When you are pregnant and you have to go to the gynecologist regularly, several examinations are carried out that can be uncomfortable for the woman since some consider it as a invasion of your privacyHowever, these examinations are necessary. It is essential that they be carried out with informed consent, explaining its usefulness, steps and possible discomforts.
One of them is the vaginal touch, which is nothing more than a exploratory test It involves inserting your fingers into the vagina to examine it. This allows the gynecologist or midwife to observe the progress of the pregnancy.
However not only useful for when you are pregnant, outside of pregnancy allows the doctor to check the size of the uterus, the state of the pelvic organs and diagnose whether or not there are any abnormalities such as cysts or other malformations. It also provides data on the cervical consistency and position and the presence of adnexal masses.
Possible vaginal examination can detect cervical incompetencies during the second trimester of pregnancy. Detecting these irregularities can prevent miscarriages or premature births thanks to this examination.
During the time of delivery, this scan is also used to know the baby's position, the dilation, consistency, descent, and rotation of the tiny new being's head. All of this information will be relevant for following the correct course of action.
What does a vaginal exam assess and how is it performed?
The professional inserts one or two fingers with a sterile glove to assess dilatation, length y consistency of the neck, the descent and orientation of the fetal head and if the membranes are intact. It can cause hassle and even a slight stained, but it shouldn't hurt if done gently. If bleeding is heavy, seek medical attention immediately. Examination should be avoided if bleeding is suspected. previous placenta.
How often is it recommended during labor?
Clinical practice guidelines recommend limiting the total number of examinations and performing them, in general, at intervals of about 4 hours in the active phase, or when there is a clinical indication (changes in contractions, sensation of straining, before analgesia). The greater the number of touches, the greater risk of infection, especially in prolonged or prolonged labors broken bag, so it is appropriate restrict frequency and act with aseptic technique.
Models of labor progression and the centimeter-per-hour myth
There are different models of labor progression (such as curves of Friedman y Zhang) that describe different rates of dilation. Modern evidence recognizes a great individual variability and questions rigid rules such as “1 cm per hour”. A birth slow but normal can give excellent results without artificially speeding up the process.
Risks, contraindications and consent
Repeated touches may increase the intrapartum and postpartum fever and the risk of chorioamnionitis when their frequency is abused. They are contraindicated in suspected placenta previa and should be evaluated with caution if there is active bleeding or Premature rupture of membranes. The teaching of the personnel in training does not justify unnecessary consecutive examinations; without information and permission they can be considered disrespectful practices.
Is it essential? Alternatives and limitations
Touch is useful, but subjective and with variability between observers; reports the status in that moment and does not accurately predict when the baby will be born. There are non-invasive signs (changes in the maternal behavior, pattern of contractions) and the so-called is investigated “purple line” as an external indicator of progress, although it is not 100% reliable. Hamilton maneuver It is not routinely recommended due to pain and increased bleeding; it could be considered only in contexts of planned inductionSome women explore the possibility of self exploration, but hygiene must be extreme and, in general, avoid it without indication and training to reduce risks.
Predicting the onset of labor: Bishop index and ultrasound
To estimate the proximity of delivery, the following are used: Bishop index (based on touch) and the cervical length by ultrasoundThe literature suggests that both may be associated with the onset of labor in the following days and with successful delivery. inductions, the Bishop being a independent predictor in several analyses. The fetal fibronectin does not always add value in term pregnancies without dynamics. In any case, no tool accurately predicts the exact moment: evolution is multifactorial.
This vaginal touch test It is necessary in women whether or not you are pregnant to avoid internal problems in the vagina and your reproductive system. At the same time, you should individualize your indication, limit its frequency and always be done with respect, science and consent, prioritizing less invasive methods whenever possible.
Integrating the best evidence with the woman's preferences, using tact when it informs clinical decisions and minimizing it when it is not essential, allows for more effective care. safe, respectful and focused on the physiology of childbirth.
