igns of pregnancy

presumptive (subjective signs) Amenorrhea, nausea, vomiting, increased urinary frequency,

excessive fatigue, breast tenderness, quickening at 18–20 weeks

probable (objective signs) Goodell sign (softening of cervix)

Chadwick sign (cervix is blue/purple)

Hegar’s sign (softening of lower uterine segment)

Uterine enlargement

Braxton Hicks contractions (may be palpated by 28 weeks)

Uterine soufflé (soft blowing sound due to blood pulsating through the placenta)

Integumentary pigment changes

Ballottement, fetal outline definable, positive pregnancy test (could be hydatidiform mole,

choriocarcinoma, increased pituitary gonadotropins at menopause)

positive (diagnostic signs) Fetal heart rate auscultated by fetoscope at 17–20 weeks or by Doppler at

10–12 weeks

Palpable fetal outline and fetal movement after 20 weeks

Visualization of fetus with cardiac activity by ultrasound (fetal parts visible by 8 weeks)

Pregnancy and fundal height measurement

Signs of pregnancy (presumptive, probable, positive)

Pregnancy and fundal height measurement As pregnancy progresses, the

fundus rises out of the pelvis (Figure 29-1). At 12 weeks’ gestation, the fundus is

located at the level of the symphysis pubis. By week 16, it rises to midway between

symphysis pubis and the umbilicus. By 20 weeks’ gestation, the fundus is typically at the

same height as the umbilicus. Until term, the fundus enlarges approximately 1 cm per

week. As the time for birth approaches, the fundal height drops slightly. This process,

which is commonly called lightening, occurs for a woman who is a primigravida around

38 weeks’ gestation but may not occur for the woman who is a multigravida until she

goes into labor