Sign and symptoms –
An abnormal absence of menstruation is called as amenorrhea. It’s the first sign of pregnancy for most women with a regular menstrual cycle. Pregnancy is the commonest cause of amenorrhoea, but other causes such as recent use of the contraceptive pill may be responsible. Occasionally a women may continue to bleed in early pregnancy around the time of suppressed menstruation. This is usually called decidual bleeding and may, continue until about 12 weeks.
|DETECTION OF HCG|
By 14 days after fertiliZation the chorion of the blastocyst is secreting chorionicgonadotrophin (HCG) harmone and this can be detected in either the mother’s blood or urine by the time of the first missed period. Modern pregnancy tests identify specifically the beta subunit of HCG and can detect as little as 25 IU/1 HCG. They are available commercially on the chemist shop.
|NAUSEA OR SICKNESS|
Many women suffer some gastric upset in the early months of pregnancy, from nausea to repeated vomiting, especially in the morning. The exact cause is unknown and raised levels of both oestrogen and human chorionic gonadotrophin (HCG) in the circulation have been blamed. Gastric motility is reduced, and in early pregnancy, the lower oesophageal sphincter is relaxed.
Increased frequency of micturition in the second and third months is due to a combination of increased vascularity and pressure from the enlarging uterus. Near term, frequency may again appear due mainly to pressure of the fetal head on the bladder.
The earliest symptoms and signs — increased vascularity and a sensation of heaviness, almost of pain — appear at 6 weeks.
By 8 weeks the nipple and surrounding area — the primary areola —have become more pigmented.
Montgomery’s tubercles — sebaceous glands which become more prominent as raised pink-red nodules on the areola.
By 16 weeks a clear fluid (colostrum) is secreted and may be expressed. By 20 Weeks the secondary areola — a mottled effect due to further pigmentation — has become prominent.
As pregnancy proceeds, areas which are already pigmented become more so — the nipples, external genitalia and anal region. Some fresh pigmentation appears on the face (chloasma) and on the abdomen (linea nigra). These changes are thought to be due to the deposition of melanin. Melanocyte-stimulating hormone is elevated from early pregnancy.
Striae gravidarum are depressed streaks on the skin of the fat areas — abdomen, breasts and thighs. After delivery they regress and persist as striae albicantes.
- F. Gary Cunningham, John C. Hauth. WILLIAMS OBSTETRICS – 22nd Ed. (2005). The McGraw-Hill Medical Publishing Division. p.72-90 . ISBN: 0-07-141315-4.
- Kevin P. henretty. OBSTETRICS ILLUSTRATED. sixth edition. Churchill Livingstone. pp 58-63.