Diagnosis of pregnancy
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Diagnosis of pregnancy






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Diagnosis of pregnancy Presentation Transcript

  • 1. DIAGNOSIS OFPREGNANCYJayashree ajith Asso.Prof.P.G.College of Nursing .C.H.R.I. Gwalior
  • 2. Diagnosis of Early Pregnancy SUBJECTIVE CHANGES History and symptoms6. Amenorrhea6 The first and the most important symptomo emotional tension, chronic disease and certain medications → delayed menses endocrine factorsn lactation, IUD and dysfunction of endocrine → pregnancy
  • 3. CONT........ Psychological factors – emotional shock fear of pregnancy infection Systemic disease – tuberculosis , malignancy
  • 4. Diagnosis of Early Pregnancy1. Morning sickness1 Fatigue, swirling, nausea and vomiting (the 6th week↑ → the 12th week↓ ).g Hyperemesis gravidarum protracted vomiting necessitating hospitalization.s Causes: HCG, delayed gastric emptying(P↑ )
  • 5. Diagnosis of Early Pregnancy1. Urinary symptoms1 Bladder irritability, frequency and nocturial Causes: increased circulation in pelvis (E and P↑), enlargement of the uterus.f urinary infection must be ruled out
  • 6. Diagnosis of Early Pregnancy1. Mastodynia1 the development of mammary ducts (E↑) and alveolar system (P↑)( circulation↑→ engorgement of the breasts4. Constipation smooth muscle relaxant (P↑)6. Weight gain
  • 7. Diagnosis of Early Pregnancy OBJECTIVE SIGNS Signs3. The changes of pelvic organse Chadwick,s sign: Vagina bluish or purple discoloration (congested pelvic vasculature). Increased vaginal discharge (E and P↑) Cevix: softening and bluish discoloration. The cervical mucus→ a granular patterne Uterocervical junctionHegar’s sign: a widened zone of softness coupled with compressibility, resulting in a doughnut-shaped, slightly spongy configuration.(softening of the isthmus of the uterus
  • 8. Hegar’s sign
  • 9. Diagnosis of Early Pregnancy1) Mcdonald,s sign .flexing the body of the uterus aganist the cervix2) Abdominal enlargement Enlargement of uterus (noticed at the 12th week)4. Breast changes4 Enlargement and vascular engorgement (6th –8th week)v Montgomery’s tubercles 6th –8th week, E and P↑e Colostrum secretion (16th week) or secondary breasts
  • 10. CONT......1. Braxton Hicks Contraction- twenty eighth weeks.2. Uterine souffle- Increase uterine blood flow and blood pulsating through the placenta3. Changes in pigmentation of the skin – linea nigra, striae, facial cholasma4. Ballottement-
  • 11. Diagnosis of Early Pregnancy Laboratory tests2. Pregnancy test2 Urine HCG test (one step): + or –o β-HCG: >25mIU/L5. Ultrasonography6) Enlargement of uterus7) Gestational sac8) Embryo or fetal pulse
  • 12. Diagnosis of Early Pregnancy1. Other tests2) Progesterone test3) Cervical mucus examination4) Basal body temperature (BBT)
  • 13. Diagnosis of mid or late pregnancy Symptoms and signs2. EDC: +9 or –3 (month), +7 (day)3. Enlargement of uterust 12th week: 2 finger above the symphysisa 16th week: midway between the symphysis and the umbilicus.t 20th – 22nd week: at the umbilicus
  • 14. Diagnosis of mid or late pregnancy1. POSITIVE CHANGES2. 15Fetal movement (FM)F The first perception: in the 18th – 20th weekst Diagnosis of pregnancy, duration of pregnancy, the safety of fetust Count: 3 times per day, 1 hour per time. sum×4= FM/12 hours. Normal:≥ 30/12 hours
  • 15. Diagnosis of mid or late pregnancy1. Fetal heart toness Heared: the 18th – 20th weekss Normal rate: 120-160bpm- Differentiation: umbilical souffle Fetal body Palpated: outlines of the fetus (the 20th week).
  • 16. Diagnosis of mid or late pregnancy Laboratory tests2. Ultrasonography3) The number of fetus4) Fetal lie5) Fetal presentation6) Fetal position7) Fetal dead or not8) Placenta and cord (velocity of flow)9) Size of fetus
  • 17. Fetal Attitude Fetal lie Refers to the relationship of the long axis of the fetus to the long axis of the mother3. Longitudinal lie The long axis of the fetus is parallel with that of the mother5. Transverse lie The long axis of the fetus crosses that of the mother vertically
  • 18. Fetal Attitude Fetal presentation2. head presentation Occiput presentation (95%), brow presentation and face presentation.4. Breech presentation5) Complete breech presentation6) Frank breech presentation7) Incomplete breech presentation: footling presentation
  • 19. Fetal Attitude Fetal position Refers to the relationship of the point of direction of the presenting part to one of the 4 quadrants of the pelvis or to the transverse diameter of the maternal pelvis.3. Occiput presentation: the occiput, O. LOA,LOT,LOP4. Face presentation: the chin, M. LMA,LMT,LMP5. Breech presentation: the sacrum, S.LSA,LST,LSP