2. Diagnosis of Pregnancy Dr.F Mehrabian MD

3. 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↑ )

4. 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

5. 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

6. 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.

7. Hegar’s sign

8. 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

9. 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

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

11. 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
…….

13. 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

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

15. 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

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

17. The End