Gynecology

Review tests

Transvaginal ultrasound

Ultrasound is a non-invasive examination technique that uses ultrasound to visualise the internal genitalia (uterus and ovaries). No preparation is required for vaginal ultrasound.

Mammography and breast ultrasound

Mammography is the radiological technique dedicated to the study of the breast. It makes it possible to detect cancer in its early stages, thus significantly improving cure rates.

It is particularly sensitive in the diagnosis of microcalcifications, which can be an early sign of breast cancer and which are difficult to detect by other imaging techniques.

A biannual mammography is recommended from the age of 35 for all patients who do not have a first-degree family history, becoming annual from the age of 40.

For a better assessment of the study, it is very effective for the woman to provide any previous mammograms she has at the time of the examination.

After the mammogram, the radiologist may request a breast ultrasound if considered appropriate, either because of the high density of the breast or to evaluate a finding detected in the mammogram.

Gynaecological surgery

This unit treats benign surgical processes (uterine myomas, hysterectomy, endometriosis, hydrosalpinx, ovarian cysts) and malignant processes (uterine and ovarian cancer) either by conventional surgery (abdominal route) or endoscopic surgery, the latter being increasingly used.

Endoscopic surgery is based on access to and direct observation of a cavity by means of an optic connected to a screen, which also allows the introduction of surgical manipulators.

In gynaecology, laparoscopy and hysteroscopy are used.

Laparoscopy consists of direct observation of the interior of the abdomen by introducing a lens through the abdominal wall, which facilitates the introduction of guides or trocars of between 5 and 12 mm in diameter that allow the surgery to be performed in a less aggressive way, with a minimal incision and a postoperative period of very few days.

Hysteroscopy is the technique that allows direct observation of the inside of the uterus. It is based on the introduction of a small calibre lens (3-5 mm) through the orifice of the cervix. It is used for the diagnosis and removal of polyps and myomas and for taking biopsies of the interior of the uterus. It is also very useful for the study of sterility or infertility problems. Hysteroscopy can be performed in most cases on an outpatient basis.

Cervical Pathology and Colposcopy Unit

The cervicovaginal smear test is performed during the gynaecological check-up, so no special preparation is necessary and it is completely painless. The cytology result is normal when the cells studied correspond to healthy tissue.
In other cases, there may be findings that are not related to cervical cancer (fungal infections, bacteria, trichomoniasis, etc.) or inflammatory cellular changes which, depending on the case, will require pharmacological treatment.
Regarding the results related to premalignant lesions and cervical cancer, in most cases they will require colposcopy to determine the degree and size of the lesion.
Colposcopy consists of direct and magnified observation of the cervix using an instrument called a colposcope, which consists of an optical system with a luminous focus that provides magnification and makes it possible to examine the affected area with great precision and, if necessary, to perform a biopsy by taking a minimal portion of tissue for histological study.

Breast Unit

This Unit is formed in a multidisciplinary way by gynaecologists, radiologists, sonographers, pathologists and surgeons for the best diagnosis and treatment of benign and malignant breast pathology.

For more information visit our Breast Unit section.

Assisted Reproduction IVF

Infertility is defined as a couple’s difficulty in getting a woman pregnant. It affects 15% of couples of childbearing age.

In couples in which the woman is under 35 years of age, it is considered normal that it can take up to a year to achieve pregnancy after normal sexual relations; in the case of women over 35 years of age, the period is shortened to six months.

After this time it is advisable to consult a reproductive specialist.

In the case of women, there are a series of risk factors that make it advisable to consult a specialist in assisted reproduction beforehand if you wish to become pregnant. The most important are:

• If you are over 38 years of age.
• If your menstrual cycles are very irregular.
• If you have uterine fibroids.
• If you have had endometriosis.
• If you have had a sexually transmitted disease.
• If you have undergone any type of abdominal surgery.

The causes of sterility are 40% due to female factor, 40% due to male factor and 20% of mixed causes, i.e. female and male.

At the Assisted Reproduction Unit of Hospital Ochoa we will carry out an initial orientation visit for your case and a study (semen analysis) of the couple TOTALLY FREE OF CHARGE.

For more information www.fivochoa.com

Pregnancy monitoring and follow-up

Based on a positive pregnancy test, a first visit will be carried out, which basically consists of:

• Ultrasound confirmation of the diagnosis of a developing pregnancy. The first ultrasound scan is performed around the second missed period (8 to 10 weeks).
• To rule out the possibility of complications (threatened miscarriage, ectopic pregnancy, etc.) at an early stage.
• Evaluate the health of the pregnant woman: medical history, weight and blood pressure control, request basic blood tests including the immunological status of all those infections that can be transmitted to the foetus through the placenta.
• Explain the possibility of performing the non-invasive prenatal test. This test can be performed from the 10th week of pregnancy by means of a blood test of the mother, does not pose any risk to the foetus, and allows the detection of the most frequent chromosomal abnormalities, fundamentally Down’s Syndrome, with a sensitivity of close to 100%, as well as other genetic alterations such as trisomies 13 and 18 and abnormalities of the sex chromosomes.

In the SECOND TRIMESTER of pregnancy, a second blood test is performed on the pregnant woman to rule out the presence of gestational diabetes (O’Sullivan test), and detection of group antibodies (indirect Coombs test).
The 20-week pregnancy ultrasound scan is very important at this stage of gestation. Its main objectives are:

• Measurement of foetal structures (skull, femur, etc.).
• Detection of malformations.
• Fetal sex.
• Location and evaluation of the placenta and amniotic fluid.
• Assessment of cervical length in relation to the risk of premature birth.

In the THIRD TRIMESTER of pregnancy the tests performed are basically:

• Blood tests oriented towards labour and obstetric anaesthesia.
• Ultrasound for the evaluation of foetal growth, amount of amniotic fluid, foetal position and state of the placenta.
• Cardiotocography or the ‘straps’ test, which consists of the continuous electronic recording of the foetal heart rate and uterine activity. This test provides us with information on the Fetal Respiratory Reserve (RRF), i.e. the placental capacity to transport oxygen from the mother to the foetus and the state of the baby’s defence mechanisms against the stress of childbirth.