Signs of Pregnancy: Presenter: Yzel V. Adavan

Signs of
Pregnancy
Presenter: Yzel V. Adavan
INTRODUCTION
Signs and symptoms of pregnancy are usually noted by the patient, which
impel her to make an appointment with a physician for confirmation of
pregnancy.
DEFINITION OF PREGNANCY
It is the state of carrying a
developing embryo or
fetus within the female
body from conception to
birth. After the egg is
fertilized by sperm then
implanted in the lining of
the uterus, it develops into
the placenta and become
embryo or fetus.
DURATION OF PREGNANCY
1. Usually 120 weeks or
2. 280 days or 10 lunar months or
3. 9 months and 7 days, calculated from the first day of last
mentrual period.
Beginning from the first day of the last menstrual period, it is

divided intro three trimesters, each lasting three months.
- First Trimester (First 12 weeks)
- Second Trimester (13-28 weeks)
- Third Trimester (29-40 weeks)
1 Trimester
st
First 12 weeks
FIRST TRIMESTER
PRESUMPTIVE SIGNS AND
● SYMPTOMS
Amenorrhea
● Morning Sickness
● Prequency of micturition
● Breast Discomfort
● Fatigue
● Fainting
- AMENORRHEA
• Absence of menstruation in woman of
reproductive age.
• Since nine months during pregnancy, period
are not occurred.
• If any type of bleeding has occurred during 9
months, it should not be confused with the
comonly met pathological bleeding.
Example: Treathened Abortion
- MORNING SICKNESS
• It is present in about 50% cases, mostly during first pregnancy.
• Nausea and vomiting begins about 6 weeks after the last menstrual
period and usually disappears by about 14 weeks.
• It is due to the high level of pregnancy hormones.
- FREQUENCY OF MICTURITION
• Resting of bulky uterus on the fundus of the bladder because of
anteverted position of uterus..
• It is present during 8-12 week of pregnancy and subside after 12
weeks.
- BREAST DISCOMFORT
• It is present during 6th week in the form of feeling of:
 Tenderness
 Tingling
 Fullness
 Increase in size
 Pigmentation of areola
 Pricking sensation
- FATIGUE
• It is frequent in early pregnancy and subside around 12-14 weeks of
pregnancy with bringing renew energy
FIRST TRIMESTER PROBABLE
SIGNS OR OBJECTIVE SIGNS
● Breast changes
● Cardiovascular changes
● Respiratory changes
● Integumentary changes
● Musculoskeletal changes
● Abdomen and Uterine changes
● Pelvic changes
- BREAST CHANGES
• These are valuable only in primiparae, compared to multiparae.
 Breast changes are evident between

6-8 weeks.
 There is enlargement with vascular
engorgement with delicate veins
visible under the skin due to
increased blood supply, making the
veins more noticeable.
 Nipples and areola (primary) become
more pigmented or darker.
 Montgomery’s tubercles are
prominent.
 The thick yellowish secretion
(colostrum) can be expressed as early
as 12th week.
- PELVIC CHANGES
• Jacquemier’s or Chadwick’s sign: It is dusky hue of vestibule and
anterior vaginal wall visible at about 8th week of pregnancy. The
discoloration is due to local vascular congestion.
- PELVIC CHANGES
• Vaginal sign: Apart from bluish discoloration of the anterior vaginal
wall, walls become softened, copious amount of non-irritating mucoid
discharge appears at 6th week. There is increased pulsation felt
through the lateral fornices at 8th week called Osiander’s Sign.
• Cervical signs: Cervix

becomes soft as early as 6th
week ( Goodell’s sign), the
pregnant cervix feels like lip
of mouth, while in non-
pregnant state like tip of nose.
- UTERINE CHANGES
A. Size, shape and consistency
• Uterus enlarged to
 Size of hen’s egg at 6th week.
 Size of cricket ball at 8th week.
 Size of fetal head at 12th week.
• Pyriform shape of nonpregnant uterus becomes globular by 12th
week. There may be asymmetrical enlargement of uterus if there is
lateral implantation.
• ( One half is more firm than other half. As pregnancy advances,

symmetry is restored, uterus feels soft and elastic)
- UTERINE CHANGES
B. Hegar’s Sign
 It is present in two third of cases.
 It can be demonstrated between 6-
10 weeks.
 It is softening and compressibility of
the lower segment of the uterus felt
on bimanual examination ( Two
fingers in anterior fornix and
abdominal fingers behind uterus).
C. Palmer’s Sign
 Regular rhythmic uterine
contraction on bimanual
examination at 4-8 weeks .
2 Trimester
nd
13-28 weeks
2ND TRIMESTER
SUBJECTIVE SYMPTOMS
ENLARGEMENT DECREASE DECREASE

AMENORRHEA QUICKENING
OF LOWER MORNING URINARY
ABDOMEN SICKNESS SYMPTOMS
2ND TRIMESTER
OBJECTIVE SYMPTOMS
SKIN CHANGES
VAGINAL ABDOMINAL
- CHOLASMA
CHANGES SIGNS
- ABDOMINAL SIGNS
A. SKIN
 Linea Nigra
 Striae
Gravidarum
 Cholasma
Gravidarum
- ABDOMINAL SIGNS
B. PALPATION
 Fundal Height
 Shape and consistency of uterus
 Braxton Hicks contraction -known as
prodromal or false labor pains,
are contractions of the uterus that
typically are not felt until the second
or third trimester of the pregnancy.
Braxton-Hicks contractions are the
body's way of preparing for true
labor, but they do not indicate that
labor has begun.
 Palpation of fetal parts
 Active fetal movements
- ABDOMINAL SIGNS
C. AUSCULTATION
 Fetal Heart Sound - is the most conclusive clinical sign of

pregnancy. It can be detected between 18-20 weeks by
stethoscope. The fetal heart rate varies from 110-160 beats/ min.
Two other sounds are confused with FHS. Those are:
• UTERINE SOUFFLE: It is soft blowing and systolic murmur heard low

down at the side of uterus, best on left side. This sound is
synchronized with maternal pulse and is due to increase in blood
flow through dilated uterine vessels.
• FETAL SOUFFLE or FUNIC: It is due to rush of blood through
umbilical artries. It is soft, blowing murmur , synchronized with FHS.
3 RD
Trimester
29-40 weeks
3RD TRIMESTER
SUBJECTIVE SYMPTOMS
• Amenorrhea.
• Progressive enlargement of abdomen.
• Palpitation and dyspnea following exertion due to
enlarge abdomen.
• Lightening: At about 38 week, sense of relief of
pressure symptoms obtained due to engagement of
presenting part.
• Frequency of micturition reappears.
• Fetal movements are more pronounced
3RD TRIMESTER
OBJECTIVE SYMPTOMS
• Palpation of fetal parts.
• Palpation of fetal movements.
• Auscultation of fetal heart sound.
• Occasional auscultation of funic soufflé.
• Cutaneous changes are more prominent with increase
pigmentation and striae.
• Uterine shape is changed from cylindrical to spherical
by 36th week.
• Fundal height: The distance between umbilicus and
ensiform cartilage is divided into three equal parts
THANK
YOU!

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Signs of Pregnancy: Presenter: Yzel V. Adavan

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Signs of

Beginning from the first day of the last menstrual period, it is

 Breast changes are evident between

• Cervical signs: Cervix

• ( One half is more firm than other half. As pregnancy advances,

ENLARGEMENT DECREASE DECREASE

 Fetal Heart Sound - is the most conclusive clinical sign of

Two other sounds are confused with FHS. Those are:

• UTERINE SOUFFLE: It is soft blowing and systolic murmur heard low

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