This document discusses the diagnosis of pregnancy from early to late stages. It outlines subjective changes like amenorrhea and morning sickness that indicate pregnancy. Objective signs examined are changes to the breasts, uterus, and cervical mucus. Laboratory tests mentioned include urine HCG tests, ultrasounds to view the fetus, and tests of progesterone and basal body temperature. The document also describes assessing fetal movement, heart rate, position and presentation during mid-late pregnancy using ultrasound and abdominal exams.

1. DIAGNOSIS OF
PREGNANCY
Jayashree ajith Asso.Prof.P.G.College of Nursing .
C.H.R.I. Gwalior

2. Diagnosis of Early Pregnancy
 SUBJECTIVE CHANGES
 History and symptoms
6. Amenorrhea
6 The first and the most important symptom
o emotional tension, chronic disease and certain
medications → delayed menses endocrine factors
n 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 Pregnancy
1. Morning sickness
1 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 Pregnancy
1. Urinary symptoms
1 Bladder irritability, frequency and nocturia
l Causes: increased circulation in pelvis (E and
P↑), enlargement of the uterus.
f urinary infection must be ruled out

6. Diagnosis of Early Pregnancy
1. Mastodynia
1 the development of mammary ducts (E↑) and
alveolar system (P↑)
( circulation↑→ engorgement of the breasts
4. Constipation
smooth muscle relaxant (P↑)
6. Weight gain

7. Diagnosis of Early Pregnancy
 OBJECTIVE SIGNS
 Signs
3. The changes of pelvic organs
e 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 pattern
e Uterocervical junction
Hegar’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 Pregnancy
1) Mcdonald,s sign .flexing the body of the uterus
aganist the cervix
2) Abdominal enlargement
Enlargement of uterus (noticed at the 12th week)
4. Breast changes
4 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 placenta
3. Changes in pigmentation of the skin – linea nigra,
striae, facial cholasma
4. Ballottement-

11. Diagnosis of Early Pregnancy
 Laboratory tests
2. Pregnancy test
2 Urine HCG test (one step): + or –
o β-HCG: >25mIU/L
5. Ultrasonography
6) Enlargement of uterus
7) Gestational sac
8) Embryo or fetal pulse

12. Diagnosis of Early Pregnancy
1. Other tests
2) Progesterone test
3) Cervical mucus examination
4) Basal body temperature (BBT)

13. Diagnosis of mid or late pregnancy
 Symptoms and signs
2. EDC: +9 or –3 (month), +7 (day)
3. Enlargement of uterus
t 12th week: 2 finger above the symphysis
a 16th week: midway between the symphysis and
the umbilicus.
t 20th – 22nd week: at the umbilicus

15. Diagnosis of mid or late pregnancy
1. POSITIVE CHANGES
2. 15Fetal movement (FM)
F The first perception: in the 18th – 20th weeks
t Diagnosis of pregnancy, duration of pregnancy,
the safety of fetus
t Count: 3 times per day, 1 hour per time.
sum×4= FM/12 hours. Normal:≥ 30/12 hours

16. Diagnosis of mid or late pregnancy
1. Fetal heart tones
s Heared: the 18th – 20th weeks
s Normal rate: 120-160bpm
- Differentiation: umbilical souffle
Fetal body
Palpated: outlines of the fetus (the 20th week).

17. Diagnosis of mid or late pregnancy
 Laboratory tests
2. Ultrasonography
3) The number of fetus
4) Fetal lie
5) Fetal presentation
6) Fetal position
7) Fetal dead or not
8) Placenta and cord (velocity of flow)
9) Size of fetus

18. Fetal Attitude
 Fetal lie
Refers to the relationship of the long axis of the
fetus to the long axis of the mother
3. Longitudinal lie
The long axis of the fetus is parallel with that of
the mother
5. Transverse lie
The long axis of the fetus crosses that of the
mother vertically

19. Fetal Attitude
 Fetal presentation
2. head presentation
Occiput presentation (95%), brow presentation
and face presentation.
4. Breech presentation
5) Complete breech presentation
6) Frank breech presentation
7) Incomplete breech presentation: footling
presentation

20. 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,LOP
4. Face presentation: the chin, M. LMA,LMT,LMP
5. Breech presentation: the sacrum, S.LSA,LST,LSP

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