Gynecology and obstetrics

Preventive healthcare for women

Early detection of diseases

Gynecological check-ups include regular examinations for the early detection of diseases of the female genital and breast area.

The aim is to detect and treat health problems such as cervical cancer, breast cancer or sexually transmitted diseases early. Typical components are the so-called Pap test (smear of the cervix), the breast examination and, depending on age or risk factors, further examinations such as ultrasound or mammography. The examination is recommended annually and is covered by the health insurance company to a certain extent.

Make an appointment
Prof. Dr. Christian Gnoth in conversation with a patient

Annual cancer screening (from 20 years):

Smear (Pap test):

Examination for cell changes on the cervix

Examination of the genital organs:

Check of uterus, ovaries and vagina.

Palpation of the breast (from 30 years):

Check for nodules or abnormalities.

HPV test (from 35 years):

The examination is carried out every three years in combination with the Pap test for the early detection of cervical cancer.

Mammography screening (50-69 years):

Every two years for early detection of breast cancer

Consultations:

Information about contraception, family planning or menopausal symptoms

Colorectal cancer screening:

From the age of 50, it is possible to carry out a stool test (iFOBT) for blood in the stool at one- to two-year intervals. You will receive the material for this from us. From the age of 55, this can be replaced by a colonoscopy. If there are any abnormalities in the stool test, you will be referred to a gastroenterologist.

Additional examinations (individual health services, IGel):

Some of our services offered are not included in the catalog of services of the health insurance companies and must therefore be paid for privately, for example:

    • Ultrasound of the breast or ovaries.
    • HPV vaccination for women over 18 years.
    • Test for sexually transmitted infections such as chlamydia (except for women under 25 who are entitled to an annual test).

You will receive separate information about these services from us, including the costs and a declaration of consent.

Pregnancy care

From the first confirmation to the birth

We are happy with you when your pregnancy test is positive! If you contact us now, an initial appointment will first be made to determine the gestational age and the expected date of delivery. Then you will receive all the information and already appointments for the further course.

During pregnancy, regular examinations are carried out to monitor the health of mother and child. These are part of the maternity care and include:

Make an appointment
Dr. med. Nina Bachmann during a sonography with a patient

Maternity care includes the following examinations:

  • Determination of gestational age
  • Collection of medical history
  • Handing out information material
  • Creation of the maternity passport

These are carried out to check the development of the child, the placenta and the amount of amniotic fluid according to a fixed schedule:

  • Basic ultrasounds: Standard in the 9th-12th, 19th-22nd and 29th-32nd week of pregnancy
  • Additional ultrasounds: In case of abnormalities or risk factors, e.g. Doppler ultrasound to check the blood supply, this is sometimes also done in cooperating practices of prenatal medicine specialists
  • Blood values (e.g. hemoglobin)
  • blood group once
  • Antibodies and infectious diseases (e.g. rubella, hepatitis).
  • The urine is tested for protein, sugar and infections.

Monitoring of maternal health.

from the 28th-30th week of pregnancy to monitor the baby’s heart tones and possible labor activity

is performed between the 24th and 28th week to detect gestational diabetes

To check the cervix and exclude possible infections. If necessary, vaginal swab for examination for group B streptococci (35th – 37th week).

Information and, if necessary, implementation of vaccinations against influenza, pertussis (whooping cough) and the RS virus during pregnancy

after clarification and depending on the risk of the pregnant woman, a so-called NIPT test is performed from the 11th week of pregnancy to determine the child’s chromosome distribution and/or first trimester screening between the 11th-14th week in a practice for prenatal medicine

Postnatal care

Your health after birth

Postnatal care is designed to check the mother’s physical and mental health after delivery and to accompany the healing process.

It takes place regularly 6-8 weeks after the birth and is covered by the health insurance company. If there is a corresponding indication or complaints, it is also possible or necessary earlier. It is best to contact us as soon as possible after the birth to arrange an appointment for this.

Postnatal care is individually tailored to you as a mother and helps to detect and treat physical and emotional problems early.

Make an appointment
A medical assistant during the preliminary interview with a patient.

Components of postnatal care:

Uterine involution:
 vaginal and abdominal examination to check whether the uterus has involuted, including examination of the cervix, vagina and pelvic floor

Examination of the cesarean section scar or perineal suture:
Exclusion of wound healing disorders

Breast examination:
 Check for complaints such as milk congestion or inflamed mammary glands (mastitis).

