UNIT 1 INTRODUCTION TO GYNECOLOGY

Definitions:

1) Puberty: Puberty is the period in which secondary sexual characteristics gradually develop.

2) Precious Puberty: Precious Puberty means when the secondary sexual characteristic in the glass starts before 8 years of life and menstruation cycle starts before 10 years then this condition is called Precious Puberty.

3) Delayed Puberty: Delayed Puberty is when the secondary sexual characteristic does not appear even after 13-14 years of life and menarche starts after 16 years, then this condition is called Delayed Puberty.

4) Menarchy: The first menstruation of life is called Menarchy.

5) Menopause: Permanent cessation of menstruation due to loss of ovarian follicular activity at the end of reproductive life is called menopause.

6) Caldosynthesis: If peritoneal fluid is aspired transvaginally from the pouch of Douglas, this condition is called Caldosynthesis.

7) Laparoscopy: Laparoscopy is a technique in which a fiber optic endoscope is introduced through the abdominal wall to visualize the peritoneal cavity.

8) Pelvic Inflammatory Disease This is usually an infection and inflammation of the upper genital tract organ, which usually involves the fallopian tubes, ovaries, and surrounding structures.

9) STD (Sexually Transmitted Disease): A sexually transmitted disease is a disease that is usually transmitted through sexual contact with an infected partner.

10) Vulvitis: Infection and inflammation of the vulva is called vulvitis.
11) Bartholinitis: Infection and inflammation of Bartholin gland/duct is called Bartholinitis.

12) Vaginitis: Inflammation of the vagina caused by infection and pathogenic organisms is called vaginitis.

13) Endometritis: Infection and inflammation of the endometrium is called endometritis.

14) Salpingitis: Infection and inflammation of fallopian tubes is called salpingitis.

15) Oophoritis: Infection and inflammation of the ovaries is called oophoritis.

16) Mastitis: Infection and inflammation of breast tissue is called mastitis.

17) Cervicitis: Infection and inflammation of the cervix is ​​called cervicitis.

18)Pyometra: Collection of pus in the uterine cavity is called pyometra.

19) Gonorrhea: is a sexually transmitted disease that is usually transmitted by nigeriagonorrhea.

20) Parametritis: Inflammation of pelvic cellular tissues is called parametritis.

21) Amenorrhea: Absence of menstruation is called amenorrhea.

22) Dysmenorrhea: Painful menstruation is called dysmenorrhea.

23)Menorrhagia: It has bleeding cycles at normal intervals but bleeding is observed in excessive amount.

24) Metrorrhagia: Metrorrhagia means irregular, acyclic bleeding from the uterus, then this condition is called metrorrhagia.

25) Epimenorrhoea: This is a condition in which the menstrual cycle is reduced to less than 21 days and the frequency remains constant, this condition is called epimenorrhoea.

26) Oligomenorrhea: Oligomenorrhea is a condition in which menstrual bleeding occurs after more than 35 days and remains constant in the same duration.

27) Dysfunctional Uterine Bleeding: This condition usually involves abnormal uterine bleeding without any organic cause such as tumor, infection, or pregnancy.

28) Uterine prolapse: This is an abnormal position of the uterus in which the uterus protrudes downward.

29) Cryosurgery: Cryosurgery is a condition in which tissues are effectively destroyed by freezing.

30)Perimyoplasty: Reconstruction of the narrow vaginal introitus is done in perimyoplasty.

31) Galactorrhea: Galactorrhea is a condition in which milky discharge is secreted from one or both breasts and is usually not related to child birth.

32)Rectocele: Rectocele is a condition in which the rectum is displaced into the vagina.

33) Enterocele: Enterocele is a condition in which the intestine is displaced into the vagina.

34) Cystocele: Cystocele is a condition in which the bladder is displaced downwards into the vagina.

35) Infertility:

Infertility is a medical condition in which there is inability to conceive a pregnancy despite having regular and unprotected intercourse for 1 year or more, then such a condition is called infertility.

It affects approximately 10-15% of couples worldwide. Infertility can be due to various factors affecting male, female or both, and can be temporary or permanent.

Type of Infertility
There are generally two types of infertility.

