Clinical examination of the pregnant and lying-in women

Clinical examination of pregnant women and new mothers starts with questioning, i.e., gathering comprehensive and in-depth history, including midwifery.
History helps the doctor to be not only accurate picture of the state of the somatics, but also on neuro-psychic activity of the examined pregnant women and new mothers. Certainly rights C. N. Myasishchev when he captures the attention of a doctor on the need to study the mental activity of man. His remarks especially should be clear to the obstetrician-gynecologist.
Anamnesis allows to reveal the feelings of a man, which is especially clearly and vividly revealed the woman during pregnancy, delivery and motherhood in the broadest sense of the word.
Often pregnant women concerning state of the somatics the practically healthy people, in fact, is not always so. They often have abnormalities of the Central nervous system, clinically manifested their psychical activity. This circumstance obliges the doctor when the conversation with the pregnant woman, especially if she is soon coming generations, to pay great attention to the identification of factors that contributes to the violation of psychosomatic medicine in it, and this information can only be obtained through a survey. Therefore, we cannot limit ourselves to the study of higher nervous activity (GNI), the study only some separate external reactions, and should seek to find out from the surveyed women the complexity of its neuro-psychic state with the past.
Given simultaneously traces of the past and the peculiarities of this, the doctor would come to the clarification of the actual causes of the existing problems in pregnant women, rather understand planned tactics of birth and offer the most appropriate and effective methods of treatment. For this purpose, collecting medical history, the doctor is obliged to personally direct the conversation with a woman, to get necessary information.
"Properly assembled history is adequate display of objective data" (A. I. Nesterov).
Numerous clinical observations suggest that the characteristics of neuro-psychic activity in pregnant women often affect the course of pregnancy, delivery and the postpartum period, and some types of obstetric pathology can be considered as a manifestation of neurosis, and, as is known, nervous breakdowns are a symptom of disorders of the higher nervous activity. Therefore, it is clear the value of the collection of anamnestic data and personal contact gynecologist with the patient.
Describing the state of the psychical activity in this pregnant, of course, we do not consider it possible on this basis to talk about the type of higher nervous activity, because the definition of the type of GNI in humans at all - a very difficult task. In addition, a gynecologist has the ability to monitor the state and behavior of pregnant women, and especially mothers only for a very short period of time, the more so on the condition affects the presence of pregnancy. Through this disguise characteristic features for this type of higher nervous activity.
On the other hand, a doctor should be remembered, as already noted above that the violation of GNI may increase due to the impact on the brain cortex of adverse factors associated with certain experiences and memories, so-called "tracking responses"previous pregnancy or childbirth (especially pathological), or be caused by the presence of a pathological state and "obsessions" at the moment, or be caused by a prolonged course of the act of birth, etc.
In connection with the mentioned to speak of identifying some of the "prevailing" (at this time) features GNI received by a doctor based on a comprehensive examination of pregnant women and mothers, including, of course, thoroughly collected history.
Irritants, which could cause the development of neurosis women, too much. Here play the role it carried over infections, including gonorrhea, long infertility, induced abortion, associated with re-vysalivaniya the uterus, injured during the previous childbirth, nervous breakdown, etc.
If you are able to identify the signs of the disorder nervous-mental activity, we should specify the time of their development, namely preceded whether the phenomena of neurosis pregnancy or they have evolved simultaneously with the latter, and then to establish the facts with which a pregnant woman binds their development.
Once assembled, the history, the doctor goes to the objective study, following a well-defined order of examination of pregnant women or mothers.