CHILD BEARING CIRCLE

This is a period from a time of puberty begining of menstrual circle from the time of menopause which marks the end of menstrual flow.

DIAGNOSIS OF PREGNANCY

The diagnosis of pregnancy requires a multifaceted approach using three main diagnostic tools. These are history and physical examination, laboratory evaluation, and ultrasonography.

The diagnosis of pregnancy has taken on greater importance in recent years as advanced reproductive technologies have become more commonplace and the ability to medically treat early extrauterine pregnancies has become a safe reality. Sensitive biochemical assays and high-resolution ultrasonography now make the diagnosis of pregnancy highly sensitive and specific.

Early signs/symptoms of pregnancy which occurs as menses case and return some weeks or months after delivery.

The diagnosis are depth or group into 3.

These are:

1. Presumptive signs
2. Probable signs
3. Positive signs

1. PRESUMPTIVE SIGNS:

The first presumptive sign is

A. AMENORRHEA: During the reproductive period of a healthy individual she is bound to have menstrual flow, therefore the presence of amenorrhea is likely to be a sign of early pregnancy unless approved otherwise.
B. MORNING SICKNESS: It is inconsistently present in about 50% of cases. The sign is most often seen in the first pregnancies than subsequent ones.

• It occurs soon following the mixed period (amenorrhea) and rarely last beyond the 3rd month..
• It varies from the sign of nausea that occur from rising up from bed to loss of appetite or even vomiting..
• But it it does not affect the health of the woman.
  C. BREAST DISCOMFORT: This comes in the form of feeling of fullness and pricking sensations.. this is evidence of notice as early as 6-8 weeks of gestation
• Nipple and the areolar becomes pigmented in dark women
• Montgomery’s tubercles are predominant and present of thick yellowish colostrum can be expressed as early from 12 weeks of gestation.
  D. FATIGUE: It is very common early signs of pregnancy.

ALTERED SIGNS UNDER PRESUMPTIVE SIGNS

• SKIN CHANGES
• QUICKENING

2. PROBABLE SIGNS

Probable signs of pregnancy are considered to be signs that the examiner can observe.

THIS SIGNS INCLUDE:

A. ABDOMINAL ENLARGEMENT

• The uterus remain a pelvic organ until the 12 weeks of gestation.
• It may be first seen as a supra pubic bulge.
• Pelvic changes is diverse and appear at different period
• The size, shape and consistency appears different period..
• At 6 weeks it enlarge to a size of Hen egg
• At 8 weeks size of a cricket ball
• At 12 weeks size of a fetal head and becomes globular and the uterus become active activated and is most common from 6-8 weeks of pregnancy.

B. BRATON HICK’S CONTRACTIONS

• Contractions are evident quickening (feeling of life) which denotes the perception of active fetal movement but the woman at 18 weeks.
• Mostly in primigravida and 2 weeks early in multiparous women.

C. PALPATION OF FETAL HEART (PART)

• This can be distantly seen and felt at 20wks.
• This helps not only to diagnosed pregnancy but also identify the presentation and position of the foetus in later weeks.

D. EXTERNAL BALLOTMENT:

• This sign is seen early at 20 wks
• also the fetus is relatively smaller than the volume of amniotic fluid.

E. INTERNAL BALLOTMENT

• This can be detected between 16-28 weeks of gestation because it is too small to detect before 16 weeks and too large to dictate after 28 weeks.

F. JACK QUEMIERS OR CHADWICK’S

• This is discolouration of the vestibule and the anterior vaginal wall commonly seen at 8weeks. This occurs as a result of congestion.

G. CERVICAL SIGN

• This is usually softening of the cervix as early as 6 weeks of gestation. It can also be called Goodwill sign.
• It is a little earlier in multiparous women than the nulliparous.
• It is as a result of vascularity.

H. PALMER’S SIGN

• This regular and rhythmic uterine contractions as early as 4-8wks.
• It is one of the visible signs which can be seen

I. IMMUNOLOGICAL TEST

• This are positive test of pregnancy..
• It’s shown by the presence of uric acid in ASSAY with the use of radio isotopes and the used splogtsphu test
• This can detect fetal pole as early as 6 weeks.

3. POSITIVE OR ABSOLUTE SIGNS OF PREGNANCY

This are confirmatory signs which help to dictate pregnancy.

This signs include:

A. Manual application of fetal part and perception of active fetal movement by the examination at about 20wks of gestation.

B. Hearing of the fetal heart sound- this is the most conclusive clinical signs of pregnancy with an ordinary stethoscope

C. Ultra sonic evidence of the embro- as early as 6 weeks and later on as the fetus grows.

D. Radiological demonstration of the fetal skeleton. This is at 16 weeks onwards.