9. Signs and symptoms of pregnancy

Question 1

what are the 3 main categories?

Answer 1

1. presumptive signs
2. probable signs
3. Definite (positive) signs

Question 2

what are the presumptive signs?

Answer 2

Nausea, vomiting, morning sickness.

-Amenorrhea.

Question 3

what are the probable signs?

Answer 3

Any physical change detected on a female:
*Discoloration and cyanosis of the vulva, vagina, and cervix (due to generalized engorgement of the pelvic organs).

• Pigmentation of the skin in the abdominal region and under the eyes.
• Chadwick sign → dark-bluish discoloration of the vaginal and cervical mucosa due to vascular congestion in pregnancy.
• Hegar sign → softening of the cervical mucous.
• Osiander sign → pulsation is felt over the lateral vaginal fornix.
• Piskacek sign → palpable lateral bulge or soft prominence where the fallopian tube meets the uterus (site of implantation).
• Positive urine pregnancy test.

Question 4

what are the definite (positive) signs?

Answer 4

Any test detecting a live fetus:
- US demonstrating fetal heart activity

• ECG, CTG
• Fetal movement
• Delivery

Question 5

what are the breast changes during pregnancy?

Answer 5

• ↑ breast tenderness.
• ↑ breast size.
• Nipples become larger, more pigmented, and more erect.
• Areolae become broader and more pigmented; striations on the skin.
• Colostrum may be expressed from the nipples.

Question 6

what are the skin changes during pregnancy?

Answer 6

• Striae gravidarum (stretch marks): reddish, slightly depressed streaks on the abdomen, breast, and thighs.
• Linea nigra: midline of the abdominal wall becomes darkly pigmented.
• Chloasma or melasma gravidarum (“mask of pregnancy”): irregular brown patches of varying size on the face and neck.
• Angiomas: red elevation at a central point with branching vasculature present on the face, neck, chest, and arms; arise secondary to estrogen effects.
• Palmar erythema.