Obstetrics and gynecology. Diagnosis of pregnancy (the most important)

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Obstetrics and gynecology. Diagnosis of pregnancy (the most important)

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7. Diagnosis of pregnancy

Diagnosis of early pregnancy is made on the basis of the identification of presumptive (doubtful) and probable signs of pregnancy.

Presumable (doubtful) signs. Associated with general changes in the body of a pregnant woman. There is a change in appetite and taste, sense of smell, nausea, sometimes vomiting in the morning, malaise, and irritability.

Possible signs of pregnancy. These are objective changes in the female genital organs, mammary glands, enlargement of the mammary glands and the release of colostrum from them when pressed, bluish coloration of the mucous membrane of the vagina and cervix, enlargement of the uterus. Early pregnancy is characterized by certain signs.

1. An increase in the uterus becomes noticeable from the 5-6th week. At the end of the 2nd month, the size of the uterus reaches the size of a goose egg. By the end of the 3rd month, the bottom of the uterus is determined at the level of the upper edge of the symphysis.

2. Horvitz-Gegar sign - the appearance of softening in the isthmus.

3. Snegirev's sign - a change in the consistency of the uterus during its palpation (after the study, the uterus becomes denser).

4. Sign of Piskachek - bulging of one of the corners of the uterus associated with the development of the fetal egg.

5. Genter's sign - a ridge-like protrusion is palpated on the anterior surface of the uterus along the midline.

Diagnosis of late pregnancy is based on the registration of reliable signs, such as: fetal movement, listening to fetal heart sounds, probing parts of the fetus, X-ray and ultrasound examination data.

Biological and immunological methods for diagnosing pregnancy. Aschheim-Tsondek reaction. With the onset of pregnancy, a large amount of chorionic gonadotropin appears in a woman’s urine, the excretion of which reaches a maximum at the 8-11th week of pregnancy. This hormone can be detected in urine from the 2nd day after implantation. A morning sample of urine is taken for testing.

Friedman reaction. To diagnose pregnancy, a mature rabbit aged 3-5 months weighing from 900 to 1500 g is used. 6 ml of urine taken from the woman being examined is injected into the ear vein of a mature rabbit 2 times over 4 days. 48-72 hours after the last injection, under ether anesthesia, observing the rules of asepsis, the abdominal cavity is opened and the genitals are examined. With a positive reaction, changes similar to those found in mice are observed in the ovaries and uterus. After 6-8 weeks if the reaction is positive and after 4 weeks if the reaction is negative, the rabbit can be taken for re-examination. The accuracy of the reaction is 98-99%.

Immunological research methods are based on the detection of human chorionic gonadotropin in the urine of the examined woman.

Author: Ivanov A.I.

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