Diagnosis of Pregnancy Symptoms
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Questions and Answers

What is a potential risk factor associated with elderly pregnancies?

  • Decreased likelihood of hypertension
  • Lower risk of chromosomal anomalies
  • Enhanced fetal health
  • Increased chance of preterm labor (correct)

Which condition may be exacerbated by maternal habits such as smoking or alcohol consumption?

  • Prolonged labor
  • Abortion (correct)
  • Cervical incompetence
  • Episiotomy rates

How does a rigid perineum affect labor in elderly pregnancies?

  • Induces uterine contractions
  • Facilitates faster delivery
  • Decreases episiotomy necessity
  • Contributes to prolonged labor (correct)

What information from menstrual history is crucial for pregnancy dating?

<p>Date of the last menstrual period (LMP) (D)</p> Signup and view all the answers

What past medical history should be screened for in a pregnant woman?

<p>History of drug allergies (D)</p> Signup and view all the answers

Which factor could indicate a need for cesarean delivery based on previous pregnancies?

<p>Previous cesarean section (B)</p> Signup and view all the answers

What complicating condition can arise due to prolonged periods of infertility?

<p>Malnutrition in the mother (D)</p> Signup and view all the answers

In assessing family history, which condition is important to be screened for during pregnancy?

<p>Hypertension (C)</p> Signup and view all the answers

At what week do breast signs become evident in pregnancy?

<p>6-8 weeks (C)</p> Signup and view all the answers

What is indicated by the presence of the Chadwick sign?

<p>Softness of the vagina (D)</p> Signup and view all the answers

What hormonal substance is primarily detected in standard pregnancy tests?

<p>hCG (D)</p> Signup and view all the answers

Which sign is characterized by asymmetrical enlargement of the uterus due to lateral implantation?

<p>Piskacek's sign (C)</p> Signup and view all the answers

What is the earliest sign that can indicate pregnancy, occurring around the 4th-5th week?

<p>Von Ferwald's sign (A)</p> Signup and view all the answers

What notable change occurs in the breast during the second month of pregnancy?

<p>Increase in size and pigmentation (C)</p> Signup and view all the answers

What is Hegar's sign indicative of during pregnancy examinations?

<p>Softening of the uterus (C)</p> Signup and view all the answers

Which sign indicates a painless contraction followed by relaxation not associated with cervical dilatation in early pregnancy?

<p>Palmer sign (D)</p> Signup and view all the answers

What is a key criterion for defining a normal pregnancy?

<p>Delivery at term between 38–42 weeks with no maternal complications (D)</p> Signup and view all the answers

Which factor is NOT associated with high-risk pregnancy?

<p>High socioeconomic status (A)</p> Signup and view all the answers

What is the optimal maternal age range for reducing maternal and perinatal mortality rates?

<p>20 - 30 years (C)</p> Signup and view all the answers

Which of the following is an example of a socioeconomic risk factor in high-risk pregnancies?

<p>Parental occupation (C)</p> Signup and view all the answers

Which of the following is a common reason for conducting routine investigations during antenatal care?

<p>To plan for delivery (D)</p> Signup and view all the answers

What is one primary aim of antenatal care?

<p>To detect conditions that may lead to maternal or fetal hazards (A)</p> Signup and view all the answers

Which statement about parity and maternal health is accurate?

<p>Higher parity may be linked to increased maternal and perinatal mortality rates (B)</p> Signup and view all the answers

What is the significance of a height less than 150 cm in pregnancy?

<p>It suggests awareness of cephalopelvic disproportion (CPD). (B)</p> Signup and view all the answers

Which condition is not classified as a medical factor contributing to high-risk pregnancies?

<p>Epilepsy (A)</p> Signup and view all the answers

A pregnant woman with a Body Mass Index (BMI) greater than 29 kg/m² is classified as which of the following?

<p>Obese (A)</p> Signup and view all the answers

What represents the best way to measure diastolic blood pressure during pregnancy?

<p>Disappearance of sounds (Korotkoff 5) (D)</p> Signup and view all the answers

What is the primary purpose of a speculum examination during a vaginal examination?

<p>To enable exfoliative cytology or collect a vaginal swab. (D)</p> Signup and view all the answers

Which symptom is NOT typically associated with anemia in pregnancy?

<p>Hyperemesis (A)</p> Signup and view all the answers

Which type of abortion refers specifically to a loss occurring naturally without medical intervention?

