Make your own free website on Tripod.com

Diagnosis of Pregnancy


Symptoms and Signs

  • Amenorrhea

    • other causes

      • hypothalamic-pituitary-ovarian axis disturbance

      • recent use of contraceptive pill

    • may continue to bleed up to 12 weeks ("decidual bleeding")

  • Nausea

    • early months of pregnancy

    • ?oestrogen, HCG

    • reduced gastric motility

    • relaxation of lower oesophageal sphincter

  • Bladder symptoms

    • Frequency

    • 2nd and 3rd months

    • increased vascularity and pressure from enlarging uterus

    • near term from pressure of foetal head

  • Breast

    • 6 weeks

      • increased vascularity

      • sensation of heaviness

    • 8 weeks

      • increased pigmentation of areola

    • Montgomery's tubercles

    • 16 weeks

      • colostrum secreted

    • 20 weeks

      • secondary areola prominent

  • Uterus

    • on bimanual examination at 7-8 weeks

    • 7 weeks - large hens egg

    • 10 weeks size of orange

    • 12 weeks size of grapefruit, palpable abdominally

    • 16 weeks mother aware of increase in abdominal size

  • Cervix

    • softening

    • bluish discolouration due to increased vascularity

  • Awareness of fetal movements

    • 16-18 weeks parous women, 18-21 in primigravida

  • Uterine contractions (Braxton Hicks')

    • painless

    • from week 9/10 onwards

    • palpable from week 20

  • Auscultation of fetal heart

    • from about 24-26 weeks with Pinard stethoscope

    • from 12-14 weeks with Doppler

  • Palpable fetal parts

    • from about 26 weeks

  • Skin Changes

    • face (chloasma)

    • abdomen (linea nigra)

    • striae gravidarum

Investigations

  • beta-HCG

    • detectable in urine by date of first missed period (25U/l)

  • Ultrasound

    • gestational sac visible after 5-6 weeks of amenorrhoea

    • TV USS can identify foetus at 5 weeks

    • TA USS  - crown rump length measurable after 7 weeks to give dates

 

Home ] Up ]