How we manage emergencies
In the gynecological and obstetrical area, there are conditions for which the examination and the ultrasound are necessary in short times.
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Vaginal, vulvarous infections or cystitis are frequent reasons for requesting quick consultancy, both in pregnancy and in women in general, in all age groups. Depending on the condition, different diagnostic strategies will be necessary, on the basis of clinical evaluation and symptoms. In pregnancy it is generally not possible to start a therapy by mouth, but only local. If the analysis of the symptoms is not enough to reach a precise diagnosis, it will be necessary to carry out specific vaginal swabs. The most frequent symptoms are inflammations, itching, vaginal discharges which may be white, dense and odorless, or yellow and smelling. Only an accurate anamnesis, and the gynecological examination, will provide the necessary data for a targeted and effective therapy, also depending on the age of the patient, the drugs taking, and the conditions that favored the infection.
PAINFUL MENSTRUATION AND OVULATION:
Normally the pain or the discomfort present in these two moments of the menstrual cycle are bearable; there are nevertheless acute conditions , in which the pain does not stop with a simple and habitual painkiller. In this situation the gynecological examination is necessarily combined with the ultrasound to exclude the presence of any ovarian cysts, which may be the possible cause of the acute symptoms.
BLOOD LOSS IN PREGNANCY:
In the first trimester of pregnancy you may find loss of dark or sometimes bright red blood. These may be given from the implantation of the embryo, in most cases, but it is not possible to callm the mother-to-be without an obstetric ultrasound that excludes any pathology, such as the detachment of the placenta that is forming. In some cases the evaluation with a blood test is necessary, especially in very early pregnancies, in which ultrasound cannot be diriment. In the most advanced stages of pregnancy, blood losses have a different meaning. Also here it is needed not only ultrasound evaluation , but also clinical; important is the measurement of blood pressure and a medical examina to assess the neck of the uterine cervix.
In adolescence and peri-menopause very abundant periods can occur due to hormonal alterations. Sometimes also the heat of summer can be a contributing factor. Many women can have massive periods in their ordinary life , and are used to their blood flows. Nevertheless there may be conditions that result in an absolute lack of control of the flow and these may be traceable to endometrial and cervical polypes, uterine fibromes (but previously diagnosed). However the most frequent cause of sporadic abnormal bleeding is due to hormonal alterations. In these cases the shock therapy consists of administering anti-hemorragics or hormonal based drugs to stop the hemorragia. The ultrasound check always remains to exclude organic causes. Normally the emergency therapy is effective and allows the person not to arrive to anemization. In very rare cases a small surgical intervention may be necessary, which will be evaluated during the doctor’s visit.
ABSCESS FROM BARTOLIN’S GLAND:
It forms from a filling of the excretor duct of the bartolin’s gland. More frequent in summer and favored by the wet environment and tight clothes, if you do not act promptly it risks to become size almost as large as an apricot! Timeliness of diagnosis and adequate therapy, in the first line of antibiotics combined with hot-humid compresses to help spontaneous drainage, are very important.