<p>Spontaneous abortion (B)</p> Signup and view all the answers

Which physiological change is commonly observed in the thyroid during pregnancy?

<p>Slight physiological enlargement occurs in 50% of cases. (C)</p> Signup and view all the answers

At what gestational age is the concept of fetal viability considered in developed countries?

<p>20-24 weeks (B)</p> Signup and view all the answers

What is one of the signs indicating the presence of edema in a pregnant woman?

<p>Evidence on the medial malleolus (A)</p> Signup and view all the answers

Which type of abortion is characterized by an empty gestational sac with absent or minimal structure?

<p>Empty sac abortion (C)</p> Signup and view all the answers

What is the term for a miscarriage that occurs after 12 weeks of gestation?

<p>Delayed miscarriage (D)</p> Signup and view all the answers

What could a pendulous abdominal shape suggest in a pregnant woman?

<p>Contracted pelvis (B)</p> Signup and view all the answers

During abdominal palpation, what is the purpose of Leopold's maneuvers?

<p>To centralize the uterus if deviated. (C)</p> Signup and view all the answers

What is indicated by recurrent miscarriages of more than three times?

<p>Habitual miscarriage (A)</p> Signup and view all the answers

In which type of abortion does a woman choose to terminate her pregnancy without any medical reason?

<p>Elective (voluntary) abortion (A)</p> Signup and view all the answers

During a bimanual examination, which structure is assessed for its consistency, shape, and position?

<p>Uterus (D)</p> Signup and view all the answers

What is the primary purpose of the umbilical grip during the Leopold's maneuvers?

<p>To palpate the presentation and position of the fetus (B)</p> Signup and view all the answers

Which of the following characteristics is NOT assessed during the second pelvic grip of Leopold's maneuvers?

<p>Fetal heart rate (B)</p> Signup and view all the answers

Where is the fetal heart sound typically identified for a normal occipito-anterior (OA) position?

<p>Between the umbilicus and the anterior superior iliac spine (ASIS) (B)</p> Signup and view all the answers

What does the Pawlik's grip primarily assess?

<p>Mobility of the presenting part and engagement (C)</p> Signup and view all the answers

In early pregnancy, which examination can help diagnose conditions such as an ectopic pregnancy?

<p>Local examination (D)</p> Signup and view all the answers

Which sign indicates fetal life and can be used to evaluate twins?

<p>Arnoux sign (B)</p> Signup and view all the answers

What does the term 'transverse lie' refer to in fetal positioning?

<p>The fetus is lying sideways across the uterus. (B)</p> Signup and view all the answers

In the context of assessing progress in labor, which fetal monitoring method is not directly used?

<p>Measuring fundal height (D)</p> Signup and view all the answers

Flashcards

Pregnancy test principle

Pregnancy tests detect the human chorionic gonadotropin (hCG) hormone in urine or blood using antibodies.

Hegar sign

Softening of the uterine isthmus, felt by placing two fingers between the vagina and abdomen.

Goodell sign

Softening of the cervix.

Chadwick sign

Vagina becoming soft, warm and violet/purple in color.

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Palmer sign

Uterine contraction and relaxation not accompanied by cervical dilation; a sign of pregnancy, potentially unreliable after 10 weeks.

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Pregnancy glandular activity

Increased sweat and sebaceous gland activity during pregnancy.

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Breast changes in early pregnancy

Increased size, vascularity, and pigmentation of the nipples and areola, and Montgomery tubercles.

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Signs of Pregnancy

Observable physical changes indicating pregnancy.

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Normal Pregnancy Criteria

A single, healthy baby delivered at term (38-42 weeks), weighing 2.5 kg or more, without maternal complications.

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High-Risk Pregnancy

A pregnancy with increased risk to the mother or baby due to various factors like socioeconomic status, maternal age, or underlying medical conditions.

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Antenatal Care (ANC) Aim

To identify potential health risks for both the mother and the baby during pregnancy, aiming to detect high-risk pregnancies early.

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First Antenatal Visit Timing

Ideally within the first two missed periods; should not be deferred beyond it.

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Socioeconomic Factors in High-Risk Pregnancy

Factors such as a low socioeconomic status, parental occupation, stress, and anxiety.

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Maternal Age in High-Risk Pregnancy

Maternal age outside the optimal range (generally 20-30) is considered a high-risk factor.

