diagnosis of pregnancy ayurvedic and modern perspective by dr. jayanth verma

1. 1

2. 2

3. 3

5. 5

6. 6

7. Subjective
signs
Cessation of
mensturation
Morning
sickness
Frequency of
micturation
Breast
symptoms
Appetite
changes
fatigue
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8. 8

9. 9

10. 4.
 Enlargement, heaviness , discomfort and pricking sensation – 6th -8th
week specially in primigravidae.
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11. 11

12. OBJECTIVE
SIGNS
BREAST
SIGNS
UTERINE
SIGNS
PELVIC
CHANGES
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13. 13

14. 14

15. 15

16. PELVIC
CHANGES
Jacquemier’s
or chadwick’s
sign
Osiander’s
sign
Goodell’s
sign
16

17. 



17


18. 



18

19. 
1.
2.
3.



19

20. UTERINE
SIGNS
HEGAR’S
SIGN
PALMER
SIGN
20

21.  Uterine Contractions felt on bimanual examination
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Elicited between 6 to 10th week.
Two finger in the anterior fornix and other hand over the
abdomen behind the uterus. The fingers of both hands can be
approximated as the lower part of the uterine body is soft and
empty.

22. 22

23. 23

24.  This hormone is only released by trophoblastic tissue produced by a
growing fetus and its associated placenta.
 Hcg present in the maternal circulation as either an intact
dimer,alpha or beta subunit,degraded form or beta core fragment.
 Detection of HCG in maternal serum and urine is evident only 8 -
10 days after conception.
 Hcg is detectable in the serum of approximately 5% of patients after
8 days of conception and in more than 98% of patients by day 11th.
 Diagnostic levels in urine seen ony about 23-24 days after
conception.
 Levels peak at 10- 12 weeks gestation and then plateau before
falling.
 In general the hcg level will double every two to three days in early
pregnancy.
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25.  USED ONLY IN SPECIAL CASES(BAD
OBSTETRIC HISTORY,SUSPECIOUS OF
ECTOPIC,ETC)
 REQUIRE SPECIAL LABS AND
EXPERTISES.
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1.
2.
3.
4.

26. 26

27. 27

28. 28

29.  AMENORRHOEA:-
 It continues, nausea ,vomitting and frequency of
micturation usually subside.
 QUICKENING:-
• Perception of fetal movements by the pregnant woman:
a. 18-20 weeks in primigravida.
b. 16-18 weeks in multipara.
 ABDOMINAL ENLARGEMENT
29

30. 30

31. 1. CHLOASMA: Pigmentation of forehead and cheek at
about 24th week.
2. BREAST CHANGES: Secondary areola is demarcated
in primigravida (usually appears by 20th week).
montgomery’s tubercles are prominent and extend upto
seondary areola.
3. LINEA NIGRA: Linea nigra extending from symphsis
pubis to ensiform cartilage as early as 20th week.
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32. 32

33. Height of uterus midway between symphysis pubis and umblicus by 16 week.
B. At umblicus 24 week.
C. At junction of lower third and upper two third between umblicus and ensiform
cartilage in 28th week.
D. Increased with progressive enlargement of the uterus.
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34. 6. BRAXTON HICK’S CONTRACTIONS:-
Irregular,infrequent,spasmodic painless contractions Without any
affect on dilation of cervix.
7. ACTIVE FOETAL MOVEMENTS:- Positive evidence of
pregnancy and a live foetus as early as 16th – 18th week.
8. FHS(FOETAL HEART SOUNDS):- Most conclusive sign
of pregnancy ,detected between 18th – 20th week . Rate 110-160/min
(uterine) souffle soft blowing ,systolic murmur heard low down at
sides of the uterus due to increased blood flow in dilated uterine
vessels,it is synchronous with maternal pulse.
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35. 9. BLUISH DISCOLOURATION of vagina,vulva,cervix is
more evident.
10. EXTERNAL BALLOTMENT Can be elicted as early as 20th
week difficult in obese patients and cases with scanty liquor amnii.
11. INTERNAL BALLOTMENT can be elicted beteen 16th-28th
week ( tapping of the cervix reveals the presence of a body which
moves away from examination finger and later returns wit a thud ).
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36. 36

37.  SONOGRAPHY:
 Routine sonography at 18 -20 weeks permits a detailed
survey of fetal anatomy ,placental localisation and the
integrity of the cervical canal.
 FETAL ORGAN ANATOMY:
 To detect any malformation.
 FETAL VIABILITY:
 RADIOLOGIC:
 16th week - fetal skeletal shadow.
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38. 38

39. 39

40. 1. AMENORRHEA persists.
2. ENLARGEMENT OF ABDOMEN- leading to the
discomfort to the patient (palpitaion or dyspnoea
following desertion).
3. LIGHTENING - 38th week – sense of relief of the
pressure symptoms due to engagemebt of the presenting
part.
4. Frequency of micturation reappears.
5. Fetal movements are more pronounced.
40

