18 Questions
Which sign involves pushing vaginal fingers in the posterior fornix to displace the fetus upwards and then fall down again?
Von Fernwald sign
What is a characteristic feature of Palmer's sign in pregnancy?
Firm, large, rounded head if presenting part is the head
What is a common cause of symmetrically enlarged uterus, NOT mentioned in the text?
Ectopic pregnancy
Which investigation method is mainly used for diagnosis during pregnancy?
Uterine palpation
Which technique involves listening to fetal heart sounds for diagnosing pregnancy?
Auscultation
What is the significance of Von Fernwald sign in pregnancy diagnosis?
It indicates the initiation of labor.
At how many weeks does the height of the uterine fundus become measurable, NOT as mentioned in the text?
10 weeks
When calculating gestational age clinically, what does the McDonalds formula involve?
Fetal weight estimation.
In obstetric diagnosis, what does the term 'Gravidity' refer to?
Number of pregnancy losses.
Which method is typically used in the first trimester for estimating gestational age via ultrasound?
Estimation of abdominal circumference.
What does Palmer's sign indicate in pregnancy diagnosis?
Presence of fetal head in the lower uterine segment.
How is the date of ovulation typically used in calculating gestational age?
Determining McDonalds formula.
What is the aim of the urine test 'agglutination inhibition test' in pregnancy?
To detect HCG in the urine
What can cause false positive results in the urine 'agglutination inhibition test' for pregnancy?
Pituitary tumors or HCG producing tumors
At what concentration of hCG in urine does the 'agglutination inhibition test' for pregnancy show a positive result?
25 mIU's
What is detected at 7 weeks during transvaginal ultrasound (TVS) for pregnancy?
Fetal pole
What is the purpose of serological tests like radio immuno-assay and ELIZA in pregnancy diagnosis?
To detect β-sub-unit of HCG in the blood
When can fetal heart beat be detected during transabdominal ultrasound (TAS) for pregnancy?
8 weeks
Study Notes
Auscultation and Ultrasound
- Auscultation of the umbilical soufflé
- Use of ultrasound for detection of fetal parts, movements, and fetal heart beats (FHB)
Calculation of Gestational Age
- Clinical methods:
- Menstruation delivery interval (Neagele's formula): addition of 7 days and 9 months to the first day of Last Normal Menstrual Period (LNMP)
- Ovulation delivery interval: pregnancy equals 266 days from the date of ovulation
- Coital delivery interval (if known)
- Date of ultrasound or pregnancy test or date of quickening
- Uterine size measurement:
- Fundal level
- Symphysis fundal height: uterine height in cm + 4 = number of gestational weeks
- McDonald's formula: duration of pregnancy in weeks = 8/7 X symphesis fundal height in cm
Ultrasound in Pregnancy
- Early in pregnancy: detection of gestational sac and crown-rump length
- Late in pregnancy: detection of biparietal diameter (BPD), femur length, abdominal circumference, and estimation of fetal weight
Important Definitions
- Gravidity (primigravida, multigravida, etc.)
- Parity (nullipara, primipara, multiparous, grand multipara)
Diagnosis during Pregnancy
- First trimester (1-14 weeks):
- Investigations: pregnancy tests (urine and serological tests) and ultrasound
- Detection of fetal heart beat and fetal pole
- Second trimester (14-28 weeks):
- Investigations: mainly ultrasound
- Third trimester (28-42 weeks):
- Abdominal enlargement and fetal movements
- Pelvic pressure symptoms
- Lightening and identification of the presenting part
- Lateral palpation (lie and position)
Differential Diagnosis of Pregnancy
- Pseudocyesis and other causes of amenorrhea
- Causes of symmetrically enlarged uterus:
- Hematometra
- Pyometra
- Subinvolution
- Submucous fibroid
- Diffuse adenomyosis
- Endometrial hyperplasia/carcinoma
- Metropathia hemorrhagica
Sure Signs of Pregnancy
- Palpation of the fetal parts by obstetrician
- Palpation of the fetal movements by obstetrician
- Auscultation of the fetal heart sounds
- Piskack's sign: asymmetrical uterus due to growth of the ovum in one cornue
- Von Fernwald sign: irregular softening of the fundus at the site of implantation
- Globular shape uterus of early pregnancy
Test your knowledge on the signs and investigations used to diagnose early pregnancy during the first trimester. Learn about Piskack's sign, Von Fernwald sign, and pregnancy tests like the agglutination inhibition test.
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