Signs and Symptom + DDs of Pregnancy
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Symptoms
Amenorrhea, Nausea and vomiting, breast tenderness and tingling, urinary frequency and urgency, Quickening (perception of 1st movement noted at about the 18th week), weight gain.
Signs (in weeks from last Menstrual period)
Breast changes (Enlargement, vascular engorgement, colostrum) start to occur very early in pregnancy and continue until the postpartum period. Cyanosis of the vagina and cervical portion and softening of the cervix occur in about the 7th week. Softening of the cervico-uterine junction takes place in the 8th week and generalized enlargement and diffuse softening of the corpus occurs after the 8th week. When a woman’s abdomen will start to enlarge depends on her body habitus and typically starts in the 16th week. The uterine fundus is palpable above the pubic symphysis by 12-15 weeks from the last menstrual period and reaches the umbilicus by 20-22weeks. Fetal heart tone can be heard by doppler at 10-12 weeks of gestation.
Differential Diagnosis
The non-pregnant uterus enlarged by myomas can be confused with the gravid uterus, but it is usually very firm and irregular. An ovarian tumor may be found midline, displacing the non-pregnant uterus to the side or posteriorly. Ultrasonography and a pregnancy test will provide accurate diagnosis in these circumstances.