上海交通大学医学院：《妇产科学》（双语） 31 Diagnosis of Pregnancy

Diagnosis of Pregnancy Liu w Department of ob Gy Ren Ji hospital

Diagnosis of Pregnancy Liu Wei Department of Ob & Gy Ren Ji hospital

Diagnosis of Early pregnancy History and symptoms 1. Amenorrhea 1) The first and the most important symptom 2) emotional tension. chronic disease and certain medications delayed menses 3) lactation, IUD and dysfunction of endocrine→ pregnancy

Diagnosis of Early Pregnancy • History and symptoms 1. Amenorrhea 1) The first and the most important symptom 2) Note 1: emotional tension, chronic disease and certain medications → delayed menses 3) Note 2: lactation, IUD and dysfunction of endocrine → pregnancy

Diagnosis of Early pregnancy 2. Morning sickness 1) Fatigue, swirling, nausea and vomiting(the 6 h week↑→the12 th week↓) 2) Hyperemesis gravidarum(妊娠剧吐): protracted vomiting necessitating hospitalization 3) Causes: HCG, delayed gastric emptying(P t

Diagnosis of Early Pregnancy 2. Morning sickness 1) Fatigue, swirling, nausea and vomiting (the 6 th week↑ → the 12th week↓ ). 2) Hyperemesis gravidarum (妊娠剧吐): protracted vomiting necessitating hospitalization. 3) Causes: HCG, delayed gastric emptying(P↑ )

Diagnosis of Early pregnancy 3. Urinary symptoms 1) Bladder irritability, frequency and nocturia 2) Causes: increased circulation in pelvis(E and Pt), enlargement of the uterus 3) urinary infection must be ruled out

Diagnosis of Early Pregnancy 3. Urinary symptoms 1) Bladder irritability, frequency and nocturia 2) Causes: increased circulation in pelvis (E and P↑), enlargement of the uterus. 3) Note: urinary infection must be ruled out

Diagnosis of Early pregnancy 4. Mastodynia(乳房胀痛) 1) the development of mammary ducts(E 1) and alveolar system(P t) 2) circulation↑→ engorgement of the breasts 5. Constipation(便秘) smooth muscle relaxant(P A) 6. Weight gain

Diagnosis of Early Pregnancy 4. Mastodynia (乳房胀痛) 1) the development of mammary ducts (E↑) and alveolar system (P↑) 2) circulation↑→ engorgement of the breasts 5. Constipation (便秘) smooth muscle relaxant (P↑) 6. Weight gain

Diagnosis of Early pregnancy Signs 1. The changes of genital organs 1) Vagina: bluish or purple discoloration (congested pelvic vasculature). Increased vaginal discharge(E and P 1) 2) Cevix: softening and bluish discoloration. The cervical mucus- a granular pattern 3) Uterocervical junction Hegar's sign: a widened zone of softness coupled with compressibility, resulting in a doughnut shaped, slightly spongy configuration

Diagnosis of Early Pregnancy • Signs 1. The changes of genital organs 1) Vagina: bluish or purple discoloration (congested pelvic vasculature). Increased vaginal discharge (E and P↑) 2) Cevix: softening and bluish discoloration. The cervical mucus→ a granular pattern 3) Uterocervical junction Hegar’s sign: a widened zone of softness coupled with compressibility, resulting in a doughnut￾shaped, slightly spongy configuration

Zone of soften Figure 26-3. Hegar's sign

Hegar’s sign

Diagnosis of Early pregnancy Abdominal enlargement Enlargement of uterus (noticed at the 12 th wee k) 2. Breast changes 1) Enlargement and vascular engorgement ( th 8 week) 2) Montgomery's tubercles(蒙氏结节):6-8t week, E and P↑ 3) Colostrum secretion(16th week) or secondary breasts

Diagnosis of Early Pregnancy 4) Abdominal enlargement Enlargement of uterus (noticed at the 12th week) 2. Breast changes 1) Enlargement and vascular engorgement (6th – 8 th week) 2) Montgomery’s tubercles (蒙氏结节): 6th –8 th week, E and P↑ 3) Colostrum secretion (16th week) or secondary breasts

Diagnosis of Early pregnancy Laboratory tests 1. Pregnancy test 1) Urine HCG test(one step): + or 2)B-HCG÷:>25mIU 2. Ultrasonography 1) Enlargement of uterus 2) Gestational sac 3) Embryo or fetal pulse

Diagnosis of Early Pregnancy • Laboratory tests 1. Pregnancy test 1) Urine HCG test (one step): + or – 2) β-HCG: >25mIU/L 2. Ultrasonography 1) Enlargement of uterus 2) Gestational sac 3) Embryo or fetal pulse

Diagnosis of Early pregnancy 3. Other tests 1) Progesterone test 2) Cervical mucus examination 3) Basal body temperature(BBT)

Diagnosis of Early Pregnancy 3. Other tests 1) Progesterone test 2) Cervical mucus examination 3) Basal body temperature (BBT)