Diagnosis of Pregnancy Dr.F Mehrabian MD

Diagnosis of Early Pregnancy Morning sickness Fatigue, nausea and vomiting (the 6th week↑ → the 12th week↓ ). Hyperemesis gravidarum protracted vomiting necessitating hospitalization. Causes: HCG, delayed gastric emptying(P↑ )

Diagnosis of Early Pregnancy Urinary symptoms Bladder irritability, frequency and nocturia Causes: increased circulation in pelvis (E and P↑), enlargement of the uterus. Note: urinary infection must be ruled out

Diagnosis of Early Pregnancy Mastodynia the development of mammary ducts (E↑) and alveolar system (P↑) circulation↑→ engorgement of the breasts Constipation smooth muscle relaxant (P↑) Weight gain

Diagnosis of Early Pregnancy Signs The changes of genital organs Vagina: bluish or purple discoloration (congested pelvic vasculature). Increased vaginal discharge (E and P↑) Cevix: softening and bluish discoloration. The cervical mucus→ a granular pattern Uterocervical junction Hegar’s sign: a widened zone of softness coupled with compressibility, resulting in a doughnut-shaped, slightly spongy configuration.

Hegar’s sign

Diagnosis of Early Pregnancy Abdominal enlargement Enlargement of uterus (noticed at the 12th week) Breast changes Enlargement and vascular engorgement (6th –8th week) Montgomery’s tubercles (6th –8th week, E and P↑ Colostrum secretion (16th week) or secondary breasts

Diagnosis of Early Pregnancy 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 Other tests Progesterone test Cervical mucus examination Basal body temperature (BBT)

Diagnosis of mid or late pregnancy 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. 20th – 22nd week: at the umbilicus …….

Diagnosis of mid or late pregnancy Fetal movement (FM) The first perception: in the 18th – 20th weeks Diagnosis of pregnancy, duration of pregnancy, the safety of fetus Count: 3 times per day, 1 hour per time. sum×4= FM/12 hours. Normal:≥ 30/12 hours

Diagnosis of mid or late pregnancy Fetal heart tones Heared: the 18th – 20th weeks Normal rate: 120-160bpm Differentiation: umbilical souffle Fetal body Palpated: outlines of the fetus (the 20th week).

Diagnosis of mid or late pregnancy 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 Fetal electrocardiography, FECG 12th week

The End