HEALTH ASSESSMENT ANG GYNECOLOGY PPT.pptx

It is relating to reproductive health especially it is interesting in nursing and midwifery students in universities

1. GROUP1 PPT NO NAMES REG NUIMERS 1 MUGISHA Samuel EACC2410147 2 Sonia NYINAWUMUNTU EACC2410291 3 NIYONZIMA Olivier EACC2410130 4 SIBOMANA Anaclet EACC2410141 5 Uwamahoro valentine EACC2410143 6 RURANGWA Elyse EACC2410150 7 IZUWAYO Pauline EACC 2410121 8 Munezero Eric EACC2410118 9 Ndagijimana Marc EACC2410302 10 Emmanuel Twagirumukiza EACC2410296 11. HAKIRE Yves EACC2410138 12 INEZA OSEE MERCI EACC2410117 13 MANISHIMWE Adeline EACC2410128 14 NYIRANSANZINEZA Claudine EACC2410146

2. QUESTION? Gynecologic Disorders : Definition Infertility Gynecologic Assessment

3. 1. introduction Gynecologic disorders it is defined as a wide range of conditions affecting the female reproductive system (uterus, ovaries, fallopian tubes, cervix, vagina, and vulva).such as : structural : Abnormalities in the physical anatomy (e.g., uterine fibroids, uterine anomalies, pelvic organ prolapse, vaginal septum). Functional: Disorders related to hormonal regulation, menstruation, or cellular processes .

4. Cont’d to disorders Infectious : Infections affecting the reproductive tract (e.g., pelvic inflammatory disease (PID), cervicitis, vulvovaginitis . Benign Neoplasms : Non-cancerous growths (e.g., ovarian cysts, uterine fibroids, vulvar/vaginal cysts). Malignancies : Cancers (e.g., cervical cancer, ovarian cancer, endometrial cancer ,

5. 2.Infertility Definition : Clinically defined as the inability to achieve a clinical pregnancy after 12 months or more of regular, unprotected sexual intercourse or 6 months if the woman is over 35 years old. Types of infertility Primary Infertility : When a woman has never achieved a pregnancy. Secondary Infertility: When a woman has previously achieved a pregnancy (regardless of outcome) but is unable to conceive again.

6. Etiology (female factors(40-50% of cases) Ovulatory Disorders (PCOS, hypothalamic dysfunction) Tubal Factors (blocked fallopian tubes due to infections or endometriosis) Uterine Abnormalities (fibroids, polyps, congenital malformations) Endometriosis : Interference with tubal patency, Endometrial fragility Advanced Maternal Age (declining ovarian reserve) Cervical Mucus Problems : Vaginal Infections, Hormone Deficiencies

7. Etiology (male factors ) Varicocele – varicose of swollen vein in the testicle Cryptorchidism – undescended testicle at birth Restrictive undergarments Occupational exposure to heat, Working in a seated position. Immunological Factors ,Autoimmune reaction, Production of antibodies that destroy sperm Obstruction in Sperm Transport like Mumps, Epididymitis, STD’s.

8. Cont’d Low Sperm Count/Oligospermia: Total sperm count >20 million per mL Poor Sperm Motility (Asthenospermia): Motility 50% or greater Abnormal Sperm Morphology ( Teratospermia ) Erectile Dysfunction or Ejaculatory Disorders

9. Female Diagnosis Hormonal Testing (FSH, LH, AMH, progesterone) Transvaginal Ultrasound (ovarian reserve, follicle count) Hysterosalpingography (HSG) (checks tubal patency) Laparoscopy (for endometriosis/adhesions)

10. Male Diagnostic Tools Semen analysis Ejaculates into a specimen container Ejaculate examined for: Number Morphology Motility Normal Semen Analysis Results Volume >2.0 mL pH 7.0 – 8.0 Total sperm count >20 million per mL Motility 50% or greater Normal forms 50% or greater

11. Diagnostic Studies Male & Female Partner Anti-sperm antibody evaluation of cervical mucus and ejaculate are tested for agglutination Indication that secretory immunological reactions are occurring between cervical mucus and sperm

12. Treatment Medications (Clomiphene, Letrozole for ovulation induction) Intrauterine Insemination (IUI) (washed sperm placed in uterus) In Vitro Fertilization (IVF) (egg retrieval, fertilization in lab, embryo transfer) Surgery (tubal repair, myomectomy for fibroids) Lifestyle Modifications (weight management, quitting smoking

13. 6. PSYCHOLOGICAL IMPACT it deeply affects emotional and mental well-being. Feelings of sadness Frustration anxiety diminished self-esteem are common.

14. 3. GYNECOLOGICAL ASSESSMENT Introduction A comprehensive gynecological assessment is a cornerstone of women's healthcare, encompassing a detailed history, physical examination, and often, various diagnostic tests.

