BG Medical Clinic

Family Medicine

Dr Andrean Damyanov

At the clinic we perform early pregnancy diagnostics, pregnancy monitoring, foetal morphology for congenital abnormalities, prevention of cancer and cancer-related illnesses of the uterus and ovaries, etc.

About us

In the clinic we perform early pregnancy diagnostics, pregnancy monitoring, foetal morphology for congenital anomalies, prevention of cancer and cancer-related illnesses of the uterus and ovaries, colposcopy and target biopsy, cervicitis treatment, diagnosis and typing of papilloma virus, diagnosis and treatment of irregular uterus bleeding etc. In a specialised Ob-gyn clinic I perform abortions and separated abrasions.

Doppler in obstetrics and gynaecology

The Doppler is the most contemporary method for determining the condition of the foetus in cases of high-risk pregnancy. The method is based on determining the speed of blood vessels in the uterus, umbilical cord and brain vessels. It is a method to determine at the earliest foetal abnormalities, applied in cases of high blood pressure pregnancies, preeclampsia, Rh isoimmunisation, also with diabetics with vessel pathology. The pathological values of the Doppler indicators are determined 10 days before it is even possible to prove foetal abnormalities with any other routine method. This gives us the chance to find out the problem early on and save the foetus.
The method is quite telling with Rh (-) pregnant women. When there is an incompatibility in the RH of the parents, it is possible that an Rh isoimmunisation occurs, in the form of hemolytic anemia.
The Doppler is a non-invasive method with which, by measuring the blood speed in the brain vessels, we can determine whether the baby has anemia and we can figure out when the right moment is for the baby to be born.
This marks sufficient progress in medicine as up until recently it was only possible via amniocentesis (drawing amniotic fluid) to determine whether the foetus was developing anemia. The Doppler is new, reliable and non-invasive method to track risk fetuses.
It finds use also in gynecology. It is used to make a differential diagnosis between a myoma, polyps and endometriosis. When bleeding, a prognosis can be made whether a certain formation on the ovary is malignant or not.

4D echography
This is the newest ultrasound technology in contemporary obstetrics and gynecology! It gives the chance to receive three-dimensional images.

Colposcopy
Colposcopy is a diagnostic procedure of thorough examination of the cervix, vagina and vulva with the help of a magnifying device called colposcope.

Gynaecological examinations
Routine gynaecological examinations for early diagnosis of cancer of the cervix and the mammary gland. Prevention, diagnosis and treatment of sterility.

Liquid based cytology

The newest method for cytology testing of the cervix is called liquid based cytology. It is a smear test in which the cells are placed in liquid vials. They are then treated with a certain device to remove all unnecessary additions to the samples, such as leukocytes, mucus, erythrocytes, so that the slides only contain cells. The method is considered most accurate. It is performed in our clinic as well.
The smear test (PAP test) is a medical test for early diagnosis of cervical cancer. This is the only malignant tumour that is considered to have a virus-related cause. It is caused by human papilloma virus (HPV). In modern diagnosis the combination of cervical cytology with a DNA test for determining the presence of a high-risk type HPV considerably raised the effectiveness of the routine cervical cancer tests.

CONTEMPORARY ASPECTS IN THE PREVENTION OF CERVICAL CANCER

♦ Implementing liquid-based cytology as a main screening method in the USA has contributed to reducing the invasive cancer rates with extra 33% in comparison to the years before its implementation.

♦ In the USA and part of the EU countries there is a tendency to implement more and more in the new screening program the combination screening – liquid based cytology and HPV-DNA test.

♦ Italy and Turkey are in the process of discussing the proposition in the new national health plan that the HPV-DNA test replace the PAP test as a first-level screening.

DISADVANTAGES OF THE TRADITIONAL CYTOLOGY

Traditional cytology is connected to a high percentage of false negative results.

Sources of false negative results:

♦ Conventional cytology uses only about 20% of the cells contained in the extracted biological material. This is grounds to determine a high chance that abnormal cells do not make it to the slide and therefore never be tested.

♦ The cells that make it to the slide are placed in a few layers. That way the top layer cells cover the underlying ones and those may be exactly the ones that have pre-cancer or cancer changes. They are exactly the cells that cannot be read by the cytologist and the announced result is only based on the visible, top layer of cells.

♦ Presence of mucus, blood and other artefacts that may prevent the accurate diagnosis.

ADVANTAGES OF THE LIQUID-BASED CYTOLOGY

The liquid based cytology is the first real improvement in traditional smear test and is the contemporary gold standard in cervical cytology. This new test provides a new level of reliability and precision of the results which is caused by the following improvements:

IN THE CLINIC:

♦ The samples are collected with a special brush or a brush and a spatula and are then transferred to a liquid vial.

♦ 100 % of the exfoliated cells are separated in the liquid vial and are then tested.

IN THE LABORATORY

An apparatus processes the extracted sample by:

♦ Turning the cell sample into a homogenised mixture in the liquid and therefore not allowing the formation of cells lumps.
♦ Spreading the cells in a single thin layer.

♦ Cleaning up the sample from blood, mucus and other artefacts.
♦ Drastically improving the quality of the test.

With the introduction of the upmentioned improvements in the protocol for the cytology test, it is the first time when a gold standard has been accepted for taking cytology material, preparation and performing of the test.

We have designed and created modern clinical space to the highest standards, equipped with the very latest technologies to deliver the premium level of care to the whole family.

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