​also determined – flexio. In the absence of pathology, the fallopian tubes are not palpable. When the hand is removed from the vagina, its walls, pelvic floor, perineum, labia and urethra are evaluated. In addition to the vagino-abdominal technique, several more are known. During recto-abdominal palpation, the inner hand is palpated, placed in the rectum. It is preferred in women with a preserved hymen, in stenoses and anomalies of the vagina. Another technique is the vagino-recto-abdominal, in which the index finger is introduced into the vagina, the middle finger into the rectum, and the outer hand exerts pressure on the abdominal wall.and the other – internal, previously prepared in a gynecological position, penetrates the vagina. The gynecological position of the hand consists of flexion of the fourth and fifth fingers, maximum extension of the first and second, and maximum abduction of the thumb. The size of the cervix – normal-, hypo- or hyperplastic, its position and consistency – compacted or softened – is evaluated by the douching. The external opening of the cervix is ​​also evaluated – normally it is closed, but in case of abortion, pregnancy, polyps, it is possible that it is partially open. Examination only through the vagina is not enough. For this, the palpation is supported by the outer hand, which through the abdominal wall presses the organs to be examined to the inner hand. The uterus, fallopian tubes and ovaries, ligaments are examined sequentially. Normally, the uterus is equidistant from the symphysis and sacrum and equidistant from the side walls of the pelvis. When it is flushed, the relationship between the axes of the uterine body and the cervix is ​​also determined – flexio. In the absence of pathology, the fallopian tubes are not palpable. When the hand is removed from the vagina, its walls, pelvic floor, perineum, labia and urethra are evaluated. In addition to the vagino-abdominal technique, several more are known. During recto-abdominal palpation, the inner hand is palpated, placed in the rectum. It is preferred in women with a preserved hymen, in stenoses and anomalies of the vagina. Another technique is the vagino-recto-abdominal, in which the index finger is introduced into the vagina, the middle finger into the rectum, and the outer hand exerts pressure on the abdominal wall.in stenoses and anomalies of the vagina. Another technique is the vagino-recto-abdominal, in which the index finger is introduced into the vagina, the middle finger into the rectum, and the outer hand exerts pressure on the abdominal wall.in stenoses and anomalies of the vagina. Another technique is the vagino-recto-abdominal, in which the index finger is introduced into the vagina, the middle finger into the rectum, and the outer hand exerts pressure on the abdominal wall.