Signs and Symptoms of Pregnancy
Signs and Symptoms of Pregnancy
During pregnancy a woman’s body adapt to the presence of the new life in it by undergoing a number of physical changes. These changes are referred to as signs and symptoms of pregnancy and are classified in three groups: Presumptive probable and positive signs (3Ps).
Presumptive signs: ‘Possible”: are those that suggest butdo not positively indicate pregnancy.
· Amenorrhea – 4 weeks
· Early morning sickness – 4 – 14 wks
· Bladder Irritation – At about 6- 12 weeks the uteru s presses on bladder especially when standing leading to frequency in micturation.
· Skin changes: Due to hormonal changes melanocyte stimulating hormone leading to hyper-pigmentation, scars are darker, chloasma, Striae gravidarum and Linea Nigra are present.
· Breast changes: starts about the 4th week there is tenderness and fullness of the breast , increase vascularity and increase dilatation of breast and chest veins.
· It becomes nodular 6-8week as a result of proliferation of peripheral lobules of the breast. There is enlargement, formation of areola by the 12th week, it becomes darker & wider. Nipples become prominent, clear fluid from the breast (Cholostrum), Montgomery tubercles, Secondary areola formation
· Abdominal changes: Fullness and enlargement of the abdomen
· Quickening : 16 – 20wks.
· Tiredness
Probable signs: are strong indicators of pregnancy but theydo not in themselves confirm the condition.
· On Vaginal Examination; Vulva: Darker in color
Vagina: Purplish due to increased vascularity (Jacquemiers 8th sign) and soft. Increased pulsation at the lateral vaginal fornices (Osiander’s sign)- 8 th weeks
Cervix:soft, purplish, increased cervical secretion – Leuchonhoea and increased mucus – operculum.
Utreus: Braxton Hicks contraction, uterine soufflé8 – 10 weeks, globular 10th than pear, Heger’s signs 6 -12 weeks, Isthmus becomes soft, uterus enlarges 8th week, abdomen Enlarges 10th week internal ballottement 16 – 28 weeks
· Biological Test: is done to detect the presence of Human Chrionic Gonadotrophic Hormone (HCGTH). This has been replaced with the use of ultrasound.
Positive signs: These are definite indications of the presenceof fetus. They must be present to confirm a diagnosis of pregnancy. These include the fetal heartbeat, palpation of fetal movement, or ultrasonic evidence of a fetus.
At about 20 weeks
· Seeing fetal movements seen or felt by the person examining
· Palpating of fetal parts
· Hearing fetal heart beats/sound 20weeks Ultrasound 16wks.
· Investigation –Plain Abdominal X-ray from 16 th week.
· Ultrasound scanning: ultrasonogram – reveals gestational sac. As early as 4 weeks
Sonicaid or Doptone – 12 weeks or even earlier