Blood pressure measurement
especially after complications such as pre-eclampsia or heavy bleeding, possibly adjustment of medication

Blood and urine test:
Check of hemoglobin level and exclusion of infections

After gestational diabetes
possibly repeated glucose test

Family planning and contraception:
Discussion of suitable contraceptive methods, e.g. breastfeeding compatibility of hormonal preparations

Breastfeeding advice:
Support with breastfeeding problems

Mental health:
Conversation about mood, exhaustion or possible postpartum depression

Recommendation or referral to postnatal courses to strengthen the pelvic floor muscles and prevent long-term complaints

Emergencies

In the gynecological practice, acute emergencies can occur both in the field of gynecology and obstetrics. Our emergency consultation allows us to treat you quickly, promptly and purposefully. Emergencies include:

Gynecology

Severe sudden lower abdominal pain:

Suspicion of cyst rupture, ovarian torsion, ectopic pregnancy or endometriosis.

Heavy vaginal bleeding

In case of cycle disorders, miscarriages or after procedures

Acute infections

E.g. urinary tract infections or fungal infections

Injuries in the genital area

After accidents, sexual violence or birth injuries.

Breast changes

Acute pain, redness (e.g. mastitis) or palpable nodules

Acute menopausal symptoms

Severe hot flashes or palpitations that require rapid action

Obstetrics

Bleeding during pregnancy

Indication of miscarriage, placental abruption or placenta previa.

Premature labor

Monitoring and, if necessary, referral to the hospital

Severe pain:

e.g. in case of threatened miscarriage or ectopic pregnancy

Suspicion of pre-eclampsia

Symptoms such as high blood pressure, severe headaches, visual disturbances or upper abdominal pain

Decreased fetal movements

Check by means of CTG or ultrasound

Premature rupture of membranes

Control and initiation of further measures

In these cases, we ask you to register by telephone or e-mail for our emergency consultation, which is offered several times a week, or to come directly at the corresponding times.

In very urgent cases and outside our consultation hours, please contact the medical on-call service on 116117 or present yourself to the emergency departments of the surrounding hospitals.

Gynecological cancers

Support from diagnosis to aftercare

If, unfortunately, we have diagnosed a gynecological cancer in you as part of the check-up (see point “Prevention”) or due to complaints, we will accompany you both during the upcoming examinations, after cancer operations and in the aftercare.

After initial diagnosis, you will be referred/admitted to a corresponding oncological center in the hospital for further planning of any surgery, chemo-, radio- and/or antibody therapy as well as possible hormone therapy. Afterwards, you will continue to be cared for by us.

Make an appointment

Order of frequency of malignant tumors in Germany:

Breast cancer (mammacarcinoma)
more than 75,000 women/year

Uterine cancer (endometrial carcinoma)
more than 10,000 women/year

Ovarian cancer (ovarian carcinoma)
more than 6,000 women/year

Cervical cancer (cervix carcinoma)
more than 4,000 women/year

Vulvar or vaginal carcinoma
more than 3,000 women/year

Aftercare after cancer

Aftercare after cancer is an essential part of the treatment to ensure the patient’s health in the long term, to detect possible relapses early and to improve the quality of life. It begins after completion of the primary therapy (surgery, chemotherapy, radiation or hormone therapy) and is individually adapted.

Early detection of a relapse (recurrence):
Monitoring of the treated area and the surrounding tissue.

Detection of metastases:
Control for possible distant metastases,

Treatment of side effects:
Long-term consequences of therapy such as lymphedema, pain or skin changes.

Psychosocial support:
Improvement of the quality of life and help with psychological stress.

Oncological aftercare takes place at regular intervals:

  • In the first 3 years after treatment: every 3 months
  • From the 4th year: every 6 months
  • From the 6th year: annually

The exact schedule can be adjusted depending on the tumor stage, therapy and your individual risk and will be discussed with you.

Physical examinations

  • Examination of the operated area and scars: Check for changes, nodules or other abnormalities.
  • Lymph node examination: Palpation of the adjacent lymph node regions

Imaging procedures

  • Breast: Mammography: Once a year, after breast-conserving surgery also more frequently or alternating with sonography
  • Ultrasound of the originally affected area and the lymphatic drainage pathways
  • Further imaging (e.g. CT/MRI): Depending on the type of tumor; for special questions, complaints or high risk.

Blood tests

  • No routine tumor marker tests, except for specific indications of a relapse with the exception of ovarian carcinoma (tumor marker CA 12-5)

Monitoring of accompanying therapies

  • Control and adjustment of hormone therapy for hormone-dependent tumors.
  • Treatment of side effects such as osteoporosis, which can be favored by certain therapies. Possibly pain therapy

Consultations

  • Discussion of your symptoms and, above all, associated fears
  • Information about a healthy lifestyle (nutrition, exercise) to reduce the risk of relapse.
  • Fertility preservation: For younger patients, early discussions about fertility options and hormone therapy, especially before planned chemotherapy, are of great importance, see also “Fertiprotekt”
  • Offers for psychological support, self-help groups or rehabilitation measures.
  • Advice on professional reintegration and social security issues.

Aftercare is often carried out by an interdisciplinary team, which includes us as gynecologists together with oncologists, general practitioners and physiotherapists as well as psychologists. It is important that you feel well cared for by us even with cancer.