Objectives
At the end of the session will be able to: Diagnose pregnancy from symptoms and
signs. Calculate the gestational age. Define important terms related to pregnancy.
Diagnosis of pregnancy
Symptoms Signs Tests False positives
Symptoms of pregnancy
Cessation of menstruation Subjective symptoms Morning sickness Irritation of breasts Nausea and vomiting Fatigue Increase in frequency of micturation
stretching of collagen and elastin. Striae gravidarum, stretch marks, red or purple during pregnancy, turns on to white after pregnancy. Situated in the lower abdomen,
Vaginal examination
Vaginal mucosa;
Jacquermins sign
Important Definitions
Gravid Parous Nullipara or nulliparous Primigravida Multiparous Multigravida Grand multiparaous
on the combined oral contraceptive pills, number of spontaneous cycles, bleeding in early pregnancy. Expected date of delivery/ confinement (EDD, EDC), Estimated by regularity of periods, no immediate past oral pills, no bleeding in early pregnancy. Naegles rule, add one year subtract 3 months add 7 days
If the cycle is irregular, or was on the combined pills How to estimate EDD; in the olden days and modern age????
Is the period of amenorrhae and the period of gestation the same????
as EDD Preterm, before 37 completed weeks of gestation Posterm, after 42 completed weeks of getation Preterm and premature Posterm and post maturity
trimesters First up to 14 weeks Second up to 28 weeks of gestation Third trimester up to 42 weeks of gestation. Each trimester has its own problems/complications/events
First Trimester
Confirm the pregnancy
Symptoms and signs Pregnancy tests Antenatal Booking, type of care Perinatal diagnosis. Be alert , high hCG and empty uterus on USS , with or without vaginal bleeding, and with or without abdominal pain!!
Second trimester
Perinatal diagnosis, USS Fetal quickening Findings at ANC
Third trimester
Findings at ANC Fetal assessment if indicated Chronological hospital admissions if any
Important terms
Braxton Hicks contractions;
Occurs from first trimester painless spontaneous irregular do not lead to labour
Lightening
Usually occurs after 36 weeks, more in primigravida. Mother notices that it is easier to breath.