Diagnosis of Pregnancy in Third Trimester

Subject: Midwifery I (Theory)

Overview

Pregnancy signs and symptoms are classified into three stages: presumptive, probable, and positive. Early breast changes, amenorrhea, morning sickness, bladder irritation, and quickening are all suspect signs. HCG in urine and blood, Hegar's sign, Jacquirer's sign, Osiander's sign, Braxton hicks contraction, and uterine balloting are all possible symptoms. Finally, positive signs include visibility of the fetus via USG or X-ray, a fetal movement that is visible and palpable, and palpable fetal components. When the presenting fetal parts engage in the pelvis at about term, the mother feels a respite of pressure symptoms known as lightning. Sonography confirms pregnancy and allows evaluation of whether the pregnancy is singleton or multiple, determining the lie and presentation, and FHS.

Signs:

  • Skin pigmentation alterations and striae gravidum are more visible.
  • The uterine shape changes to a more globular shape, and the umbilicus is everted.
  • The fundal height is increasing.
  • Braxton hick's contractions are becoming more noticeable.
  • Fetal motions are plainly discernible.
  • Fetal organs are palpable.
  • Auscultation demonstrates consistent FHS.

Symptoms:

  • Amenorrhea persists.
  • The enlargement of the abdomen progresses.
  • When the presenting fetal parts engage in the pelvis around the term, the mother feels a respite of pressure symptoms known as lightning.
  • Active fetal movements become more noticeable and uncomfortable.
  • When the fetal head engages in the pelvis towards term, there is a frequency of micturition.

Investigation:

  • Sonography verifies pregnancy and allows for the determination of whether the pregnancy is a singleton or multiple, as well as the lie and presentation and FHS.
  • X-ray to evaluate pelvimetry for CPD.

References

  • Medscape. 1994. 2017 http://emedicine.medscape.com/article/262591-overview#a3
  • GFMER. 22 September 2016 http://www.gfmer.ch/Obstetrics_simplified/Diagnosis_of_pregnancy.htm
  • BabyMed. 2001. 2017. http://www.babymed.com/tag/early-pregnancy-diagnosis#
  • WHO, UNFPA, UNICEF, 2003. Pregnancy, childbirth, Postpartum and Newborn care (PCPNC): A guide for essential practice, “IMPAC” World bank.
  • Tuitui R. 2002, A textbook of Midwifery A (Antenatal), 3rd edition, Vidyarthi Pustak Bhandari (Publisher and Distributor), Bhotahity, Kathmandu
  • Web MD. 2005. 2017 http://www.webmd.com/baby/guide/third-trimester-tests#1
  • Tuitui R. 2002, A textbook of Midwifery B (Intranatal), 3rd edition, Vidyarthi Pustak Bhandari (Publisher and Distributor), Bhotahity, Kathmandu
Things to remember
  • The signs and symptoms of pregnancy are classified into three stages: presumptive, probable, and positive.
  • Early breast changes, amenorrhea, morning sickness, bladder irritation, and quickening are all presumptive signs.
  • HCG in urine and blood, Hegar's sign, Jacquemier's sign, Osiander's sign, Braxton hicks contraction, and uterus allocation are all possible symptoms.
  • Positive indicators include the visualization of a fetus via USG, X-ray, or ultrasound.
  • Fetal activity is apparent and tactile, as are fetal components.
  • When the presenting fetal parts engage in the pelvis around the term, the mother feels a respite of pressure symptoms known as lightning.
  • Active fetal movements become more noticeable and uncomfortable.
  • Skin pigmentation changes, striae gravidum becomes more visible, and the uterine form changes.
  • Sonography verifies pregnancy and allows for the determination of whether the pregnancy is singleton or multiple, as well as the lie and presentation and FHS.
Questions and Answers

Third Trimester

Symptoms

  • Amenorrhea persists.
  • The abdomen grows bigger over time.
  • When the presenting fetal parts engage in the pelvis around term, the mother feels a reduction in pressure symptoms known as "lightening."
  • Uncomfortable active fetal movements become more pronounced.
  • When the fetal head engages in the pelvis as it approaches term, micturition occurs frequently.

Signs

  • Changes in skin pigmentation and gravid striae are more obvious.
  • The umbilicus is everted, and the uterus assumes a spherical form.
  • The fundal height keeps increasing.
  • More obvious are the braxton hicks contractions.
  • Fetal movements are simple to observe.
  • Fetal organs you can feel.
  • Regular FHS is audible during auscultation.

Investigation

  • Sonography can evaluate whether a pregnancy is single or multiple, confirming pregnancy and establishing the presentation and FHS.

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