This document discusses the diagnosis of pregnancy through various subjective and objective signs across the three trimesters. In the first trimester, diagnosis is based on presumptive, probable and positive signs like amenorrhea, morning sickness, and breast changes that can be detected through immunological tests. In the second trimester, signs like quickening and fetal movements become apparent on examination along with sonography findings. The third trimester sees further enlargement of the abdomen and fundal height, as well as signs like lightening and increased fetal movements. Differential diagnoses like pseudocyesis are also mentioned. Sensitive modern tests allow for highly accurate pregnancy diagnosis.

1. DIAGNOSIS OF
PREGNANCY
PRESENTED BY,
MRS.P.CHRISTENA.S.RAM,
M.SC-NURSING- OBG
DEPT OF OBG NSG
CHENNAI.

2. INTRODUCTION
• ANTENATAL PERIOD COVERS THE TIME OF PREGNANCY FROM
THE FIRST DAY OF LAST MENSTRUAL PERIOD (LMP) TO THE
STRAT OF TRUE LABOUR
• PREGNANCY MAY BE DIAGNOSED EVEN BEFORE SHE HAS
MISSED A PERIOD AS EARLY AS 5-6 WEEKS AFTER
CONCEPTION
• DIAGNOSIS OF PREGNANCY IN THE FIRST TRIMESTER AND
EARLY SECOND TRIMESTER
• IT IS BASED ON A COMBINATION OF PRESUMPTIVE SIGN,
PROBABLE SIGN AND POSITIVE SIGN

3. FIRST TRIMESTER
(FIRST 12 WEEKS)

4. SUBJECTIVE SYMPTOMS
• AMENORRHOEA
• MORNING SICKNESS
• FREQUENCY OF MICTURATION
• BREAST DISCOMFORT
• FATIQUE

5. OBJECTIVE SIGNS
• BREAST CHANGES
• PER ABDOMEN
• PELVIC CHANGES
• UTERINE SIGNS
• VAGINAL SIGN
• CERVICAL SIGN

6. IMMUNOLOGICAL TESTS
IMMUNO ASSAY
WITHOUT
RADIOISOTOPES
IMMUNO ASSAY WITH
RADIOISOTOPES

7. SECOND
TRIMESTER
(13-28 WEEKS)

8. SUBJECTIVE SYMPTOMS
• AMENORRHOEA CONTINUES
• QUICKENING
• PROGRESSIVE ENLARGEMEN
• NAUSEA,VOMITING AND FREQUENCY OF
MICTURITION USUALLY SUBSIDES

9. OBJECTIVE SIGNS
• GENERAL EXAMINATION
– CHOLASMA
– BREAST CHANGES
• MORE ENLARGED
• PROMINENT VEINS UNDER THE SKIN
• SECONDARY AEROLA -20TH WEEK
• PROMINENT MONTGOMERY’S TUBERCLES
• COLOSTRUM –THICK & YELLOWISH-16TH WEEK
• VARIABLE DEGREE OF STRIAE

10. • ABDOMINAL EXAMINATION
– INSPECTION
– PALPATION
• FUNDAL HEIGHT
• UTERUS FEEL SOFT & ELASTIC
• BRAXTON-HICKS CONTRACTION
• PALPATION OF FETAL PARTS
• ACTIVE FETAL MOVEMENTS
• EXTERNAL BALLOTTEMENT

11. • AUSCULATION
– FETAL HEART SOUND
– UTERINE SOUFFLE
– FUNIC OR FETAL SOUFFLE
• VAGINAL EXAMINATION
⁻ BLUSIH DISCOLOURIZATION ,SOFTENING OF
VAGINA
⁻ SOFTEN CERVIX
⁻ SOFTEN VULVA
• INVESTIGATION
– SONOGRAPHY
– REAL-TIME SONOGRAPHY
– MRI

12. LAST TRIMESTER
(29-40 WEEKS)

13. SUBJECTIVE SIGNS
• AMENORRHOEA PERSIST
• ENLARGEMENT OF ABDOMEN
• LIGHTENING-38TH WEEK
• FREQUENCY OF MICTURITION REAPPERS
• FETAL MOVEMENTS –MORE PRONOUNCED

14. OBJECTIVE SIGNS
• CUTANEOUS CHANGES
• UTERNINE SHAPE
• FUNDAL HEIGHT
• SYMPHYSIS FUNDAL HEIGHT (SFH)
• BRAXTON- HICK CONTRACTION
• FETAL MOVEMENTS EASILY FELT
• PALPATION OF FETAL PARTS
• FETAL HEART SOUND
• SONOGRAPHY
– GESTATIONAL AGE
– AMNIOTIC FLUID VOLUME
– PLACENTAL ANATOMY

15. DIFFERENTIAL
DIAGNOSIS OF
PREGNANCY

16. • PSEUDOCYESIS
– CYSTIC OVARIAN TUMOUR
– FIBIORIOD
– ENCYSTED PERITIONITIS
– DISTENDED URINARY BLADDER

17. CONCLUSION
• The diagnosis of pregnancy has taken on
greater importance in recent years as
advanced reproductive technologies have
become more commonplace and the
ability to medically treat early extrauterine
pregnancies has become a safe reality.
Sensitive biochemical assays and high-
resolution ultrasonography now make the
diagnosis of pregnancy highly sensitive
and specific.

18. REFERENCES
• Hiralal konar.(2011).D.C.Dutta’s-textbook of
obstetrics.(7th edition).new central book agency,
Kolkata
• BT Basvanthappa (2014) textbook of midwifery
and gynecology , (1st edition,) Jaypee brothers
medical publishers (p) ltd New Delhi
• Diane fraser,Margaret cooper(2009).Myles –
textbook for midwives, (15th edition) ,elsevier p
ltd Churchill livingstone
• https://www.glowm.com/

19. THANK YOU !!!