Can a gynecologist diagnose pregnancy during an early examination?

One of the first things a woman might do is make an appointment with her gynecologist if she thinks she might be pregnant. Confirming an early pregnancy is frequently the first priority because it can raise a lot of questions.

A gynecologist might be able to identify early pregnancy symptoms during a first examination, but how reliable is this information? The response may vary depending on a number of variables, such as the doctor’s techniques and the stage of the pregnancy.

Although many women use home pregnancy tests, many also seek confirmation from their healthcare provider. However, what precisely can a gynecologist see in those initial weeks? Let’s discuss what to expect from your visit and what happens during an early pregnancy examination.

A doctor"s capabilities are limited

A home test, available at any pharmacy and even at the supermarket checkout, has a big advantage over a medical examination at the earliest stages. A test immediately after a delay, and sometimes even before it, will show a second strip, reacting to a special hormone – hCG, which is produced by the chorionic villi after the embryo is implanted in the uterus (this usually happens a week after ovulation). A doctor cannot detect traces of hCG, and during a standard examination on the chair he will not see anything special that would indicate an "interesting situation" – the uterus is still of normal size, not enlarged, because the size of the baby at the beginning of the delay is less than a millimeter. That is why you should not run to the gynecologist with a clearly positive test for pregnancy before the delay or in the first days after it – the doctor, alas, will not see anything except your joy and “striped” dough. A visit to the doctor should be timed to coincide with the time when ultrasound diagnostics can confirm the fact of pregnancy. Before and immediately after the delay, and the ultrasound doctor is unlikely to see anything in the patient"s uterus.

At week five of pregnancy, the fertilized egg starts to take shape, and at week six, the heartbeat of the embryo can be heard and seen. By this point, the first physiological symptoms typically manifest, enabling the physician, if needed, to verify the existence of the "interesting situation" during a physical examination.

During an initial examination, a gynecologist can often identify early signs of pregnancy by evaluating physical changes, such as an enlarged uterus or changes in the cervix. However, since these symptoms can occasionally be mild, particularly in the very early stages, more examinations such as blood tests or ultrasounds are usually required to definitively confirm the diagnosis.

Doctor"s terms

The first incomprehensible thing that women usually encounter when they come to an appointment with their "striped tests" after a delay is completely different terms from the doctor"s lips. The doctor, without inspecting anything, just asks when there were last menstruation, and with the help of a round obstetric calendar it calculates the obstetric period – it is usually more real, which confuses future mothers. The fact is that conception is possible only during ovulation, and which of the sexual acts led to the birth of a new life, and whether ovulation was timely, no one can know. That is why it is customary in the obstetric environment to measure the period according to obstetric standards. Doctors calculate the period as follows: the first day of the last menstruation is the first day of pregnancy.

In other words, a woman is four weeks pregnant by the first day of the delay, and five weeks pregnant if she shows up for her appointment after missing a week of menstruation. This shouldn’t be confusing because the global consensus is that this method of determining pregnancy is accurate.

Symptoms and signs that are important for the doctor

• presumed;
• possible;
• objective (they are also reliable).

A woman typically experiences a plethora of assumed signs and symptoms in the early stages, particularly if she dreams of having a child. In this state, bloating, insomnia, and the want to eat pickles are all interpreted by the woman as signs of pregnancy, effectively replacing reality with desire. As a result, physicians are dubious about patient complaints like:

• nausea in the morning;
• changed tastes and smells;
• headache (back, lower back);
• sleepiness (not sleepy at all);
• mood changes and you want to cry (laugh, swear, beat someone);
• chest pain, nipples have become very sensitive;
• urination has become frequent.

A specialist will listen to the patient, of course, but he needs more solid proof, like credible and plausible pregnancy symptoms. These are the following:

• increased blood circulation and blood filling of the vagina and uterine walls, an increase in the size of the uterus;
• slight swelling of the labia majora (a sign of fullness of the vulva);
• absence of menstruation;
• confirmed elevated hCG levels based on the results of a laboratory blood test;
• confirmation of the presence of a fertilized egg in the uterus based on ultrasound diagnostics.

As was previously mentioned, even for a highly qualified physician using a high-resolution device, it is extremely difficult to examine the embryo in the uterus up to five weeks. As a result, starting in the fifth week of pregnancy, a doctor can verify your pregnancy solely through an ultrasound and a blood test for hCG. The thicker layer of endometrium called the corpus luteum in the ovary is the most a doctor can see prior to this.

