Pregnancy diagnosis - early and late

Question 1

Early methods of pregnancy diagnosis?

Answer 1

1. History and Symptoms - amenorrhea, morning sickness
2. Objective signs (inspection) - breast pain, weight gain, constipation
3. Ultrasound - 5 weeks - gestational sac
4. Immunological tests - hcG in maternal urine

Question 2

Late methods of pregnancy diagnosis?

Answer 2

1. History and Symptoms
2. Inspection and Palpation
3. Ultrasound

Question 3

Symptoms of early pregnancy?

Answer 3

BU FAM
Breast enlargement
Urinary symptoms
Fatigue
Amenorrhea - most important, has to be after 10 days of expected menses
Morning sickness - peak at 6-12 weeks, due to high hCG

Question 4

Objective signs of early pregnancy

Answer 4

Enlarged abdomen
Weight gain
Genital changes:
1. Chadwicks sign - bluish discolouration of the cervix due to increased oestrogen. (increased venous blood flow)
2. Hegars sign - soft cervical isthmus with firm cervix on manual palpation
3. Palmers sign - regular, rhythmic uterine contractions on bimanual examination

Question 5

Immunological sign of early pregnancy?

Answer 5

Pregnancy test. HCG detected in urine or Serum as early as 10 days after conception.

Question 6

US findings of early pregnancy?

Answer 6

5 weeks - Gestational sac seen
6 weeks - yolk sac seen
7 weeks - Fetal heartbeat heard

Question 7

Symptoms of late pregnancy

Answer 7

Abdominal distention
Nausea and vomiting dissapear
Braxton - hicks contractions appear (20 weeks)
Fetal movements

Question 8

Palpation of late pregnancy?

Answer 8

LEOPOLDS MANUEVERS
1. First maneuver - Fundal grip. Indicated which part is in fundus - if hard, round - head. If soft and asymmetrical - buttocks
2. Second maneuver - lateral grip. Determines which side the Fetal back is. If smooth and hard - back. If pointy then knees and elbows
3. Third maneuver - Pawlicks grip. Confirms presenting part. One hand squeezes - if head moves up - not engaged, if filmly planted - engaged.
4. Fourth maneuver - confirms the Fetal presentation. Face woman’s feet and use both hands and squeeze - also determined Fetal attitude (are the flexed or extended) and station

Question 9

US finding of late pregnancy?

Answer 9

Fetal size
Fetal number (also chorion number if twins)
Fetal anatomy
Placental anatomy