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Medical Conditions in High-Risk Pregnancy

Pre-existing medical conditions like diabetes (DM), anemia, heart disease, or kidney issues.

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Parity and High-Risk Pregnancy

Higher parity or having had multiple pregnancies increases the risk of complications for both mother and child.

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Risk factors for older pregnant women

Women over 35 years old are at increased risk for complications like chromosomal abnormalities, prolonged labor, and cesarean section.

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Occupational risks during pregnancy

Certain jobs can expose pregnant women to hazards like infectious diseases, anesthetic gases, or radiation.

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Impact of smoking during pregnancy

Smoking can increase the risk of miscarriage, preterm birth, low birth weight, and other complications.

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Importance of LMP in pregnancy

Last Menstrual Period (LMP) is crucial for calculating the estimated due date (EDD) and tracking pregnancy progress.

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Effects of rapid pregnancies

Having pregnancies close together can increase the risk of maternal malnutrition and complications.

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Significance of previous uncomplicated home deliveries

A history of uncomplicated home deliveries can indicate a lower risk of complications in future pregnancies.

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Previous cesarean section (CS) implications

Previous CS often leads to planning for another CS in future pregnancies to avoid complications.

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Assessing general appearance in pregnancy

Examining the pregnant woman's physical build, nutrition, and breathing can provide clues about her health status.

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Fundal Height

The distance measured from the top of the uterus (fundus) to the top of the pubic bone. It's measured in centimeters or by using the ulnar border of the hand.

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Leopold's Maneuvers

A series of four abdominal palpations used to determine the position, presentation, and lie of the fetus in the uterus.

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Pawlik's Grip

The third Leopold's maneuver where the examiner grasps the lower pole of the uterus to feel the presenting part and determine if it's engaged.

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Fetal Heart Rate (FHR)

The heart rate of the unborn baby, which is a vital sign monitored during pregnancy and labor.

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Arnoux Sign

The presence of two distinct fetal heart rates, suggesting the possibility of twins.

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FHR Auscultation Site

The area on the mother's abdomen where the fetal heart rate is best heard, which varies based on fetal position.

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Ballottement

A technique where a gentle tap on the cervix causes the presenting part of the fetus to bounce back.

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Vaginal Examination Steps

A systematic process to visually inspect the vagina, cervix, and internal organs using a speculum and bimanual palpation.

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Cystocele

A protrusion of the bladder into the vagina, often caused by weakened pelvic floor muscles.

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Uterine Prolapse

A condition where the uterus descends into the vagina, sometimes even protruding outside the body.

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Rectocele

A protrusion of the rectum into the vagina, similar to a cystocele, caused by weakened pelvic floor muscles.

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Types of Abortion

Abortion can be classified as spontaneous (natural) or induced (intentional), further categorized by their specific characteristics.

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Threatened Abortion

A condition with potential for loss, characterized by vaginal bleeding but no cervical dilation or expulsion of fetal tissue.

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Missed Abortion

Fetal death in the uterus without any visible signs of expulsion, such as bleeding.

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Incomplete Abortion

Partial expulsion of the fetal tissue from the uterus, often accompanied by bleeding and pain.

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What are common concerns for short pregnant women?

Pregnant women shorter than 150 cm are at increased risk of cephalopelvic disproportion (CPD), a condition where the baby's head is too large to pass through the pelvis. This can complicate labor and delivery.

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How might obesity during pregnancy affect the baby?

Obese pregnant women are at higher risk for developing gestational diabetes, hypertension, and having a baby with macrosomia (large size) or dystocia (difficult labor).

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What are the key signs of a high blood pressure in pregnancy?

A diastolic pressure above 90 mmHg is considered high. Doctors rely on the disappearance of sounds during blood pressure measurement (Korotkoff 5) instead of muffling (Korotkoff 4) to accurately measure diastolic pressure in pregnant women.

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What are the signs of jaundice in pregnancy?

A yellow discoloration of the skin, sclera (white of the eyes), tongue and hard palate indicates jaundice, which can be triggered by infection or premature rupture of membranes (PROM).

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What are the signs of pallor in pregnancy?

A pale complexion, particularly in the lower eyelids, tongue and nail beds may indicate anemia, bleeding or a pregnancy complication.

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What are the signs of a thyroid issue during pregnancy?

A slightly enlarged thyroid is normal during pregnancy, affecting about half of all pregnant women. However, monitor for other signs of thyroid dysfunction.

