obstetric examination

After the pregnancy is determined, the following obstetric examinations should be performed: blood routine, urine routine, leucorrhea routine, three pairs of hepatitis B, liver function, hepatitis C, syphilis, HIV, couples with thalassemia screening, teratogenic kits + parvovirus B19, G6PD, blood pressure, weight check. Obstetric examination is an essential check item for pregnant women. Basic Information Specialist classification: maternity check check classification: biochemical examination Applicable gender: whether women are fasting: fasting Analysis results: Below normal: Normal value: no Above normal: negative: A negative test result indicates that the pregnant woman is in a normal condition. Positive: A positive indication may present a pregnancy risk. Tips: Do not rinse the vagina within 24 hours before the test, because water can easily wash away the bacteria that cause the disease, affecting the doctor to make a correct diagnosis. Normal value Blood tests are performed during the check-up, mainly to check whether the pregnant woman has anemia and other blood diseases. The contents of the examination include white blood cells, red blood cells, hemoglobin, and platelets. The method of examination is very simple. Use a steel needle to tie your fingers and take a little blood sample. That's it. Normal values ​​of blood routine examination: (1) Normal value of hemoglobin: 110~150 (g/L). (2) normal white blood cells: 10 * 10 ~ 12 * 10 (g / L) (some pregnant women can reach 15 * 10g / L). (3) Normal platelet value: 100*10~300*10 (g/L). To determine whether a pregnant woman is anemia, the main reason is to see the test results of hemoglobin. If it is lower than 110g/L, it is anemia and needs to be well conditioned. At the time of the birth examination, they were all normal. Clinical significance One-stop screening for Down's syndrome screening for early pregnancy in 11-13 weeks of pregnancy, including: 1. Pregnant women's age, height, weight, and race. 2. Determination of pregnancy-associated serum protein and free-human chorionic gonadotropin in maternal serum. 3. Ultrasound detection of the risk prediction results of the comprehensive examination of the posterior cervical skin transparent layer thickness (NT), fetal heart rate, nasal bone, facial angle, cardiac artery catheter and tricuspid blood flow at 11-13 weeks of pregnancy. The above results were calculated by the internationally adopted fetal chromosomal abnormality risk assessment system for early pregnancy, and the risk rate of the fetus with Down syndrome was calculated. The positive screening rate was 90%-95%. Serological screening of Down's syndrome at 14-21 weeks of gestation. Pregnancy 19-24 weeks, high, abdominal circumference, blood pressure, weight check, three-dimensional ultrasound exclusion screening in the second trimester. Pregnancy screening for 24-28 weeks of pregnancy, abdominal circumference, blood pressure, weight examination, extrapelvic measurement, OGTT, and high risk factors for diabetes. Pregnancy 28-34 weeks of high, abdominal circumference, blood pressure, weight check, three-dimensional ultrasound exclusion screening in the third trimester of pregnancy, ECG, repeated risk of sugar screening. After 36 weeks of gestation, the uterus is high, abdominal circumference, blood pressure, weight check, NST. Pregnancy 37-38 weeks of high, abdominal circumference, blood pressure, weight check, BPS score. Positive results may be diseases: pregnancy resistance, sub-suspension, threatened abortion, sputum, premature delivery, uterine rupture, umbilical cord prolapse, induced abortion, persistent occipital lateral position dystocia 1. Before the physical examination, the description includes past medical records, menstrual menstruation in the last 3 months, problems in menstruation, problems in sexual life, and the progress of previous pregnancy. 2. Do not rinse the vagina within 24 hours before the test, because water can easily wash away the bacteria that cause the disease, affecting the doctor to make a correct diagnosis. 3. When doing pelvic examination, you can go to the toilet first. In order to show the pelvic organs, B-ultrasound examination must be used to drink more than 500ml 2 to 3 hours before the examination, or to inject 300 ml of sterile isotonic saline into the bladder through the catheter to properly fill the bladder. 4. When doing vaginal speculum examination, the vaginal speculum will be deeply breathed when inserted, as relaxed as possible. The more nervous it is, the more likely it is to cause pain and affect the inspection effect. 5. Regular examination of the Pap smear. Inspection process Visual inspection Pay attention to the shape of the abdomen, the height of the uterus, the presence or absence of stretch marks, surgical scars, edema, etc. 2. Palpation Pay attention to the tension of the abdominal wall muscles, whether there is separation of the rectus abdominis muscles, the sensitivity of the uterine muscles, and the amount of amniotic fluid. The height of the fundus was measured by hand, and the height of the pubic humerus and the abdominal circumference were measured with a soft ruler. Subsequently, the four-step palpation method was used to check the size of the uterus, the type of fetal production, the first exposure of the tire, the orientation of the tire, and whether the first exposure of the tire was connected. Step 1: The examiner placed the bottom of the uterus with both hands to understand the shape of the uterus and measure the height of the fundus. It is estimated whether the size of the fetus matches the number of weeks of pregnancy. Then, with a slight push between the two fingers, the fetal part at the bottom of the palace is judged. If you do not touch the big part at the bottom of the palace, you should think that it may be a horizontal production. Step 2: The examiner's right and left hands are placed on the left and right sides of the abdomen, one hand is fixed, the other hand is gently pressed and examined, and the two hands are alternated to carefully distinguish the position of the fetal back and the fetal limbs. Step 3: The examiner's right thumb is separated from the rest of the 4 fingers, placed above the pubic symphysis, holding the first exposed part of the tire, further to find out whether it is the fetal head or the fetal buttocks, and pushing it to determine whether it is connected. Step 4: The examiner's left and right hands are placed on both sides of the first exposed part of the tire, and pressed down to the pelvic inlet direction to check whether the diagnosis of the first exposed part of the tire is correct, and determine the extent to which the first exposed part of the tire enters the basin. 3. Auscultation The fetal heart is heard on the abdominal wall of the mother near the back of the fetus. The normal fetal heart rate is 120-160 beats per minute. Pay attention to the fetal heart rate and the presence or absence of the umbilical cord murmur accompanying the fetal heart. Not suitable for the crowd Special diseases: Patients with hematopoietic dysfunction, such as leukemia, various anemia, myelodysplastic syndrome, etc., unless the examination is essential, try to draw less blood. Adverse reactions and risks 1, subcutaneous hemorrhage: due to pressing time less than 5 minutes or blood draw technology is not enough, etc. can cause subcutaneous bleeding. 2, discomfort: the puncture site may appear pain, swelling, tenderness, subcutaneous ecchymosis visible to the naked eye. 3, dizzy or fainting: in the blood draw, due to emotional overstress, fear, reflex caused by vagus nerve excitement, blood pressure decreased, etc. caused by insufficient blood supply to the brain caused by fainting or dizziness. 4. Risk of infection: If you use an unclean needle, you may be at risk of infection.

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