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Wednesday, 20.09.2017, 10:15
Main » Gynecology » Diagnosis of pregnancy 
20:38
Diagnosis of pregnancy


Diagnosis of pregnancy

Issues of diagnosis of pregnancy troubled people since ancient times.


To find out whether the pregnant woman in ancient Egypt, she was given a drink made from special herbs (bududu-ka), and milk a woman who gave birth to a boy. If this drink vomit, so a woman is pregnant, the pregnancy is otherwise absent.

The ancient Jews were forced to determine the pregnancy a woman walking on the soft grass, if remained a deep mark, then the pregnancy existed.

Midwives Ancient Greece has had a considerable knowledge. Thus, to determine pregnancy are based on a number of objective criteria: absence of menstruation, lack of appetite, salivation, nausea, and the appearance of yellow spots on the face. However, they have resorted to such preposterous means: before the eyes of a woman rubbing a red stone, and if the dust gets in your eyes, a woman was considered pregnant, otherwise the pregnancy was denied.

Even Hippocrates (460-377 BC) was a lot of false and erroneous ideas about the pregnancy. In particular, he believed that pregnancy can be recognized by your eyes, but at the same time, one of the first signs of pregnancy, he considered the termination period.

Soranus of Ephesus (1st century BC) established the following signs of pregnancy:
  • delayed menses
  • swollen breasts, and the vessels of the skin of the mammary glands are made tortuous, bluish and swollen
  • there is an urge to vomit
  • appear under the eyes dark circles, and his face sometimes yellow spots
  • over time increases a pregnant belly and begins to feel fetal movement.

Diagnosis of pregnancy, respectively, gradually improved the development of human society. Today, the diagnosis of pregnancy is on the basis of the survey, women physical examination and laboratory studies.

Signs of pregnancy on their diagnostic value is divided into
conjectural
likely to appear relatively early
reliable, commonly found in the second half of pregnancy.

It is understandable therefore, that the use of reliable signs for early diagnosis of pregnancy is impossible.

Among the alleged (doubtful) pregnancy symptoms appear early, although not in every pregnancy, but still have some diagnostic value are the following:
dyspepsia, feeling a sense of heaviness in the epigastric region, salivation, nausea, vomiting, morning fasting, changes in appetite or aversion to certain types of food (usually meat), the appearance of any particular interest in acute and especially acidic foods, constipation, a desire to consume food inedible substances lime , chalk, clay, etc.
functional disorders of the nervous system and psyche: easy irritability, increased sense of smell and hearing, tearfulness, isolation
changes in metabolism: the deposition of subcutaneous fat, especially abdominal pigmentation of the nipple and areola, the white line, and sometimes the face. The appearance of bands (scarring) of pregnancy.

All these symptoms are common in pregnant women, but not necessarily related to pregnancy and, therefore, called speculative.

Among the probable signs of pregnancy can be classified as follows:
  • cessation of menstruation in healthy, sexually active women of childbearing age
  • congestion bluish color of the mucous of the vagina, its walls and the vaginal part of cervix
  • increase in the size of the uterus, respectively, the term latency periods, the change in its normal shape and consistency
  • breast engorgement and the appearance in their colostrum.


All of these symptoms in most cases actually characterize pregnancy, but can sometimes appear, and other causes. For example, the delay of menstruation may be psychogenic nature, cause the uterus to increase the growing tumor. Therefore, these pregnancy symptoms are valuable not taken separately and together.

By significant (undeniable) featured pregnancy include the following:
  • definition of parts of the fetus at palpation of the uterus, is most easily able to identify a round, dense part of the head, as well as small parts of hands and feet
  • fetal movements, defined by a hand exploring
  • listening to the fetal heart with a stethoscope or with heart monitor.


These signs are 100% certify pregnancy, but are late, as can be observed only from the end of IV or early V month of pregnancy. One of the highlights in the diagnosis of pregnancy is a vaginal examination and palpation of the uterus so that it is necessary to elaborate.

The value of the normal non-pregnant uterus in the longitudinal axis is approximately 79 cm (neberemenevshih slightly lower in parous few more). With the onset of pregnancy and in the process of its development increases the value of the uterus. By the end of the month III pregnancy the uterus is still in the pelvic cavity and can only test the vaginal examination. Only after this deadline will not umeschayas in the pelvis, the uterus comes out of it and can feel out of the abdominal wall, and eventually leads to a marked increase in the abdomen.

The normal non-pregnant uterus is normally pear-shaped, somewhat flattened in the anteroposterior size. With the onset of pregnancy is in the process of further development of its form of cancer is changing. First, it assumes a spherical shape, then a few asymmetrical, spherical, and then again by the end of pregnancy ovoidnuyu. Acquisition of spherical uterus along with other symptoms is quite common for pregnancy.

Spherical shape of the uterus can be observed already with 56 weeks of pregnancy, and this form can be kept to about 910 weeks. Starting with 78 weeks of pregnancy the uterus becomes asymmetric, namely, one of the corners a few stuck out as if protrudes as compared to the other side. The appearance of the asymmetry due to the fact that the implantation of a fertilized egg in the uterus usually occurs near the mouth of the pipe on which the egg is transported. This characteristic shape of the uterus during this period of pregnancy was noted first Piskachekom (Piscacek) and offered them as a diagnostic criterion. In the future, with the development of pregnancy, the asymmetry of the uterine body disappears, and then the symptom Piskacheka not be determined.


Consistency with the onset of pregnancy changes: it becomes much softer. Softening of the uterus is due to increase in size and number of muscle fibers from the enrichment of the body with blood stagnation. Special softening observed in the isthmus of the uterus. Sometimes it is so pronounced softening of that in the study of the body of the uterus seems as if separated from the cervix. The second feature of the pregnant uterus is the volatility of its consistency. In the study of the pregnant uterus is noted at the beginning of her myagkovataya consistency, and in the research process and the uterus becomes thicker. Such a change in the uterus at the time of the study is particularly characteristic feature for the pregnancy.

Diagnosed very early pregnancy is usually an internal investigation of midwifery is not always possible, as obtained with the main symptoms of pregnancy can be detected not earlier than 56 weeks gestation. Until then, the pregnancy does not lead to noticeable changes in the uterus. Even in the longer term is sometimes not created full confidence in the accuracy of the data. Yet often required to establish a pregnancy before 5 weeks, for example, to produce a mini-abortion.



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