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What is a potential reason for a pregnant woman to have swollen ankles?

Swollen ankles are common in pregnancy due to increased blood volume and pressure in the legs. However, it's important to check for deep vein thrombosis (DVT) as a potential complication.

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How does palpation aid in evaluating a pregnant woman's abdomen?

Palpation, often using the four Leopold's maneuvers, helps determine the baby's position and size. It also assesses for any abnormalities in the position or size of the uterus.

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Study Notes

Diagnosis of Pregnancy

  • First Trimester Symptoms: Amenorrhea (cessation of menstruation) is a key sign, but may be present due to other factors like lactation or ovarian tumors. Other possible symptoms include breast changes (heaviness, pain, enlargement, tingling), color changes in the breasts, morning sickness (nausea, sometimes vomiting), and urinary frequency (increased urination).
  • Morning Sickness: Often starts around 6 weeks and resolves around 6-12 weeks. Severe nausea and vomiting may indicate a molar or multiple pregnancy.
  • Urinary Symptoms: Increased urinary frequency, especially at night, and increased susceptibility to infections are common, but generally decrease after the third month (though they may fluctuate in the last few weeks leading up to the end of pregnancy).
  • Breast Symptoms: Breast tenderness, heaviness, enlargement, and colostrum production can signify pregnancy. These symptoms begin in the second month and worsen over time (much more pronounced in advanced pregnancy).

Mode Changes

  • Mode Changes: Possible changes in mood include fatigue, sleepiness, depression, irritability, and insomnia.

Other Symptoms

  • Other Symptoms: Possible symptoms include mild uterine cramping, bloating, constipation, heartburn, nasal congestion, shortness of breath, and pregnancy-related lightheadedness that resolves upon lying down, which can be concerning if it is associated with abnormal heart rate.

Genital Signs

  • Vulva: Softening and a violet color.
  • Vagina: Softening, warming, and violet color.
  • Cervix: Enlarged, soft, and violet color by the sixth week.
  • Uterus: Enlarged and soft. The shape of the uterus changes from globular to a more rounded shape by week 8.

Investigations

  • Pregnancy Tests: Use the detection of the hCG hormone in the urine or serum (immunoassays are used).
  • Direct Agglutination Test: Done on urine and is negative if there is no hCG in the urine.
  • Enzyme-Linked Immunosorbent Assay (ELISA): A more sensitive test that can detect hCG in serum well before the first missed period.
  • Fluoroimmunoassay (FIA): A precise test for detecting very low levels of hCG.
  • Radioimmunoassay (RIA): Highly sensitive method for detecting hCG.
  • Immunoradiometric Assay (IRMA): Faster assay for detecting hCG.

Second Trimester (13-28 weeks)

  • Symptoms: Presumptive until fetal movement is felt. Symptoms include increased breast symptoms and decreased urinary symptoms and morning sickness.
  • Signs: Quickening (perception of fetal movement), progressive abdominal enlargement.
  • Signs Related to Skin/Abdomen: Increased pigmentation, striae gravidarum (stretch marks), and linea nigra.
  • Signs Related to Reproductive Organs: Ballottement.
  • Investigations: Follow up from initial visits; no additional tests needed beyond initial ones depending on symptoms.

Sure Signs of Pregnancy

  • Inspection and Palpation of Fetal Movement: Observing and feeling fetal movements through palpation, or detecting sounds like umbilical soufflé.
  • (Additional) Auscultation of fetal heart sounds or umbilical soufflé sounds
  • Ultrasound or X-ray: Visualizing the fetus for confirmation.

False Positive/Negative Pregnancy Tests

  • Causes of False Positive Tests: Proteinuria, hematuria, tumors producing hCG, and other conditions.
  • Causes of False Negative Tests: Collecting the test urine early in the cycle, using diluted urine, or storing urine too long in the room.

Differential Diagnosis of Pregnancy (Early/Late Pregnancy)

  • Causes of Secondary Amenorrhea: Identifying potential causes that could mimic pregnancy early in pregnancy.
  • Causes of Symmetrically Enlarged Uterus: Differentiating between pregnancy and potential tumors or masses in the pelvis/abdomen.

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Description

Explore the key signs of pregnancy, focusing on first trimester symptoms such as amenorrhea, breast changes, and morning sickness. Learn about urinary and breast symptoms that may indicate pregnancy, their onset, and duration. This quiz provides essential knowledge for understanding early pregnancy diagnostics.

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