Diagnosis of pregnancy

Objectives
At the end of the session will be able to: • Diagnose pregnancy from symptoms and
signs. • Calculate the gestational age. • Define important terms related to pregnancy.

Diagnosis of pregnancy • Symptoms • Signs • Tests • False positives .

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Symptoms of pregnancy • Cessation of menstruation • Subjective symptoms • Morning sickness • Irritation of breasts • Nausea and vomiting • Fatigue • Increase in frequency of micturation .

Montgomery's tubercles( hypertrophied sebaceous glands). Striae gravidarum.Signs of pregnancy • Breast. . areola pigmentation. Situated in the lower abdomen. Linea nigra. • Face. Brown pigmentation. red or purple during pregnancy. mask usually patchy (Cholasma) • Abdomen. stretch marks. Fullness. brown or black pigmentation- stretching of collagen and elastin. reliable sign in Primigravida. turns on to white after pregnancy.

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Jacquermin’s sign Dark Bluish colouration Chadwick’s sign • Hegar’s sign of pregnancy Bimanual palpation of soft uterine isthmus between the cervix and the body. Cystic sensation of uterus by 8 weeks • Leukorrhea. increase in vaginal discharge .Vaginal examination • Vaginal mucosa.

org/Prod ucts/Obstetric_and_Newborn_Care_1 /lesson_4_Section_1.brooksidepress.http://www.htm .

Important Definitions • Gravid • Parous • Primigravida Nullipara or nulliparous • Multigravida Multiparous • Grand multiparaous .

add one year subtract 3 months add 7 days . on the combined oral contraceptive pills. Estimated by regularity of periods. bleeding in early pregnancy. EDC). no bleeding in early pregnancy. • Expected date of delivery/ confinement (EDD. regular. no immediate past oral pills. irregular.Calculation of the gestational age • Last menstrual period (LMP). number of spontaneous cycles. Naegle’s rule.

If the cycle is irregular. in the olden days and modern age???? Is the period of amenorrhae and the period of gestation the same???? . or was on the combined pills How to estimate EDD.

It is not the same • • • • as EDD Preterm. It is a period of time .Terms related to pregnancy • Term. before 37 completed weeks of gestation Posterm. after 42 completed weeks of getation Preterm and premature Posterm and post maturity .

 Each trimester has its own problems/complications/events .Period of gestation (Trimesters) Pregnancy is divided into three trimesters • First up to 14 weeks • Second up to 28 weeks of gestation • Third trimester up to 42 weeks of gestation.

First Trimester • Confirm the pregnancy Symptoms and signs Pregnancy tests Antenatal Booking. with or without vaginal bleeding. type of care Perinatal diagnosis. and with or without abdominal pain!! . high hCG and empty uterus on USS . Be alert.

Second trimester • Perinatal diagnosis. USS • Fetal quickening • Findings at ANC .

Third trimester • Findings at ANC • Fetal assessment if indicated • Chronological hospital admissions if any .

forms in the last trimester of pregnancy. . It provides the usual method of approach to deliver the baby during Caesarean section (CS). more in primigravida. Mother notices that it is easier to breath. Lightening Usually occurs after 36 weeks. Occurs from first trimester painless spontaneous irregular do not lead to labour Lower uterine segment The thin expanded lower portion of the uterus( the isthmus).Important terms • Braxton Hicks contractions. after 32 weeks of gestation.

deep pelvic grip 4. vaginally • The four Leopoldt’s grip.More important terms • Presenting part The part of the fetus felt abdominally. Suprapubic palpation with one hand to identify the presenting part • To identify the station . Lateral grip 3. with two hands 1. Fundal grip 2. Pawlik’s grip.

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