SIGNS AND SYMPTOMS OF PREGNANCY
BRAXTON-HICK’S CONTRACTIONS
- irregular painless abdominal contractions
PRESUMPTIVE SIGNS
Subjective signs: suggestive of pregnancy
MNEMONIC(PRABBL)
Least indicative of pregnancy
P – ositive pregnancy test
* amenorrhea
R – eturn of fetus when uterus is pushed w/
fingers (ballottement)
* morning sickness (nausea&vomiting)
* fatigue
* urinary frequency
* breast changes
* skin changes
A – softening cervix (goodells sign)
B – raxton- hick’s contractions
B – luish color of vulva, vagina, cervix
(chadwicks)
L – ower uterine segment is soft (hegar’s sign)
* quickening (fetal movement felt by woman)
* uterine enlargement
* weight increase
POSITIVE SIGNS OF PREGNANCY
Objective signs – originate from the fetus
Definite signs of pregnancy
MNEMONICS(PRESUME)
P – ERIOD ABSENT (amenorrhea)
R – eally tired (fatigue)
E – nlarged breast and uterus
* presence of fetal heart sound
* fetal outline by ultrasound
* fetal parts felt by examiner
* fetal movement felt by the examiner
S – kin changes
U – rinates frequently
M – ovement perceived (quickening)
E – mesis ( nausea)
Mnemonic (FETUS)
F - etal movement felt by the examiner
E – lectronic device detects FHT
T- he fetal parts are felt
PROBABLE SIGNS
U- ltrasound detects baby
* positive pregnancy test; due to presence and
rising HCG in maternal blood and urine
S- ee visible fetal movements
* chadwick’s sign; bluish to purplish
discoloration of the cervix, vagina and perineum
due to high vascularity in the area.
SIGNS AND WHEN IT APPEARS
* goodell’s sign; softening of the cervix
* hegar’s sign; softening of the lower uterine
segment(isthmus) due to compressibility of the
uterus.
* positive pregnancy test – 1 wk after
implantation
* Morning sickness- 2 wks. after implantation
* Amenorrhea- 2 wks. after implantation
* Breast changes- 2 wks. after implantation
BALLOTEMENT
- when the lower uterine segment (cervix)
tapped by the examiner’s finger and left there,
fetus float upward, then sinks back and gentle
tap is felt on the finger
* Urinary frequency- 3 wks. after implantation
* chadwicks sign- 6 wks. after implantation
* Goodell’s sign- 5 wks. after implantation
* Hegar’s sign* 6 wks.
* Sonographic evidence of gestational sac- 6
wks.
* Fatigue- 12 wks.
ACROSOMAL REACTION
* Abdominal enlargement- 8-12 wks.
* hyaluronidase – enzyme released bu the
spermatozoa
* Ballotement- 14 wks.
* Quickening- 18-20 wks
* Braxton hicks contrations – 20 wks
* Fetal outline felt by examiner- 20 wks.
* Chloasma/melasma- 24 eks.
* Linea Nigra- 24 wks.
- dissolves the outermost
protective covering of the ovum(corona radiata)
* acrosin – dissolves a portion of the zona
pellucida & will enter ovum.
( STRUCTURAL CHANGES OF PLASMA TO
PREVENT POLYSPERMY/ MULTIPLE
SPERMENTING THE OVUM)
* Striae gravidarum- 24 wks.
FERTILIZATION OCCURS IN THE FALLOPIAN
TUBE
FERTILIZATION
ZYGOTE
- “conception”, “fecundation”,
“impregnantation”
- fertilized ovum
- product of fertilization
- union of ovum and spermatozoon
- site: outer third or ampulla of the fallopian
tube
JOURNEY OF AN EGG
STEP 1 : egg leaves ovary and enters fallopian
tube
STEP 2 – sperm enters egg and unites w/
nucleus
STEP 3 – fertilized egg divides into 2, 4, 8 cells
Spermatozoon carried 23 chromosomes
Ovum carried 23 chromosomes
Fertilized ovum has 46 chromosomes
* x carrying spermatozoon entered the ovum,
two x chromosome (female)
* y carrying spermatozoon fertilized ovum, x
and y chromosome (male)
STEP 4- calls attach to uterus
OVUM
- mature egg cell
- can stay viable & capable of being fertilized for
only 24 hours up to 48 hours after ovulation
- Protective buffer:
* zona pellucida- ring surrounding the ovulated
ovum
CLEAVAGE
- series of mitotic cell division by the zygote
BLASTOMERS (4 days)
- daughter cells arising from the mitotic cell
division by the zygote
- 4 cell, 8 cell blastomers
MORULA (72 hours)
* corona radiata- circle of cells
- travelling form
SPERM
- produced by 16-50 more blastomers
- head contains DNA
- migrates from fallopian tube and reaches the
uterine cavity about 3-4 days after fertilization
- Midpiece- contains mitochondria to form atp
energy
- Filament- long tail for locomotion
- after ejaculation sperm reaches the ampulla of
the fallopian tube
SPERM CAPACITATION
- breakdown of the plasma membrane covering
of the sperm head
- binds with zona pellucida of the ovum
* Another 3-4 days, morula becomes a
BLASTOCYST consisting:
- inner cell mass and become the future embryo
- trophoblast, become the placenta and
membrane
BLASTOCYST
- result from continues multiplication of morula
as it floats freely in the uterine cavity
- large cells tend to collect the periphery of the
ball, leaving a fluid space surrounding an inner
cell mass
- embeds into the uterine lining
- composed of :
Trophoblast/ trophoderm- outer layer; absorb
nutrients from the endometrium
- develops into
placenta, fetal membranes, umbilical cord,
amniotic fluid
- secrete human
chorionic gonadotropin that prolongs the life of
the corpus luteum
Embryonic disc/ inner cell mass – inner cell
mass
- gives rise to the
three primary ger layers; ectoderm, mesoderm,
endoderm
IMPLANTATION/ NIDATION
- contact between the growing structure and
uterine endometrium
-7-710 days after fertilization
- site: upper fundal portion/ upper one third of
the uterus