1) Primary infertility,
2) Secondary infertility

1) Primary Infertility:
It is indicated for patients who have not been able to conceive a single pregnancy.

2) Secondary Infertility:

Thus, prior pregnancy indicating conception but subsequent failure to conceive is called secondary infertility.

36) Dysuria: Difficulty in passing urine is a condition called dysuria.

37) Leukorrhea: Vaginal discharge in excessive amount is called Leukorrhea.

38) Dyspareunia: Dyspareunia means coital act being difficult and painful.

39) Epareunia : It is defined as inability to practice coital act.

40) Hirsutism: Hirsutism is the excessive growth of androgen dependent sexual hair on the face and central part of the body.

41) Urethrocele: It is generally defined as downward displacement of the uterus.

42) Fertility: The ability to bear a child in the uterus is called fertility.

• Gynecological history taking and investigation

History Taking

In it the woman’s complaint is written in her own words and written in the gynecological case record as follows,

1) Registration Number:

full name,
address,
telephone number,
name,
Insurance Details.

2) Demographic Data:

Patient’s Age,
Marital Status,
parity,
Occupation.

3)Chief Complaint or Present History:

origin,
Duration and Progress of Disease.

4) Past History:

medical history,
Surgical history.

5) Personal History:

diet,
Bowel and micturition,
Habbitt & Addickson,
Anne’s medication.

6) Marital History:

History of dyspareunia,
Contraceptive used or any sexual disease,

7) Family History:

History of Diabetes,
hypertension,
History of allergy,
carcinoma,
multiple births,
Thyroid disease.

8) Menstrual Disease:

Age at Menarchy,
past menstrual cycle,
Present menstrual cycle.

9) Obstetric:

Number of Full Term Delivery,
Pre-term delivery,
History of Abortion,
parity,
Date of Last Delivery,
History of postpartum hemorrhage,
History of Peripheral Sepsis,
History of caesarean section,
Immunization States.

Physical Examination:

1) General Examination:

Height in cm,
Weight in Kg,
nutritional status,
appearance,
paler,
edema,
lymphadenopathy,
Vital sign.

2) Systemic Examination:

Neurovascular status,
cardiovascular system,
respiratory system,
Intangumetry System,
skeletal system,
Hematological system.

3) Gynecological Examination:

A) Abdominal examination,
B) Pelvic examination.

A) Abdominal Examination:

inspection,
palpation,
Askalstation.

1) Inspection: Abdomen no sep, umbilical scar and lump.

2) Palpation: Properly check for any tenderness, rigidity and abnormal mass like structure filling.

3) Auscultation: Check if any peristalsis movement is felt.

B) Pelvic Examination: It usually involves examination of external genital area for appearance, any discharge and scar.

A) Bimanual examination: It usually checks the condition of cervix and uterus.

B) Speculum Examination: This usually involves examination of the cervix, vagina, or vaginal discharge, as well as screening for cancer.

C)Rectal Examination: It usually involves examination of the pelvic structures with gloved lubricated fingers. It is assessed whether there is any swelling and fissures.

Investigations:

General Investigations
Complete Blood Count (CBC),
Urine Analysis,
Blood Sugar Investigation,
Liver function test,
Kidney function test,
routine chest x-ray,
Pulmonary function tests: PO2 test, vital capacity,
ECG,
I/V pyelography,
blood grouping,
RH factor,
BT (Bleeding Time) & CT (Clotting Time),
Blood test for VDRL test, HIV test.
Special tests such as tumor markers.
Bacterial examination for genital tract.

Special Test:

1) PAP test: It is usually done for cervical cancer screening.

2) Cytohormone evaluation: It is commonly used to detect the levels of ovarian hormones estrogen and progesterone.

3) Uterine aspiration cytology: It is commonly used to detect endometrial cancer in postmenopausal women.

4) Cytoscopy: It visualizes the vagina and cervix.

5) Endometrial Biopsy: Endometrial biopsy is done when there is a condition of tubercular endometritis.

6) Other Tests:
ultrasonography,
CT scan,
MRI,
Radiological investigations such as hysterosalpingography (HSG) are performed to check the patency of the fallopian tubes.
Gynecological endoscopy such as laparoscopy and hysteroscopy.
Investigations like etc. are performed.