Subjective (Presumptive) Changes

• The subjective changes of pregnancy are the symptomsthe woman experiences and reports. Because they

can be caused by other conditions, they cannot be considered proof of pregnancy

• Amenorrhea, absence of menses, is the earliest symptom of pregnancy (with regular periods). It is not a

reliable sign of pregnancy by itself, but if it were accompanied by consistent nausea, fatigue, breast

tenderness, and urinary frequency, pregnancy would be very likely.

• Morning sickness - Nausea and vomiting that occurs early in the day (1st Trimester)

- Women who experience NVP often have a more favorable pregnancy outcome than those who do

not.

• Excessive fatigue (1st& 3

rd trimester)

• Urinary frequency asthe enlarging uterus presses on the bladder (1st and 3

rd trimester)

• Breast changes(tenderness)

• Quickening (feelslike gas pains and isthe moment in pregnancy when the women starts to feel/perceive fetal

movements in the uterus), occurs 16-20 weeks after the LMP

Objective (Probable) Changes

• An examiner can perceive the objective changesthat occur in pregnancy. Because these changes can have

other causes, they do not confirm pregnancy.

• Changes noted in the uterus and vagina during pregnancy within the first three months of pregnancy

– Softening of the cervix (Goodell’ssign)

– Dark violet coloration of cervix, vagina, and vulva (Chadwick’s sign)

– Softening of lower part of uterus, the isthmus (Hegar’s sign)

– An ease in flexing of the body of the uterus against the cervix (McDonald’s Sign)

– Progressive uterine enlargement - Know

o The fundus of the uterus is palpable just above the symphysis pubis at about 10-12 weeks’

gestation

o At the level of the umbilicus at 20 to 22 weeks’ gestation

o Between 24-34 weeksthe height of the fundus correlates with the weeks of gestation

o Note: Woman can have other things growing here that aren’t a baby such asfibroids

- Enlargement of the abdomen (2nd Trimester she said thisis when the uterus becomes an abdominal

organ)