Transcript Slide 1

Diagnosis of
Pregnancy
Dr.F Mehrabian MD
Diagnosis of Early Pregnancy
2. Morning sickness
1) Fatigue, nausea and vomiting (the 6th
week↑ → the 12th week↓ ).
2) Hyperemesis gravidarum protracted
vomiting necessitating hospitalization.
3) Causes: HCG, delayed gastric
emptying(P↑ )
Diagnosis of Early Pregnancy
3. Urinary symptoms
1) Bladder irritability, frequency and
nocturia
2) Causes: increased circulation in pelvis
(E and P↑), enlargement of the uterus.
3) Note: urinary infection must be ruled
out
Diagnosis of Early Pregnancy
4. Mastodynia
1) the development of mammary ducts
(E↑) and alveolar system (P↑)
2) circulation↑→ engorgement of the
breasts
5. Constipation
smooth muscle relaxant (P↑)
6. Weight gain
Diagnosis of Early Pregnancy
• Signs
1. The changes of genital organs
1) Vagina: bluish or purple discoloration
(congested pelvic vasculature). Increased
vaginal discharge (E and P↑)
2) Cevix: softening and bluish discoloration. The
cervical mucus→ a granular pattern
3) Uterocervical junction
Hegar’s sign: a widened zone of softness coupled
with compressibility, resulting in a doughnutshaped, slightly spongy configuration.
Hegar’s sign
Diagnosis of Early Pregnancy
4) Abdominal enlargement
Enlargement of uterus (noticed at the 12th
week)
2. Breast changes
1) Enlargement and vascular engorgement (6th –
8th week)
2) Montgomery’s tubercles (6th –8th week, E and
P↑
3) Colostrum secretion (16th week) or secondary
breasts
Diagnosis of Early Pregnancy
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Laboratory tests
Pregnancy test
Urine HCG test (one step): + or –
β-HCG: >25mIU/L
Ultrasonography
Enlargement of uterus
Gestational sac
Embryo or fetal pulse
Diagnosis of Early Pregnancy
3. Other tests
1) Progesterone test
2) Cervical mucus examination
3) Basal body temperature (BBT)
Diagnosis of mid or late pregnancy
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Symptoms and signs
EDC: +9 or –3 (month), +7 (day)
Enlargement of uterus
12th week: 2 finger above the symphysis
16th week: midway between the
symphysis and the umbilicus.
3) 20th – 22nd week: at the umbilicus
4) …….
Diagnosis of mid or late pregnancy
3. Fetal movement (FM)
1) The first perception: in the 18th – 20th
weeks
2) Diagnosis of pregnancy, duration of
pregnancy, the safety of fetus
3) Count: 3 times per day, 1 hour per time.
sum×4= FM/12 hours. Normal:≥
30/12 hours
Diagnosis of mid or late pregnancy
4. Fetal heart tones
1) Heared: the 18th – 20th weeks
2) Normal rate: 120-160bpm
3) Differentiation: umbilical souffle
5. Fetal body
Palpated: outlines of the fetus (the 20th
week).
Diagnosis of mid or late pregnancy
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Laboratory tests
Ultrasonography
The number of fetus
Fetal lie
Fetal presentation
Fetal position
Fetal dead or not
Placenta and cord (velocity of flow)
Size of fetus
Diagnosis of mid or late pregnancy
2. Fetal electrocardiography, FECG
12th week