Question

26. Differentiate between Hegar, Chadwick, and Goodell signs. 27. Differentiate between probable and presumptive signs of pregnancy 28. What is meant by Intrauterine growth retardation (IUGR)? What are some causes? Concerns? 29. What is a transcervical foley? Why is it used? signs and symptoms, treatment, nursing considerations and interventions. (A chart might be helpful)

Answer 1

Hegar's Sign	Goodell's Sign	Chadwick's Sign
It is demonstrated between 6-10 weeks, a little earlier in multiparae. This sign is based on the fact that - Upper part of the uterus is enlarged by the growing fetus, Lower part of the body is empty and extremely soft and the cervix is comparatively firm.Because of variation in consistency, on bimanual examination, the abdominal and vaginal fingers seems to appose below the body of the uterus. Examination must be gentle to avoid the risk of abortion.	It is a significant softening of the vaginal portion of the cervix from increased vascularization. This vascularization is a result of hypertrophy and engorgement of the vessels below the growing uterus. The softening is pronounced surrounding the external os and also in the upper part. The pregnant cervix feels like the lips of the mouth. Cervix becomes soft as early as 6th week.	Chadwick sign is a bluish discoloration of the cervix, vagina, and labia resulting from increased blood flow. It can be observed as early as 6 to 8 weeks after conception. It is more pronounced as pregnancy advances and is more definitely present in multiparae.

27.

Presumptive sign

Presumptive signs of pregnancy refers to signs and symptoms that may resemble pregnancy signs and symptoms, but may in fact be caused by something else.

Presumptive signs are:
Amenorrhea
Nausea and vomiting
increased size and increased feeling of fullness in breast
pronounced nipples
Urinary frequency.

Probable Sign

Probable signs of pregnancy are signs that indicate pregnancy the majority of the time. However, there is still the chance they can be false or caused by something other than pregnancy, like presumptive signs.
A positive pregnancy test is a probable sign of pregnancy. However, in some instances, pregnancy tests can give off false positives for a variety of reasons, such as the urine being too diluted when the test is taken, or the instructions not being followed completely. An enlarged abdomen is another probable sign of pregnancy, but this can also occur from bloating during menstruation or a slight weight gain.

Probable signs are :
Uterine enlargement
Hegar's sign
Goodell's sign
chadwick sign
Ballottement (rebounding of the fetus against the examiner's fingers on palpation)
Braxton Hicks contraction( irregular painless contractions that may occur intermittently throughout pregnancy)
Positive pregnancy test for determination of the presence of human chorionic gonadotropin.

Positive sign

Positive signs of pregnancy are signs that cannot, under any circumstances, be mistaken for other conditions, and are evidence that pregnancy has occurred.

These signs include:
Fetal heart rate detected by doppler transducer at 10 to 12 weeks and by fetoscope at 20 weeks of gestation.
Active fetal movements palpable by examiner.
Outline of fetus on ultrasonography.

28.

Intrauterine Growth Retardation:

Intrauterine growth retardation is said to be present in those babies whose birth weight is below the tenth percentile of the average for the gestational age.

Causes:

The causes of fetal growth restriction can be divided into four groups.

• Maternal cause:

Pre-pregnancy weight and nutritional status, poor weight gain during pregnancy, poor nutrition, anemia, alcohol and drug use, maternal smoking, recent pregnancy, pre-gestational diabetes, gestational diabetes, pulmonary disease, cardiovascular disease, renal disease, hypertension.

• Fetal cause: Structural abnormalities , chromosomal abnormalities, infection like TORCH, multiple pregnancy.
• Placental cause: Due to poor uterine blood flow to the placental site for a long time, Placenta previa, Abruption, Circumvallete, Infarction and Mosaicism.
• Unknown : The cause remains unknown in about 40 per cent.