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Diagnosis of pregnancy for undergraduate

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Undergraduate course lectuers in Obstetrics&Gynecology,Faculty of Medicine ,Zagazig University,Egypt Prepared by DR Manal Behery – PowerPoint PPT presentation

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Title: Diagnosis of pregnancy for undergraduate


1
Diagnosis of pregnancy
DR MANAL BEHERY Zagazig University ,EGYPT
2
Principles of diagnosis
  • In the majority of women, the diagnosis of
    pregnancy is usually straightforward based on a
    history of amenorrhea and a positive pregnancy
    test.
  • women with irregular periods or irregular vaginal
    bleeding , the diagnosis of pregnancy is more
    complex.
  • Other symptoms of pregnancy may alert the
    clinician to the possibility of pregnancy.

3
Symptoms of pregnancy
  • Amenorrhoea HOWEVER
  • Pregnancy may occur during period of lactation
    amenorrhea.
  • Slight bleeding early in pregnancy (threatened
    abortion) may be considered by the patient as
    menses .
  • Hartman's symptoms slight bleeding occurs at
    time of menstruation

4
Symptoms of pregnancy
  • Morning sickness nausea, rarely vomiting
    confined to morning
  • Increased frequency of micturition.
  • Enlargement of the breast and sensation of
    heaviness.
  • Easy fatiguability and tendency to sleep.
  • Emotional changes e.g. change of the appetite

5
In the second and third trimesters
  • 1-Abdominal enlargement
  • 2-Quickening
  • -1st perception (sensation) of fetal
    movements by the lady
  • -PG (18-20 weeks), MP (16-18 weeks)

6
Signs of pregnancy
7
Chloasma gravidarum
  • Butterfly face
  • pigmentation

8
Breast signs
  • Increased pigmentation of the nipple and lry
    areola.

9
Appearance of Montgomery tubercle in the areola
  • dilated sebaceous glands

10
Abdominal stria
11
Linea nigra
12
- Abdominal signs Inspection-
13

2- Palpation
14
Auscultation
  • Auscultation of FHS as early as 10-12 weeks by
    sonicade
  • Auscultation of FHS as early as 20-24 weeks by
    Pinard stethoscope
  • Auscultation of umbilical souffle as early as
    20-24 weeks.
  • Auscultation of uterine souffl

15
Pregnancy tests Principle
  • Detection of
  • HCG in the
  • urine or
  • serum .

16
1- Urinary pregnancy test
  • Classically it becomes Ve 7- 10 day after 1st
    missed period
  • Commercial testing kits are available that are
    sensitive to 25 iu/L in urine.
  • By the time the mother has missed her first
    menstrual period, her hCG levels are around 100
    iu/L.

17
Serum pregnancy test
  • Classically it becomes Ve 5- 7 days before 1 st
    missed period
  • A quantitative serum HCG assay level of gt 5 iu/L
    will usually denote a pregnancy.
  • With a normal intrauterine pregnancy, the hCG
    level doubles approximately every 36-48 hours.

18
Tran abdominal US
19
Transvaginal ultrasound ( TVS)
20
12 WEEKS GESTATION
  • CROWN RUMP
  • LENGTH(CRL)

21
2ND TRIMESTER
22
Sure signs of pregnancy
  • Inspection of fetal parts as early as 20th week.
  • -Inspection of fetal movements as early as
    20th week.
  • Palpation of fetal movements as early as 20th
    week.
  • -Palpation of fetal parts as early as 20th
    week.

23
Sure signs of pregnancy
  • -Auscultation of FHS at 10-12 weeks by sonicade
  • Investigations Visualization of fetal parts by
    ultrasound

24
  • Thank you
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