妇科第一次见习Diagnosisofpregnancyantenatalcare要点.pptVIP

Diagnosis of pregnancy Antenatal care Ou Wenjun Learning objectives Realize the significance of antenatal care and perinatology Be familiar with the definition and diagnosis of fetal lie, fetal presentation, and fetal position Master: (1)the diagnosis of the first-, second- and third-trimester pregnancy (2)methods of antenatal examination Part one Diagnosis of pregnancy Stages of pregnancy Pregnancy starts from LMP, averagely lasting for 280 days=40 weeks Divided into 3 stages: First trimester: LMP~ 13+6 weeks Second trimester: 14 weeks~27+6 weeks Third trimester: 28 weeks~delivery Purpose: to confirm pregnancy, embryo number, and gestational age to exclude ectopic pregnancy or other pathologic condition Diagnosis of the first-trimester pregnancy Diagnosis of the first-trimester pregnancy Symptoms signs Assistant examination Symptoms and signs Amenorrhea Morning sickness Bladder frequency Changes in breasts Changes in the genital organs Amenorrhea Sexual history Regular menstrual cycles Delay time10 days Earliest, but not specific Morning sickness Nausea and vomiting, most severe in the morning 50% of pregnancy Reason: rapidly rising serum levels of hCG 6~ 12 weeks’ gestation Chilly, dizzy, weak, hypnosia, lack of appetite, fond of sour food, disgusted with oil Bladder frequency Reason: increased bladder circulation and pressure from the enlarging uterus Usually disappears after 12 weeks’ gestation Changes of breast Mastodynia (breast tenderness) Enlargement Montgomery’s tubercles: enlargement of circumlacteal sebaceous glands of the areola Linea nigra Changes in the genital organs Bluich or purplish discoloration of the vagina and cervix During 6~8 weeks’ gestation, widening of the softened area of the isthmus, resulting in compressibility of the isthmus on bimanual examination, is called Hegar sign. Changes in the genital organs The body of the uterus is felt to be globular and it progressively enlarges during pregnancy. At 8 weeks, twice its normal size At 1