15. A. General Medical History a review of systems, past medical conditions surgical history allergies and current medications Chronic conditions such as diabetes hypertension

16. B. Gynecological History Menstrual History (cycle length, flow, pain) Obstetric History (pregnancies, deliveries, abortions) Sexual History (STI risk, contraception use) Contraceptive History: Past and current methods used, reasons for discontinuation, and any associated side effects Screening History: Dates and results of previous Pap tests, HPV tests Symptoms Review: such as pelvic pain, abnormal vaginal bleeding, discharge, itching, dyspareunia (painful intercourse)

17. c. Family history A family history of gynecological cancers ( e.g.,ovarian , breast, uterine) endometriosis, or other genetic conditions can significantly influence a woman's risk profile and guide further screening or genetic counseling

18. D. Social History Ask for Lifestyle factors such as : Smoking alcohol consumption illicit drug use Diet Exercise occupational exposures can all impact gynecological health.

19. II. Physical Examination: A Hands-On Assessment General Physical Examination This involves assessing : vital signs general appearance performing a focused examination of relevant systems based on the patient's history

20. B. Breast Examination A clinical breast examination (CBE) is performed to check for: lumps skin changes nipple discharge or other abnormalities it can detect palpable masses and educate patients on breast self-awareness. This technique involves both visual inspection and palpation of the breast tissue and axillary lymph nodes.

21. C. Pelvic Examination Inspection (external genitalia for lesions, discharge). Speculum Exam (cervix for abnormalities, Pap smear). Cervical Cytology (Pap Test): . This is a primary screening tool for cervical cancer. HPV Testing: HPV testing detects the presence of high-risk human papillomavirus types. Vaginal Discharge Assessment: STI Screening: Collection of samples (e.g., endocervical swab, urine)

22. D. Bimanual Examination After removing the speculum, the clinician inserts two gloved fingers into the vagina and places the other hand on the abdomen to palpate the uterus, ovaries, and adnexa. This allows for assessment of: Uterus: Size, shape, position, mobility, and tenderness Ovaries and Adnexa: Size, shape, consistency, and tenderness of the ovaries and fallopian tubes Pelvic Tenderness: Assessment for generalized or localized tenderness.

23. III. Diagnostic Tests and Imaging Pap Smear (cervical cancer screening) HPV Testing (high-risk strains detection) Ultrasound (transvaginal/abdominal for fibroids, cysts) Biopsy (endometrial biopsy for abnormal bleeding) Blood Tests (hormonal assays, infection screening) Saline Infusion Sonohysterography (SIS) / Hysterosonography Magnetic Resonance Imaging (MRI)

24. IV. Specialized Procedures: Deeper Insights Colposcopy: (a magnified viewing instrument) to examine the cervix, vagina, and vulva Endometrial Biopsy: diagnose conditions like endometrial hyperplasia, polyps, or cancer Hysteroscopy: to investigate abnormal bleeding Laparoscopy: is inserted to visualize the pelvic and abdominal organs.

25. V. Interpretation and Management: Synthesizing Information The final step in an accurate gynecological assessment involves synthesizing all the gathered information from the History,physical examination, and diagnostic tests to arrive at a diagnosis and formulate a comprehensive management plan. This plan may include: Counseling and Education Medical Management Surgical Intervention Referral to Specialists Follow-up and Monitoring

26. Conclusion The gynecological assessment that is history collection and physical examination and understand the all method of breast examination, abdominal examination and pelvic examination that is speculum examination, digital examination, bimanual examination, recto abdominal and rectovaginal examination. It is not merely a series of tests but a holistic evaluation aimed at promoting and maintaining women's reproductive health throughout their lives. The continuous evolution of medical knowledge and technology further refines the accuracy and scope of these assessments, ensuring better patient

27. Reference Practice Committee of the American Society for Reproductive Medicine. (2021). Diagnostic evaluation of the infertile female: a committee opinion. Fertility and Sterility, 116(5), 1226-1238. Hricak , H., & Reinhold, C. (2022). MRI of the Pelvis: A Practical Approach. Springer. Federle , M. P., Rosado-de-Christenson, M. L., & Woodward, P. J. (2021). Diagnostic Imaging: Abdomen. Amirsys . American College of Obstetricians and Gynecologists (ACOG). (2023). Well-Woman Visit. Bates, B. (2022). Bates' Guide to Physical Examination and History Taking. Lippincott Williams & Wilkins. Dains , J. E., Baumann, L. C., & Scheibel, P. (2023). Advanced Health Assessment and Clinical Diagnosis in Primary Care. Elsevier. Centers for Disease Control and Prevention (CDC). (2024). Diabetes and Women's Health. Speroff , L., & Fritz, M. A. (2022). Clinical Gynecologic Endocrinology and Infertility. Lippincott Williams & Wilkins.

28. End THANK YOU !!!!!!!!