Ask about age, parity (number of pregnancies, including this pregnancy), parity (number of vaginal deliveries over 28 weeks of pregnancy) and this pregnancy (headache, dizziness, dizziness, nausea, vomiting, palpitation, shortness of breath, edema, vaginal bleeding, etc.). ), previous delivery history (history of dystocia and postpartum hemorrhage, fetal size and survival) and previous health status (such as heart disease)

Diagnosis of early pregnancy

symptom

1. Women of childbearing age who have a history of menopause and sexual life should be suspected of pregnancy if their menstruation is overdue 10 days or more. Menopause may be the earliest and most important symptom of pregnancy. But it should be noted that menopause is not necessarily pregnancy.

2. Early pregnancy reaction About half of women have symptoms such as chills, dizziness, fatigue, lethargy, salivation, loss of appetite, liking sour food or hating greasy food, nausea and vomiting in the morning after menopause for about 6 weeks, which is called early pregnancy reaction. The early pregnancy reaction is that it disappears after pregnancy 12 weeks.

3. Frequent micturition occurs in the early pregnancy, which is caused by the enlarged anteversion uterus pressing the bladder in the pelvic cavity. About 0/2 weeks after pregnancy, when the uterus enters the abdominal cavity and no longer compresses the bladder, the symptoms of frequent urination naturally disappear.

Pathology/physical signs

1. Breast changes From the eighth week of pregnancy, the breasts gradually increase. Pregnant women feel slight breast swelling and nipple pain. The examination shows that the nipple and its surrounding skin (areola) are dark in color and there are Montessori nodules around the areola.

2. Changes in reproductive organs during pregnancy? Vaginal endoscopy was performed at 8 weeks. Visible vaginal wall and cervical hyperemia, purple-blue. With the progress of pregnancy, the uterine body becomes bigger and softer. When the fundus of uterus exceeds the pelvic cavity, it can touch the upper part of pubic symphysis.

accessory examination

1 Ultrasonic inspection

(1)B-ultrasound imaging: It is a quick and accurate method to check early pregnancy. In the enlarged outline of the uterus, the circular halo of the amniotic sac can be seen. The pregnancy ring can be seen as early as the fifth week of pregnancy. If rhythmic fetal heart rate and fetal movement are seen in the pregnancy ring, it can be diagnosed as early pregnancy and live fetus.

(2) Ultrasonic Doppler method: In the enlarged uterine area, the ultrasonic Doppler instrument can hear rhythmic, single and high-pitched fetal heart sounds, which can be diagnosed as early pregnancy and live fetus, first appearing at the seventh week of pregnancy.

2. Pregnancy test: HCG positive in blood and urine is helpful to diagnose early pregnancy.

3. For women with biphasic body temperature measured by basal body temperature, the high temperature phase does not continue to decline, and the possibility of early pregnancy is high. But the basal body temperature curve can only reflect the corpus luteum function, but not the embryo condition.

Note: A positive pregnancy test should not be used as the only basis for diagnosis, because sometimes there will be false positives. In addition, patients with ectopic pregnancy and trophoblastic diseases are positive for HCG in blood and urine. Therefore, medical history, signs and ultrasonic examination results should be combined to avoid misdiagnosis.

Diagnosis of second and third trimester pregnancy

After the second trimester of pregnancy, the uterus is obviously enlarged, and the fetus can be touched, the fetal movement can be touched, and the fetal heart sound can be heard, which is easy to diagnose.

symptom

After experiencing early pregnancy, I gradually felt abdominal enlargement and conscious fetal movement.

Pathology/physical signs

1. Uterus enlargement The uterus gradually increases with the progress of pregnancy. When examining the abdomen, it is helpful to judge the number of weeks of pregnancy by measuring the height of the fundus by hand and the length of the uterus above the pubic bone with a ruler. The height of uterine fundus varies with the distance between umbilical cord and shame of pregnant women, fetal development, amniotic fluid volume, singleton or multiple births, and is for reference only.

2. Fetal movement The activity of the fetus hitting the uterine wall in the uterus is called fetal movement. Fetal movement is a sign that the fetus is in good condition. Pregnant women are pregnant 18? At the 20th week, conscious fetal movement began. The more weeks of pregnancy, the more active the fetal movement, but it gradually decreases at the end of pregnancy. Fetal movement is about 3 per hour? Five times.

3. Fetal heart sounds during pregnancy 18? At 20 weeks, fetal heart sounds can be heard through the abdominal wall of pregnant women with a stethoscope. Fetal heart sounds are disyllabic, like clocks and watches? Tick tock? Sound, faster. Every minute 120? 160 times. Hearing fetal heart sounds can confirm pregnancy, which is a live fetus. Listening to fetal heart sounds should be differentiated from uterine murmurs, abdominal aortic sounds, fetal movement sounds and umbilical cord murmurs.

4. After 20 weeks of pregnancy, you can touch the body in the uterus through the abdominal wall. The fetal head is round and hard, with a sense of floating ball; Fetal back is wide and flat; The fetus is hip breadth and soft, with a slightly irregular shape; Fetal limbs are small and irregular [3].

accessory examination

1. Ultrasound examination B-mode ultrasound imaging method can not only display the number of fetuses, the mode of fetal delivery, fetal presentation, fetal position, fetal heartbeat, placental position, but also measure multiple radial lines such as the biparietal diameter of fetal head to observe whether there is any fetal body surface abnormality. Ultrasonic Doppler method can detect fetal heart sound, fetal movement sound, umbilical blood flow sound and placental blood flow sound.

2. Fetal ECG At present, indirect methods are widely used to detect fetal ECG in China, and the success rate is high after 20 weeks of pregnancy. The advantage of this method is non-invasive and reusable.

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