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INTRODUCTION
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TERMINOLOGY, GYNAECOLOGY: Study of female reproductive system., FIBROID: An abnormal non-cancerous growth of the muscles in the uterus., PUBERTY: When girl or boy become sexually mature., INFERTILITY: Inability to conceive., HYSTERECTOMY: Surgically removal of the uterus., CERVICAL LACERATION: A tear in the cervix.
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CONT…., MENOPAUSE: Cessation of menses., HYSTERSCOPY: A procedure used to examine the inside of the womb (uterus)., DYSPAREUNIA: Painful coitus., PID: An infection of reproductive organs in women., COLPOSCOPY: A magnified look at the cervix with a speculum in place.
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INTRODUCTION, Gynecology is the branch of medicine that focuses on women’s bodies and their reproductive health. It includes the diagnosis, treatment and care of women’s reproductive system and also screening and treating issues associated with women’s breast.
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DEFINITION, OBSTETRICS:, A branch of medical science that deals with pregnancy, childbirth and postpartum period., GYNAECOLOGY:, A branch of medicine that deals with the diseases and routine physical care of reproductive system of women.
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GYNAECOLOGICAL HISTORY TAKING, Gynecological history taking involves a series of methodical questioning of a gynecological patient with the aim of developing a diagnosis or a differential diagnosis on which further management of the patient can be arranged. This further treatment may involve examination of the patient, further investigative testing or treatment of a diagnosed condition. , There is a basic structure for all gynecological histories but this can differ slightly depending on the presenting complaint. When taking any history in medicine it is essential to understand what the presenting complaint means and what the possible causes (differential diagnosis) of the presenting complaint may be.
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BIODATA OF PATIENT, Name, Age , Address , Ethnicity , Occupation , Religion , Marital status , Social status
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Presenting complaint :, “What is the problem that brought you to the hospital/clinic?” Best to record this in the patient’s own words. “Were you referred by your doctor or did you self‐refer yourself to the hospital/clinic?”
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History of presenting complaint, Pain - Uterine; colicky pain felt in sacrum and groins Ovarian; Iliac fossa with radiation down anterior aspect of the thigh to the knee , Site - Localized/general/symmetrical, abdominal or pelvic , Onset (sudden or gradual), duration and evolution over time , Character and Severity , Relieving/Precipitating/Exacerbating factors - Help to date (Exercise, posture, external stimuli) , Associated features e.g. bowel or urinary symptoms, peritonitis, nausea, Timing , Effects - Impact on life, functional capacity, disability, hygiene, sexuality, employment, , Relationships , Spread - Radiation
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MENSTRUAL HISTORY, Menarche and menopause , 1st day of last menstrual period , Length of bleeding (days) , Frequency Regularity Bleeding between periods , Bleeding after intercourse , Any post menopausal bleeding *Nature of periods , Heavy? , Clots? , Flooding?
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PAST OBSTETRICAL HISTORY, Gravidity and Parity , Dates of deliveries , Length of pregnancies , Induction of labor/Spontaneous Normal Delivery? , Weight of babies Sex of babies , Complications before, during and after delivery
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PAST MEDICAL HISTORY, Operations (particularly pelvic or abdominal) and psychiatric illnesses., Identify presence of diabetes, epilepsy, thromboembolism, UTIs, STIs and other chronic conditions (e.g. thyroid disease, cardiac disease, asthma, connective tissue disorders).
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DRUG HISTORY, Prescribed medications , Non-prescribed medications/herbal remedies , Recreational drugs , Any known drug allergies .
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Sexual history, Frequency of sexual intercourse , Type of contraception used? , Any complaints before ,during and after sexual intercourse? , Dyspareunia –superficial or deep?
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Family history, “Are your parents still alive?” “Do they suffer from any illness?” – if dead “What was the cause of death?”, Do you have any brothers or sisters?” – if yes – “What is their state of health?” , Is there any family related disease in your family that you are aware of?” –diabetes, hypertension, malignancy, twins.
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Personal History, Sleep , Appetite , Micturition , Defecation , Weight loss or gain , Addiction, Family History , Medical conditions , Gynecological conditions , Malignancies , Consanguinity
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Social History, Occupation , Support network , Smoking , Alcohol , marital status , Ranking
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GENERAL EXAMINATION, Observe general appearance, state of nutrition, gait, level of consciousness, responsiveness etc., Height and weight- BMI, Vital sign (TPR BP), Hand and arms- assess tobacco-stained fingers, clubbing , Head and neck- facial hair distribution, anemia jaundice, cyanosis, achne, lymphadenopathy, thyroid diseases, Legs- ankles swelling
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BREAST EXAMINATION
