Diagnosis of Pregnancy

An overdue menstrual period remains, for most women with a regular menstrual cycle, the first suggestion of pregnancy.

Pregnancy is the commonest cause of amenorrhoea but other causes such as disturbances in the hypothalamic–pituitary–ovarian axis or recent use of the contraceptive pill may be responsible.

Nausea or sickness

Many women suffer some gastric upset in the early months of pregnancy, from nausea and anorexia to repeated vomiting, especially in the morning. The cause is unknown and raised levels of both oestrogen and human chorionic gonadotrophin (HCG) in the circulation have been blamed. Gastric motility is reduced, and in early pregnancy, the lower oesophageal sphincter is relaxed.

Bladder symptoms

Increased frequency of micturition in the second and third months is due to a combination of increased vascularity and pressure from the enlarging uterus. Near term, frequency may again appear due mainly to pressure of the fetal head on the bladder.

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Breast changes

The earliest symptoms and signs — increased vascularity and a sensation of heaviness, almost of pain — appear at 6 weeks. By 8 weeks the nipple and surrounding area — the primary areola — have become more pigmented. Montgomery’s tubercles — sebaceous glands which become more prominent as raised pink-red nodules on the areola.

By 16 weeks a clear fluid (colostrum) is secreted and may be expressed. By 20 weeks the secondary areola — a mottled effect due to further pigmentation — has become prominent.

Jun 15, 2016 | Posted by in OBSTETRICS | Comments Off on Diagnosis of Pregnancy
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