Signs of Pregnancy – That Nurses Must Know

Signs of Pregnancy: As we know, Pregnancy can be diagnosed by a woman herself before she misses a period. Usually Antepartum period (pregnancy state) covers from first day of Last Menstrual Period to the beginning of True labor. Antepartum period is divided in to three trimesters. Each trimester having 13 weeks (o3 months). In Practice,

  1. First Trimester- 01 (from conception) to 12 Weeks
  2. Second Trimester - 13 to 27 Weeks
  3. Third Trimester- 28 to 40th weeks

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Diagnosis of Pregnancy

Pregnancy can be diagnosed in first & second trimester based on the combination of presumptive and probably signs of pregnancy. Later in gestation, it self evident.

Presumptive Signs of Pregnancy are physiological changes which woman experiences that it indicates that she is pregnant.

Probable Signs of Pregnancy includes signs that are detected upon examination by examiner apart from presumptive signs.

Positive Signs of Pregnancy includes those which are directly attributable to the fetus as detected and documented by examination and diagnostic studies.

Presumptive Signs of Pregnancy

  1. Abrupt cessation of menstruation
  2. Nausea and Vomiting from 4th to 14th week (usually at morning called morning sickness)
  3. Tingling, Tenseness nodularity and enlargement of the breasts and enlargement nipples around 3rd to 4th week.
  4. Increased frequency of micturition between 6th-12th week
  5. Increased Fatigue
  6. Darkening of Breasts. i.e.Darkening of the nipples and primary and secondary areolar change
  7. Appearance of Montgomery's tubercles
  8. Continued Elevation of basal body temperature
  9. Colostrum expression
  10. Increased Salivation
  11. Quickening (Feeling of First Fetal Movement) around 18th-20th weeks
  12. Skin Pigmentation and Conditions such as Cholosma, Striae abdomen, Linea Nigra, Palmar erythema

Probable Signs of Pregnancy

  1. Uterus Enlargement & Change in shape
  2. Presence of Human chorionic gonadotrophin hormone in blood(4th-12th week) & urine (6th-12 week) (Pregnancy strips Tests)
  3. Hegar's Sign: Softening and compressibility of isthmus (6th-12th weeks)
  4. Jacquemier's Sign/Chadwick's sign: Violet Blue Discoloration of Vulva and vaginal mucosa due to increased vascularity which is evident by 6th week
  5. Osiander's Sign: Pulsation in lateral fornices at 8th week
  6. Goodell's Sign: Softening of cervix from a non-pregnant state to firmness similar to the tip of a nose to the softness of lips
  7. Braxton Hicks Contractions (16th week)
  8. Ballotmoent of fetal head (16th-28 week)

Positive Signs of Pregnancy

  1. Fetal Visualization by USG at 06th week
  2. Visualization of Fetal Skeleton by X-Ray at 12th week
  3. Fetal Heart Sound heard by USG at 06th week
  4. Fetal Heart Sound heard by Fetoscope by 20th week
  5. Palpable Fetal Movement at 22nd week
  6. Visible Fetal Movement above 21 weeks
  7. Palpable fetal body parts above 24the week