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Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
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Diagnosis of pregnancy

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  • 1. DIAGNOSIS OF PREGNANCY PRESENTED BY : MS. VRUTI PATEL, F.Y.M.SC. NURSING, SCN
  • 2. INTRODUCTION Presumptive signs Probable signs Positive signs
  • 3. DIAGNOSIS THE PREGNANCY In first trimester In second trimester In third trimester
  • 4. FIRST TRIMESTER (FIRST 12 WEEKS) Subjective Sentence  Amenorrhoea – Abrupt cessation of menstruation at 4th week  Morning sickness (Nausea and vomiting) from 4th – 14th week  Frequency of micturition (Bladder irritability  Breast discomfort  Fatigue
  • 5. Objective sign • Breast changes - valuable only in primigravidae • Per abdomen • Pelvic changes • Jacquemier’s or chadwick’s sign • Vaginal sign • Cervical signs - as early as 6th week (Goodell’s sign) • Uterine signs : (a) Size, shape and consistency (b) Hegar’s sign (c) Palmer’s sign
  • 6. IMMUNOLOGICAL TESTS FOR DIAGNOSIS OF PREGNANCY • Principle : Pregnancy tests depend on detection of the antigen (hCG) present in the maternal urine or serum with antibody either polyclonal or monoclonal available commercially.
  • 7. (A) Immuno assays without radioisotopes • Agglutination inhibition tests – Using latex (L.A.I.) • Principle of agglutination inhibition tests • Direct agglutination test (hCG direct test) • Enzyme-linked immunosorbent assay (ELISA • Fluoroimmuno assay (FIA)
  • 8. (B) Immuno assay with radiosotopes • Radioimmunossay (RIA) - used for determining the doubling time of hCG (ectopic pregnancy monitoring) • Immuno-radiometric assay (IRMA) - detect hCG as low as 0.05 mIU/ml Selection of time Collection of urine Other uses of pregnancy tests Ultrasonography
  • 9. SECOND TRIMESTER (13-28 WEEKS) Symptoms : • subjective symptoms –such as nausea, vomiting and frequency of micturition usually subside • Quickening (feeling of life) • Progressive enlargement of the lower abdomen
  • 10. General Examination o Chloasma : Pigmentation over the forehead and cheek o Breast changes - enlarged with prominent veins, Secondary areola, Montgomery’s tubercles are prominent and extended, Colostrum
  • 11. o Abdominal examination • Inspection • Palpation • Auscultation - Uterine souffle - soft blowing and systolic murmur heard low down at the sides of the uterus, best on the left side; Funic of fetal soufflé is due to rush of blood through the umbilical arteries
  • 12. o Vaginal Examination • The bluish discolouration • Internal ballottement
  • 13. o Investigations • Sonography • Fetal organ anatomy • Magnetic Resonance Imaging (MRI
  • 14. LAST TRIMESTER (29-40 WEEKS) Symptoms (1) Amenorrhoea persists (2) Enlargement of the abdomen is progressive (3) Lightening – At about 38th week (4) Frequency of micturition (5) Fetal movements
  • 15.  SIGNS • Cutaneous changes more prominent with increased pigmentation and striae • Uterine shape changed from cylindrical to spherical beyond 36th week.
  • 16. • Fundal height • Symphysis fundal height (SFH) The upper border of the fundus is located by the ulnar border of the left hand and this point is marked
  • 17. • Braxton-Hicks contractions are more evident. • Fetal movements are easily felt
  • 18. • Palpation of the fetal parts • FHS
  • 19. • Sonography
  • 20. DIFFERENTIAL DIAGNOSIS • Uterine Fibroid, • Cystic Ovarian Tumour, • Encysted Tubercular Peritonitis, Haematomata • Even Distended Urinary Bladder, etc.

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