This document discusses the symptoms and stages of diagnosing pregnancy. It outlines the positive, probable, and presumptive symptoms seen in each trimester, including morning sickness and breast changes in the first trimester. Methods for diagnosing pregnancy include immunoanalysis tests that detect human chorionic gonadotropin (hCG) in urine or serum using techniques like radioimmunoassay. General checkups examine changes to the breasts, skin, abdomen, vagina, and fetus throughout each trimester until delivery. Differential diagnoses are also considered to rule out other potential causes of symptoms.

2. A Few Symptoms are there
to Diagnose Pregnancy.
• Positive symptoms
• Probable symptoms
• Presumptive symptoms

3. Stages of Diagnosis
• In first trimester (0 to 12 weeks)
• In second trimester (13 to 28 weeks)
• In third trimester (29 to 40 weeks)

4. First trimester (First 12 weeks)
Subjective sentence
• Morning sickness includes vomiting and nausea
from 4th to 14th week
• Amenorrhoea – unexpected end of menstruation
at 4th week
• Breast Problems Weakness
• Frequent micturition (irritability of bladder)

5. Uterine
symptoms
a) Palmer’s sign
b) Size, consistency and
shape
c) Hegar’s sign
Objective
Symptoms
• Pelvic changes
• Vaginal symptom
• Per abdomen
• Changes of breast – only in
primigravidae
Cervical
symptoms
as early as 6th
week (Goodell’s
symptom)
Chadwick’s or
Jacquemier’s sign

6. Principle – Commercially
available monoclonal or
polyclonal antibodies are used
to test pregnancy, depending
on the detection of antigen
present in urine or serum.

7. A) Immuno Analysis without
Radioisotopes
• Direct agglutination examination
• Principle of agglutination inhibition
examination
• Fluoroimmuno analysis
• Enzyme-linked immunosorbent analysis
• Agglutination inhibition check up – using latex

8. B) Immuno analysis with radiosotopes
• Immuno-radiometric analysis – identify hCG as low as 0.05
mlU/ml
• Radioimmunossay – used to check the doubling time of
hCG (ectopic pregnancy monitoring)
• Collection of urine
• Selection of time
• Ultrasonography
• Other pregnancy tests

9. Second trimester (13 to 28
weeks)
Signs:
• Quickening (presence of a new life)
• Subjective signs like vomiting, nausea and
frequent micturition
• Expansion of the lower abdomen

10. General Checkups
Breast changes – Expanded with
prominent veins, montgomer’s tubercles
are enlarged and prominent, secondary
areola.
Chloasma – Pigmentation over the
cheeks and forehead.

11. Abdominal Test
• Palpation
• Inspection
• Auscultation - Uterine
souffle – gentle
blowing and systolic
murmur heard at the
sides of the uterus,
best on the left side;
Funic of fetal soufflé is
occurred due to rush
of blood through the
umbilical arteries.

12. Vaginal Checkup
• Internal ballottement
• Bluish discoloration

13. Examinations
• Anatomy of fetal organ Sonography
• Magnetic resonance imaging (MRI)

14. Last trimester (29 to 40 weeks)
Signs
• Movement of fetus
• Lightening - at about 38th week
• Enhanced abdomen
• Amenorrhoea continues
• Frequent micturition

15. • Shape of uterine - Changed from cylindrical to spherical beyond 36th week
• Cutaneous changes – More prominent with enhanced pigmentation and striae
• Symphysis fundal height (SFH) –The ulnar border of the left hand is marked to locate
the upper border of the fundus
• Height of the fundal
• You can feel fetal movements easily
• Contractions of Braxton - Hicks are more noticeable
•FHS
•Fetal parts are palpated
•Sonography - Transabdominal
ultrasound is performed using
ultrasound transducer, through
which sound waves are sent into
the abdomen for fetus detection
Symptoms

16. Differential Examination
• Cystic ovarian tumour
• Uterine Fibroid
• Enlargement of urinary bladder
• Encysted tubercular peritonitis, haematomata