Confirming Pregnancy

Sarah Stewart 2010

Creative Commons BY

Image: 'Motherhood' http://www.flickr.com/photos/42998601@N00/35552588

Early signs of pregnancy

Kangaroo Pregnancy Test

http://www.vectorjunky.com/detail-Cartoons-Kangaroo_Pregnancy_Test.php

Missed period (amenorrhea)

• Some women have light bleeding at the time they expect their period

• Amenorrhea can also be caused by:– Stress, excessive exercise, menopause,

illness, contraceptive pill, low body weight, breastfeeding

Image: 'On the peak' http://www.flickr.com/photos/10545985@N04/2215963717

Nausea and vomiting

• Starts around 4 weeks and starts to ease at 12 weeks, but every woman is different

• Need to exclude:– Gastroenteritis, UTI, food poisoning

Image: 'Daisy blue 1' http://www.flickr.com/photos/52352295@N00/181354778

Breast changes• Increased blood supply, feel tense and

tender, nipple (areola) darkens & prominent veins

• May also be caused by:– Contraceptive pill, menopause, hormonal

inbalance

http://www.slideshare.net/drneelesh/diagnosis-of-pregnancy

Fatigue

• Felt by many women until second trimester. Thought to be caused by initial surge of progesterone

• Not to be confused with:– Stress, lack of sleep, poor diet, anemia,

illness

Image: 'Snore' http://www.flickr.com/photos/95492938@N00/728766287

Frequency of micturition

• Caused by pressure of swelling uterus on bladder and increased vascularity

• Not to be confused with:– UTI, Diabetes, diuretic medication

Image: 'untitled‘ http://www.flickr.com/photos/38785544@N03/3920538687

Later signs of pregnancy

Image: 'Un beso antes de que salgas‘ http://www.flickr.com/photos/24175071@N00/3392533716

Skin changes• Pigmentation, chloasma (facial

pigmentation), linea nigra (vertical line that appears on the abdomen), darkened areola

http://en.wikipedia.org/wiki/File:Linea_nigra.jpg

Enlarged uterus

• Felt above symphis pubis after 12 weeks

• Can be caused by:– Fibroids, Hydatidiform mole

Image: 'What's It Feel Like?' http://www.flickr.com/photos/54304913@N00/2731678376

Baby movements (quickening)

• About 20 weeks gestation for primipara (first time mother)

• About 16 weeks gestation multiporous woman (mother who has had more than 1 pregnancy)

• Can be confused with ‘wind’

Image: 'Orion foot' http://www.flickr.com/photos/11677434@N04/3032532231

Braxton Hicks contractions

• From 16 – 20 weeks gestation

Image: 'Mother to Be' http://www.flickr.com/photos/52798669@N00/3656184801

Internal changes

• Hegar’s sign– Softening of cervical isthmus, cervix appears

bluish and engorged

• Jacquemier’s sign– Vaginal mucosa becomes lilac colour

• Osiander’s sign– Pulsating felt in vaginal fornices

• Softening Cx – Softens from about 10 weeks gestation

Hydatidiform mole• Causes symptoms of pregnancy

– Nausea and vomiting, enlarged uterus, breast changes, enlarged abdomen

• Often causes bleeding around 12 weeks gestation

http://www.obgyn.net/us/gallery/Gyn_Abnormal_Incomplete_Hydatidiform_Mole_Color.jpg

Confirmation of pregnancy

Image: 'The cross shined!' http://www.flickr.com/photos/62722383@N00/1362638054

Pregnancy test

• Looking for increased human chorionic gonadotrophin (HCG)

• Laboratory blood test or home urine test • Urine test can detect pregnancy on first day

of missed period• False results

– Too early in pregnancy, instructions not followed properly, faulty test kit, hydatidiform mole

• If negative, repeat in 1 weekImage: 'Positive' http://www.flickr.com/photos/11018968@N00/194870242

Ultrasound scan

• Fetal heart can be seen at about 5 – 6 weeks gestation

Image: 'Baby is Mighty Mekon‘ http://www.flickr.com/photos/30787616@N00/54852406

Fetal heart and parts

• Fetal heart can be heard:– About 10 weeks gestation with sonocaid– About 24 weeks gestation with pinard

• Fetal parts can be felt on palpation from toward end of second trimester

Image: 'MidwifeJasper-3' http://www.flickr.com/photos/69041429@N00/2491593942

References

• Better Health Channel. (2009). Pregnancy - signs and symptoms. Retrieved April 18, 2010, from http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Pregnancy_signs_and_symptoms

• Pairman, S., Pincombe, J., & Thorogood, C. (2006).

Midwifery: Preparation for practice. Chatswood : Elsevier.