Signs of pregnancy
presumptive (subjective signs) Amenorrhea, nausea, vomiting, increased urinary frequency,
excessive fatigue, breast tenderness, quickening at 18–20 weeks
probable (objective signs) Goodell sign (sof
...
Signs of pregnancy
presumptive (subjective signs) Amenorrhea, nausea, vomiting, increased urinary frequency,
excessive fatigue, breast tenderness, quickening at 18–20 weeks
probable (objective signs) Goodell sign (softening of cervix)
Chadwick sign (cervix is blue/purple)
Hegar’s sign (softening of lower uterine segment)
Uterine enlargement
Braxton Hicks contractions (may be palpated by 28 weeks)
Uterine soufflé (soft blowing sound due to blood pulsating through the placenta)
Integumentary pigment changes
Ballottement, fetal outline definable, positive pregnancy test (could be hydatidiform mole,
choriocarcinoma, increased pituitary gonadotropins at menopause)
positive (diagnostic signs) Fetal heart rate auscultated by fetoscope at 17–20 weeks or by Doppler at
10–12 weeks
Palpable fetal outline and fetal movement after 20 weeks
Visualization of fetus with cardiac activity by ultrasound (fetal parts visible by 8 weeks)
Pregnancy and fundal height measurement
Signs of pregnancy (presumptive, probable, positive)
Pregnancy and fundal height measurement As pregnancy progresses, the
fundus rises out of the pelvis (Figure 29-1). At 12 weeks’ gestation, the fundus is
located at the level of the symphysis pubis. By week 16, it rises to midway between
symphysis pubis and the umbilicus. By 20 weeks’ gestation, the fundus is typically at the
same height as the umbilicus. Until term, the fundus enlarges approximately 1 cm per
week. As the time for birth approaches, the fundal height drops slightly. This process,
which is commonly called lightening, occurs for a woman who is a primigravida around
38 weeks’ gestation but may not occur for the woman who is a multigravida until she
goes into labor
Naegele’s rule
Add seven days to the first day of your LMP and then subtract three months. For
example, if your LMP was November 1, 2017: Add seven days (November 8, 2017).
Subtract three months (August 8, 2017).
The EDD is calculated by adding seven days to the first day of the last menstrual period, subtracting
three months and adding one year.
This formula is known as Naegele's Rule. For example, if the patient's last menstrual period, LMP,
was on August 10, 2019, the EDD would be calculated as follows. LMP equals August 10, 2019 plus
seven days. August 17, 2019, minus three months. May 17, 2019 plus one year and that equals May
17, 2020.
Hematological changes during pregnancy
During pregnancy, the heart is displaced upward and to the left within the chest cavity
by the gravid uterus’s pressure on the diaphragm. As pregnancy progresses, the risk for
inferior vena cava and aortic compression leading to supine hypotension increases
when the woman lies in a supine position. To avoid hypotension and potential syncope,
the woman should be advised to lie in a left lateral position. Hemodynamic changes and
anatomic changes also may alter vital signs in the pregnant woman (Table 29-2).
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