Early pregnancy hormonal changes cause physiological changes in the female body that eventually allow the doctor to detect pregnancy while the patient is on a chair for examination. This typically occurs between weeks six and seven of pregnancy.

Many women think that having a gynecological exam in the first trimester of pregnancy could harm the unborn child or result in miscarriage. This is a false impression. Microtraumas of the vaginal vessels after the insertion of instruments (the vagina, under the influence of progesterone, begins to be supplied with more blood and the vessels become more fragile) and a small pinkish discharge after the examination are not a threat of miscarriage, as worried women write on thematic forums. A delicate and qualified specialist will not do anything that could even theoretically harm. These microtraumas do not endanger the unborn child or the expectant mother.

Nowadays, a lot of gynecological offices have ultrasound scanners, so it’s not hard to figure out how far along a patient is in her pregnancy and whether it’s uterine or ectopic even at the first visit, which happens to be a week after the delay began.

Vaginal examination – how accurate are the results?

Early on, nothing abnormal is found during a chair vaginal examination; the absence of menstruation is the only objective indicator of a potential pregnancy. However, amenorrhea frequently indicates hormonal imbalances, certain neoplasms and tumors, as well as inflammatory diseases. Menstruation may not simply stop because of pregnancy. Additionally, at this early stage, a doctor’s only option is to perform a standard gynecological examination in order to rule out any potential pathologies.

The gynecologist can easily determine pregnancy based on physiological changes within 2-3 weeks of the start of the delay. The swollen labia may appear somewhat bluish due to increased blood circulation in the genital area.

Utilizing specialized mirrors, the vagina and cervix are examined. There is a strong likelihood that the woman is pregnant if there is swelling and cervix displacement in the center.

When a woman is bimanually palpated during a pregnancy, the uterus’s body is enlarged and has a spherical shape. The walls of the female reproductive organ are also softened. The uterine walls in women who are not pregnant are distinguished by their pear-shaped form and dense consistency. When a woman is pregnant, her cervix is more mobile and readily moves toward the uterine walls when palpated because progesterone, the pregnancy hormone, causes the isthmus to soften. This is how Rusin’s sign is evaluated.

The so-called obstetric sign of Snegiryov is the uterus’s capacity to contract and compress in response to touch; this ability is not identified in the early stages of pregnancy. During examinations, expectant mothers begin to exhibit this sign around the eighth week of pregnancy.

Goodell’s sign refers to the softening of the cervix that is experienced by all pregnant women. Progesterone precisely affects the cervix in this way. However, softening does not indicate that the fetus is in danger because progesterone has again caused a thick plug of cervical mucus to form inside the cervical canal. It will prevent bacteria, viruses, and other unwanted "guests" from entering the uterus.

Asymmetry in the female reproductive organ is identified at 7-8 weeks. One corner of the uterus, where the embryo has attached itself, is the one that starts to protrude. Obstetricians and gynecologists refer to this sign as Piskachek’s sign.

A gynecologist can provide insightful advice in the early stages of pregnancy, though diagnosis accuracy may vary. The doctor will probably perform a comprehensive examination on your first visit, which will probably involve going over your medical history and symptoms. They might also use ultrasound or a pelvic exam to look for early pregnancy indicators. It’s crucial to remember that the most trustworthy confirmations, like home pregnancy tests and blood work, typically come from a combination of tests.

The early symptoms of pregnancy can be subtle, making it difficult to diagnose, even though a gynecologist’s expertise is essential. Many times, the early indicators of pregnancy can be confused with other medical conditions, so it’s important to have further testing done as your doctor advises. Ensuring the optimal care for the developing baby and the mother is facilitated by an early and precise diagnosis.

In the end, it’s wise to make an appointment with a gynecologist if you think you might be pregnant. They can walk you through the procedure, run the required tests, and give you advice on what to do next. Their knowledge and assistance are invaluable in confirming your pregnancy and guaranteeing a healthy beginning for both you and your child.

Video on the topic

Pregnancy diagnostics | Lyudmila Shupenyuk

Is it possible to determine pregnancy from the first week?

Can a gynecologist diagnose pregnancy during an examination at an early stage?