Pregnancy is a physiological period of a woman’s life, which covers the time from fertilization of the mature egg to birth of the developed fetus. The duration of a normal pregnancy is on average 40 gestational weeks or 10 lunar months (280 days – 10 lunar months of 28 days). The period of pregnancy is divided into three trimesters: first trimester, covering the period up to 13 years; second trimester – from 14 to 26 years of age; third trimester – from 27 to 40 years of age The date of birth is determined by the Nagele formula – subtract 3 months from the first day of the last menstruation and add 7 days to that day. Of course, this formula is not absolutely valid for all pregnant women due to variations in the length of their monthly cycle. Ultrasound examination is also used to clarify the due date. To establish early pregnancy, all the information collected during the obstetric-gynecological examination is important – obstetric anamnesis, examination, palpation, laboratory tests and ultrasound examination. The main objectives in establishing an early pregnancy are: determining its location (intrauterine or ectopic), determining the term of pregnancy, determining the number of embryos (single or multiple) and determining whether the development of the embryo corresponds to the term of pregnancy. When taking an obstetric history, the date of the last menstrual period is of primary importance. It is necessary to extract detailed information about the menstrual cycle of the patient – duration, duration of menstruation, abundance, as well as duration of amenorrhea. Since not all amenorrhea means pregnancy, it is important to determine the presence of other complaints from the patient, such as bleeding and/or pelvic pain, which may be caused by an ectopic pregnancy. Causes of amenorrhea can be some gynecological diseases such as uterine polyps, uterine fibroids, polycystic ovary syndrome, etc. Of the patient’s subjective complaints, symptoms such as morning sickness, change in appetite, severe fatigue, painful breasts, irritability, change in sense of smell, etc., are important. Very often, early pregnancy symptoms can resemble those of premenstrual syndrome (PMS). Obstetric-gynecological examination aims to establish changes characteristic of a woman when pregnancy occurs. From the examination, changes in the pigmentation of the skin can be detected – darker areolas, a more pronounced midline of the abdomen, stronger pigmentation of the genitals. On the side of the mammary glands, the changes on examination may consist of increased sizes and the appearance of the characteristic network of Haller – multiple venous vessels that are visible due to the increased size of the breast. After the inspection, the so-called pelvic examination, in which a speculum is inserted into the vagina and the vagina and cervix are carefully examined. An uncertain sign of pregnancy is the livid coloring of the vaginal mucosa.During the pelvic examination, bimanual palpation is also performed, which aims to establish the status of the cervix and changes in the uterine body. During pregnancy, the cervix is softened, and this is not always a permanent symptom. Palpation of the uterus determines its size, consistence and position. During pregnancy, the consistency of the uterus is soft, most pronounced in the isthmic part – Hegar’s symptom. Sometimes in the place of attachment of the fetal egg, a bump can be palpated – the so-called. Piskacek’s sign. This sign is most noticeable between the 8th and 12th grade. In addition to the consistency, the position of the uterus also changes – anteversion and anteflexion increase, and the uterus begins to stand up – Hector’s symptom. The most reliable methods for establishing early pregnancy are ultrasound examination and measurement of plasma levels of beta-human chorionic gonadotropin (beta-CHG). Beta-CHG levels double every 48 hours until 7 yrs, from 7 to 12 yrs. their value is maintained, and after the 12th grade begin to decrease. The measurement of the hormone can be done with a qualitative, urine or quantitative, blood test. Along with the measurement of beta-CHG, the ultrasound examination is also of great importance. Usually, such a study is recommended with a delay of at least 7-10 days, which corresponds to 5 years. With an earlier examination, it is not certain whether an ultrasound will be able to confirm a pregnancy. During an ultrasound examination at 5 years of age an embryo sac is visible, and in 7-8 years cardiac activity can also be detected. The detection of early pregnancy occurs after a comprehensive gynecological examination, which combines both physical examination methods such as inspection, palpation and auscultation, as well as clinical methods using equipment (ultrasound examination) and laboratory methods aimed at establishing the levels of beta-CHG.the ultrasound examination is also of great importance. Usually, such a study is recommended with a delay of at least 7-10 days, which corresponds to 5 years. With an earlier examination, it is not certain whether an ultrasound will be able to confirm a pregnancy. During an ultrasound examination at 5 years of age an embryo sac is visible, and in 7-8 years cardiac activity can also be detected. The detection of early pregnancy occurs after a thorough gynecological examination, which combines both physical examination methods such as inspection, palpation and auscultation, as well as clinical methods using equipment (ultrasound examination) and laboratory methods aimed at establishing the levels of beta-CHG.the ultrasound examination is also of great importance. Usually, such a study is recommended with a delay of at least 7-10 days, which corresponds to 5 years. With an earlier examination, it is not certain whether an ultrasound will be able to confirm a pregnancy. During an ultrasound examination at 5 years of age an embryo sac is visible, and in 7-8 years cardiac activity can also be detected. The detection of early pregnancy occurs after a thorough gynecological examination, which combines both physical examination methods such as inspection, palpation and auscultation, as well as clinical methods using equipment (ultrasound examination) and laboratory methods aimed at establishing the levels of beta-CHG.
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