CHADWICK SIGN

CHADWICK SIGN IS A BLUISH DISCOLORATION OF THE CERVIX,

VAGINA AND VULVA CAUSED BY VENOUS CONGESTION. CHADWICK’S
SIGN CAN BE OBSERVED AS EARLY AS 6-8 WEEKS AFTER CONCEPTION,
AND IS OFTEN USED AS AN EARLY SIGN OF PREGNANCY.

THE DIAGNOSIS OF PREGNANCY REQUIRES A MULTIFACETED

APPROACH USING 3 MAIN DIAGNOSTIC TOOLS. THESE ARE HISTORY
AND PHYSICAL EXAMINATION, LABORATORY EVALUATION, AND
ULTRASONOGRAPHY. CURRENTLY, PHYSICIANS MAY USE ALL OF
THESE TOOLS TO DIAGNOSE PREGNANCY AT EARLY GESTATION AND
TO HELP RULE OUT OTHER PATHOLOGIES. THE CLASSIC
PRESENTATION OF PREGNANCY IS A WOMAN WITH MENSES OF
REGULAR FREQUENCY WHO PRESENTS WITH ABSENCE OF
MENSTRUATION (AMENORRHEA), NAUSEA, VOMITING, GENERALIZED
MALAISE, AND BREAST TENDERNESS.

IMPORTANT ASPECTS OF THE MENSTRUAL HISTORY MUST BE

OBTAINED. THE WOMAN SHOULD DESCRIBE HER USUAL MENSTRUAL
PATTERN, INCLUDING DATE OF ONSET OF LAST MENSES, DURATION,
FLOW, AND FREQUENCY. ITEMS THAT MAY CONFUSE THE DIAGNOSIS
OF EARLY PREGNANCY ARE AN ATYPICAL LAST MENSTRUAL PERIOD,
CONTRACEPTIVE USE, AND A HISTORY OF IRREGULAR MENSES.
ADDITIONALLY, AS MANY AS 25% OF WOMEN BLEED DURING THEIR
FIRST TRIMESTER, FURTHER COMPLICATING THE ASSESSMENT

GOODELL’S SIGN
GOODELL’S SIGN IS AN INDICATION OF PREGNANCY. IT IS A
SIGNIFICANT SOFTENING OF THE VAGINAL PORTION OF THE CERVIX. A
POSITIVE GOODELL SIGN IS CHARACTERIZED BY SOFTENING OF THE
CERVIX, TYPICALLY NOTICED IN THE FIRST 4 TO 8 WEEKS OF
PREGNANCY, WHILE IT CAN RAISE SUSPICION OF PREGNANCY, IT IS
NOT A DEFINITIVE INDICATION OF PREGNANCY.
THE GOODELL SIGN REFERS TO A PROBABLE SIGN OF PREGNANCY,
CHARACTERIZED BY SOFTENING OF THE CERVIX. A POSITIVE
GOODELL SIGN OCCURS DUE TO INCREASED BLOOD FLOW NOTICED IN
THE CERVIX DURING THE FIRST 4 TO 8 WEEKS OF PREGNANCY, WHICH
CAN ALSO GIVE THE VAGINAL PART OF THE CERVIX A BLUISH
APPEARANCE (CHADWICK SIGN). THE GOODELL SIGN, AS WELL AS
OTHER PHYSICAL SIGNS, CAN BE IDENTIFIED DURING PHYSICAL
EXAMINATION OF THE CERVIX, PERFORMED BIMANUALLY AND WITH
A SPECULUM.

HEGAR’S SIGN
HEGAR’S SIGN IS AN INDICATION OF PREGNANCY IN A WOMAN,
SPECIFICALLY THE COMPRESSIBILITY AND SOFTENING OF THE
CERVICAL ISTHMUS (THE PORTION OF THE CERVIX BETWEEN THE
UTERUS AND THE VAGINAL PORTION OF THE CERVIX) AND THE
UTERINE CERVIX APPEARING BLUISH AND ENGORGED.

THE SIGN IS USUALLY PRESENT DURING SECOND AND THIRD MONTHS

OF PREGNANCY FROM THE FOURTH TO SIXTH WEEK. IT IS NOT A
POSITIVE INDICATOR OF PREGNANCY, AND ITS ABSENCE DOES NOT
EXCLUDE PREGNANCY.

THE HEGAR SIGN IS TYPICALLY CAUSED BY VARIOUS PHYSIOLOGICAL

CHANGES THAT OCCUR DURING THE FIRST SIX WEEKS OF
PREGNANCY. IN EARLY PREGNANCY, INCREASED BLOOD FLOW,
ESTROGEN, PROGESTERONE, AND PROSTAGLANDIN SYNTHESIS AS
WELL AS OTHER BIOCHEMICAL CHANGES MAY ALTER CERVICAL
TISSUE COMPOSITION. MORE SPECIFICALLY, THESE CHANGES OFTEN
LEAD TO REDUCTIONS IN COLLAGEN CONCENTRATION AND AN
INCREASE IN DERMATAN SULFATE PROTEOGLYCANS IN THE
CERVICAL TISSUE, RESULTING IN SOFTENING OF THE CERVICAL
ISTHMUS, OR HEGAR SIGN.

HEGAR SIGN IS A NON-SPECIFIC INDICATION OF PREGNANCY

CHARACTERIZED BY THE COMPRESSIBILITY AND SOFTENING OF THE
CERVICAL ISTHMUS. THE HEGAR SIGN USUALLY PRESENTS DURING
THE FOURTH TO SIXTH WEEK OF PREGNANCY AND MAY BE PRESENT
UNTIL THE 12TH WEEK OF PREGNANCY. HEGAR SIGN IS TYPICALLY A
RESULT OF THE VARIOUS CHANGES TO THE CONSISTENCY OF THE
CERVICAL ISTHMUS DURING THE FIRST SIX WEEKS OF PREGNANCY. IT
CAN BE PHYSICALLY ASSESSED BY A MEDICAL PROFESSIONAL BY
BIMANUAL EXAMINATION IN WHICH THE CONSISTENCY OF THE
LOWER UTERINE SEGMENT MAY FEEL SOFT WHEN COMPARED TO THE
BODY OF THE UTERUS SITUATED ABOVE AND CERVIX SITUATED
BELOW.