Diagnosis of Pregnancy Dr.F Mehrabian MD

2. Diagnosis of PregnancyDr.F Mehrabian MD

3. Diagnosis of Early Pregnancy • Morning sickness • Fatigue, nausea and vomiting (the 6th week↑→ the 12th week↓ ). • Hyperemesis gravidarum protracted vomiting necessitating hospitalization. • Causes: HCG, delayed gastric emptying(P↑ )

4. Diagnosis of Early Pregnancy • Urinary symptoms • Bladder irritability, frequency and nocturia • Causes: increased circulation in pelvis (E and P↑), enlargement of the uterus. • Note: urinary infection must be ruled out

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

6. Diagnosis of Early Pregnancy • Signs • The changes of genital organs • 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 • Uterocervical junction Hegar’s sign: a widened zone of softness coupled with compressibility, resulting in a doughnut-shaped, slightly spongy configuration.

7. Hegar’s sign

8. Diagnosis of Early Pregnancy • Abdominal enlargement Enlargement of uterus (noticed at the 12th week) • Breast changes • Enlargement and vascular engorgement (6th–8th week) • Montgomery’s tubercles(6th–8th week, E and P↑ • Colostrum secretion (16th week) or secondary breasts

9. Diagnosis of Early Pregnancy • Laboratory tests • Pregnancy test • Urine HCG test (one step): + or – • β-HCG: >25mIU/L • Ultrasonography • Enlargement of uterus • Gestational sac • Embryo or fetal pulse

10. Diagnosis of Early Pregnancy • Other tests • Progesterone test • Cervical mucus examination • Basal body temperature (BBT)

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

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

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

15. Diagnosis of mid or late pregnancy • Laboratory tests • Ultrasonography • The number of fetus • Fetal lie • Fetal presentation • Fetal position • Fetal dead or not • Placenta and cord (velocity of flow) • Size of fetus

16. Diagnosis of mid or late pregnancy • Fetal electrocardiography, FECG 12th week

17. The End