DIAGNOSIS OF

PREGNANCY

Prof Hamonangan Hutapea

SpOGK
Departement of Obstetrics and
Gynecology
University of Sumatera Utara
Medan

Signs and Symptoms

`Amenorrhoea
Nausea or sickness
Bladder symptoms
Breast changes
Uterine changes

Signs and Symptoms

Palpable Uterine Enlargement
Awareness of Fetal Movement
(Quickening)
Palpable Uterine Contraction
Auscultation of Fetal Heart
Palpable Fetal Parts

Signs and Symptoms

Skin Changes :
- due to the deposition of Melanin
- Striae Gravidarum

Pregnancy Tests
Detection of HCG
- Now we can detect HCG as
low as 25IU/l HCG.
Ultrasound
-By vaginal route,identify
fetus as early as 5 Wks Gest.

Abdominal Examination
Before we do Abd.Palpation we need to know the
Definition of:
1. The Presentation
2. The Attitude
3. The Lie
4. Position :
- Left Occipito-Anterior (LOA)
- Left Occipito-Lateral (LOL)
- Left Occipito-Posterior (LOP)
- Occipito-Posterior (OP)

4. Position :
- Occipito Anterior (OA)
- Right Occipito-Anterior (ROA)
- Right Occipito-Lateral (ROL)
- Right Occipito-Posterior(ROP)

Abdominal Palpation

1.
2.
3.
4.

The examintion must be made

Systematically
Remember the tissue layer of the
Abdomen that can be interposing
Palpation of the Fundus
Identifying the Back and the Limbs
Identifying the lower part.Head?
Identify the presence of head/breech at
the lower part..fixed/mobile

Ask, and answer, 6 questions

1. Is the Fundal Height consistent with the
2.
3.
4.
5.
6.

estimation of maturity?
Is the LIE longitudinal?
What is the Presentation?
Is the Cephalic presentation a Vertex?
What is the Position of the Vertex?
Is the Vertex Engaged?

Vaginal Examination In
Pregnancy.:
- no longer a routine part of antenatal Exam
- still sometimes required :

To assess maturity
To exclude suspected abnormality
To identify the presenting part

Examination in Pregnancy
To exclude or confirm gross degrees
of contraction
To assess the ripeness of the cervix
To assess pelvic capacity

THANK YOU