Diagnosis of pregnancy.pptVIP

Diagnosis of Pregnancy Liu Wei Department of Ob Gy Ren Ji hospital Diagnosis of Early Pregnancy History and symptoms Amenorrhea The first and the most important symptom Note 1: emotional tension, chronic disease and certain medications → delayed menses Note 2: lactation, IUD and dysfunction of endocrine → pregnancy Diagnosis of Early Pregnancy Morning sickness Fatigue, swirling, nausea and vomiting (the 6th week↑ → the 12th week↓ ). Hyperemesis gravidarum (妊娠剧吐): protracted vomiting necessitating hospitalization. Causes: HCG, delayed gastric emptying(P↑ ) Diagnosis of Early Pregnancy Urinary symptoms Bladder irritability, frequency and nocturia Causes: increased circulation in pelvis (E and P↑), enlargement of the uterus. Note: urinary infection must be ruled out Diagnosis of Early Pregnancy Mastodynia (乳房胀痛) the development of mammary ducts (E↑) and alveolar system (P↑) circulation↑→ engorgement of the breasts Constipation (便秘) smooth muscle relaxant (P↑) Weight gain Diagnosis of Early Pregnancy Signs The changes of genital organs Vagina: bluish or purple discoloration (congested pelvic vasculature). Increased vaginal discharge (E and P↑) Cevix: softening and bluish discoloration. The cervical mucus→ a granular pattern Uterocervical junction Hegar’s sign: a widened zone of softness coupled with compressibility, resulting in a doughnut-shaped, slightly spongy configuration. Hegar’s sign Diagnosis of Early Pregnancy Abdominal enlargement Enlargement of uterus (noticed at the 12th week) Breast changes Enlargement and vascular engorgement (6th –8th week) Montgomery’s tubercles (蒙氏结节): 6th –8th week, E and P↑ Colostrum secretion (16th week) or secondary breasts Diagnosis of Early Pregnancy Laboratory tests Pregnancy test Urine HCG test (one step): + or – β-HCG: 25mIU/L Ultrasonography Enlargement of uterus Gestational sac Embryo or fetal pulse Diagnosis of Early Pregnancy Other tests Progesterone test Cervical mucus examination Basal body temperature (BBT