Pregnancy is defined as the period of time between conception and birth during which the fertilized ovum matures and grows in the female’s ovum (Didona and Marks 1996). This period is sometimes referred to as the ante partum prenatal or antenatal period. The length of pregnancy last approximately 280 days.
Signs and Symptoms of Pregnancy
During pregnancy a woman’s body adapt to the presence of the new life in it by undergoing a number of physical changes. These changes are referred to as signs and symptoms of pregnancy and are classified in three groups: Presumptive probable and positive signs (3Ps).
Presumptive signs: ‘Possible”: are those that suggest butdo not positively indicate pregnancy.
· Amenorrhea – 4 weeks
· Early morning sickness – 4 – 14 wks
· Bladder Irritation – At about 6- 12 weeks the uteru s presses on bladder especially when standing leading to frequency in micturation.
· Skin changes: Due to hormonal changes melanocyte stimulating hormone leading to hyper-pigmentation, scars are darker, chloasma, Striae gravidarum and Linea Nigra are present.
· Breast changes: starts about the 4th week there is tenderness and fullness of the breast , increase vascularity and increase dilatation of breast and chest veins.
· It becomes nodular 6-8week as a result of proliferation of peripheral lobules of the breast. There is enlargement, formation of areola by the 12th week, it becomes darker & wider. Nipples become prominent, clear fluid from the breast (Cholostrum), Montgomery tubercles, Secondary areola formation
· Abdominal changes: Fullness and enlargement of the abdomen
· Quickening : 16 – 20wks.
Probable signs: are strong indicators of pregnancy but theydo not in themselves confirm the condition.
· On Vaginal Examination; Vulva: Darker in color
Vagina: Purplish due to increased vascularity (Jacquemiers 8th sign) and soft. Increased pulsation at the lateral vaginal fornices (Osiander’s sign)- 8 th weeks
Cervix:soft, purplish, increased cervical secretion – Leuchonhoea and increased mucus – operculum.
Utreus: Braxton Hicks contraction, uterine soufflé8 – 10 weeks, globular 10th than pear, Heger’s signs 6 -12 weeks, Isthmus becomes soft, uterus enlarges 8th week, abdomen Enlarges 10th week internal ballottement 16 – 28 weeks
· Biological Test: is done to detect the presence of Human Chrionic Gonadotrophic Hormone (HCGTH). This has been replaced with the use of ultrasound.
Positive signs: These are definite indications of the presenceof fetus. They must be present to confirm a diagnosis of pregnancy. These include the fetal heartbeat, palpation of fetal movement, or ultrasonic evidence of a fetus.
At about 20 weeks
· Seeing fetal movements seen or felt by the person examining
· Palpating of fetal parts
· Hearing fetal heart beats/sound 20weeks Ultrasound 16wks.
· Investigation –Plain Abdominal X-ray from 16 th week.
· Ultrasound scanning: ultrasonogram – reveals gestational sac. As early as 4 weeks
Sonicaid or Doptone – 12 weeks or even earlier