41. 41

42. 1. Cutaneous changes are more
prominent with increased
pigmentation and striae.
2. Uterine shape- from cylinderical to
spherical beyond 36th wek.
3. Fundal height-
 Junction of the upper and middle
third at32 weeks.
 Level of ensiform cartilage at 36
weeks
 Comes down at 32 weeks level at 40th
week beacause of the engagement of
the presenting part.
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43. 4. Symphysis fundal height:- It is measured from upper
border of symphysis pubis to uppr border of fundas after
24 weeks. It measured in centimetres and it corresponds to
the number of eeks upto 36 weeks .
5. Braxton hick’s contractions are more evident.
6. Foetal movement is easily felt.
7. Foetal parts are easily palpated ,identification of
lie,presentation and position.
8. FHS distinctly heard, difficult in obesity,polyhydraminos.
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44. 44

45.  SONOGRAPHY
 Fetal growth assessment can be made
more accurate.
 Amniotic fluid volume assessment – for
oligo / polyhydroaminos.
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46. 46

47.  sadyogruheeta -garbha
lakshanas vyaktha-garbha-lakshanas. Sadyogruheeta- garbha-
lakshanas ( including presumptive and probable signs )
coition.Vyaktha-garbha-
lakshanas (positive sings)
47

48. 48

49.  lqJqr vuqlkj
 Je
 Xykfu
 r`’k.kk
 lfDFk;ksa esa
“kSfFkY;
 “kqdz ,oa “kksf.kr
vocU/k
 ;ksfu LQqj.k
 pjd vuqlkj
 fu’Bhou (Fkwduk)
ckj ckj
 xkSjo (Hkkjhiu)
 vaxksaa esa “kSfFkY;
 rUnzk
 g`n; osnuk
 r`fIr
 ;ksfu }kjk cht
xzg.k
49

50.  Charaka described as repeated spitting, heaviness,
malaise, drowsiness, horripilation, uneasiness,
pain in the chest, a feeling of satisfaction,
retention of the ejaculated semen in the yoni
(Cha. Sam., Sha. 2/23).
 Sushruta described as.fatigue, langour, excessive
thirst, lassitude of the thighs, retention of shukra
and shonitha (absence of menstrual and coital
discharges) and quivering in the vagina .
(Sus. Sam., Sha. 3/10).
 Vaghbhatta described as body pain, satisfaction,
heaviness, quivering, retention and combination
of shukra and aarthava, palpitation, dizziness,
excessive thirst, are the immediate sings of
pregnancy .(Ash. Hru., Sha. 1/37-38).
 Vaagbhatta I includes nausea and excessive
salivation also in the list of symptoms.
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51. 51

52.  pjd vuqlkj
 vkrZokn”kZu
 eq[k ls lzko
 vUu vfuPNk
 NfnZ
 vEydkerk
 mPp uhp Hkko vkdka{kk
 LrU; mRifRr
 iSjksa esa “kksFk
 vks’Bksa ,oa LrueaMyksa esa dkykiu
 jksejkth mRifRr
 ;ksfu dk pkVkyRo
 “kjhj dk Hkkjhiu
 vka[kksa esa Hkkjhiu
 lqJqr vuqlkj
 Lruksa ds eq[k esa dkykiu
 jksejkth mRifRr
 vka[kksa dh iydsa ckj ckj cUn
gksuk
 izlsd
 FkdkoV
 “kqHk xU/kksa ls mf}Xu
52

53.  These are the signs and symptoms observed after
the growth of the embryo becomes conspicuous.
 They are described by Charaka as are amenorrhea,
excessive salivation, dislike for food, vomiting,
anorexia, craving for sour substances, alternate
desires for article which are of high or low quality
(beneficial/non-beneficial), heaviness of body,
langour of eyes, milk secretion in breasts,
blackening of lips and areola, slight oedema of
feet, development of romaraji (the vertical streak
of hair line extending to the umblicus) and
dilation of vagina (Cha. Sam., Sha. 4/16).
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54.  In addition to these, Sushrutha and Bhaavamisra
mention - repeated drooping of eyes, vomiting without
apparent cause, aversion to good smells and excessive
salivation and tiredness as symptoms (Sus. Sam., Sha.
3/11) and (Bha. Pra. Poo. Gar. 3/42).Vruddha
Vaagbhatta inAshtaanga Sangraham along with the
other signs and symptoms also mentions the increase in
the weight of the embryo causes diversion for her
nuterients and thus her energy also decreases (Ash. San.
Sha. 2/9 and 59). Vaagbhatta in Ashtaanga Hrudaya -
adds the symptoms emaciation, indigestion, burning
sensation of the whole body and expression of various
desires.
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55.  SUBMITTED BY:-
 JAYANTH VERMA
 BAMS 3RD YEAR
 ROLLNO: 38
 GAC PATIALA
 SUBMITTED TO:-
 DR. K.K. CHOPRA
( HOD STRI ROG DEPTT.)
 DR. MEENU
( LECTURER)
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