Health news
Health news top Health news

   Login  |  Register    
Health News Make AMN Your Home PageDiscussion BoardsAdvanced Search ToolMedical RSS/XML News FeedHealth news

Diagnosis & differential diagnosis of pregnancy

Introduction

It is advantageous to diagnose pregnancy as promptly as possible when a sexually active woman misses a menstrual period or has symptoms suggestive of pregnancy. In the event of a desired pregnancy, prenatal care can begin early, and potentially harmful medications and activities such as drug and alcohol use, smoking, and occupational chemical exposure can be halted. In the event of an unwanted pregnancy, counseling about adoption or termination of the pregnancy can be provided at an early stage.

 

Pregnancy Tests

All urine or blood pregnancy tests rely on the detection of hCG produced by the placenta. hCG levels increase shortly after implantation, approximately double every 48 hours, reach a peak at 50-75 days, and fall to lower levels in the second and third trimesters. Laboratory and home pregnancy tests use monoclonal antibodies specific for hCG. These tests are performed on serum or urine and are accurate at the time of the missed period or shortly after it.

Compared with intrauterine pregnancies, ectopic pregnancies may show lower levels of hCG that level off or fall in serial determinations. Quantitative assays of hCG repeated at 48- to 72-hour intervals are used in the diagnosis of ectopic pregnancy as well as in cases of molar pregnancy, threatened abortion, and missed abortion. Comparison of hCG levels between laboratories may be misleading in a given patient because different international standards may produce results that vary by as much as twofold.

Manifestations of Pregnancy

The following symptoms and signs are usually due to pregnancy, but none are diagnostic. A record of the time and frequency of coitus is helpful for diagnosing and dating a pregnancy.

A. Symptoms
Amenorrhea, nausea and vomiting, breast tenderness and tingling, urinary frequency and urgency, “quickening” (perception of first movement noted at about the 18th week), weight gain.

B. Signs (in Weeks From LMP)
Breast changes (enlargement, vascular engorgement, colostrum), abdominal enlargement, cyanosis of vagina and cervical portio (about the seventh week), softening of the cervix (seventh week), softening of the cervicouterine junction (eighth week), generalized enlargement and diffuse softening of the corpus (after eighth week).

The uterine fundus is palpable above the pubic symphysis by 12-15 weeks from the LMP and reaches the umbilicus by 20-22 weeks. Fetal heart tones can be heard by Doppler at 10-12 weeks of gestation and at 20 weeks with an ordinary fetoscope.

Differential Diagnosis

The nonpregnant uterus enlarged by myomas can be confused with the gravid uterus, but it is usually very firm and irregular. An ovarian tumor may be found midline, displacing the nonpregnant uterus to the side or posteriorly. Ultrasonography and a pregnancy test will provide accurate diagnosis in these circumstances.

Provided by ArmMed Media
Revision date: July 8, 2011
Last revised: by Janet A. Staessen, MD, PhD

Email this to a friend Bookmark this! Printable Version

RELATED STORIES:

We are pleased to let readers post comments about an article. Please increase the credibility of your post by including your full name and email.

All comments are reviewed by our editors before they are posted on the site. Just keep it clean, kids. Commenting is not available in this weblog entry.

   [advanced search]   
Interactive Quiz:
1. The most common form of contraception used by couples in the United States is
Pills
Condom
Diaphragm
Intrauterine device (IUD)
Permanent sterilization

UrologyToday.net


Health Centers
  Pediatric & Adolescent
  Gynecology


  Teenage Pregnancy

  Contraception for Adolescents

  Delayed Puberty

  Menstrual Irregularities

  Adolescent Dysmenorrhea

  Hyperandrogenism

  Ovarian Masses

  Breast Diseases

  Sexually Transmitted Diseases

  Chronic Pelvic Pain
  Gynecologic Clinical
  Examination


  Imaging in Pediatric
  Gynecology


  Ambiguous Genitalia in the
  Newborn


  Ovarian Cysts

  Precocious Puberty

  Sexual Abuse

  Vulvo-Vaginal Disorders


  Gynecology


  Endometriosis

  Premenstrual Syndrome

  Dysmenorrhea

  Vaginitis

  Cervicitis

  Cervical Polyps

  Genital Prolapse

  Uterine Prolapse

  Pelvic Inflammatory Disease

  Ovarian Tumors

  Painful Intercourse

  Infertility

  Rape

  Menopausal Syndrome

  Contraception

  Urinary Incontinence

  Overview

  Stress Urinary Incontinence

  Urge Urinary Incontinence

  Mixed Incontinence

  Overflow Incontinence

  Bypass Incontinence

  Pregnancy Health Center

  Gynecologic cancers

  Obstetrics

  Diagnosis of pregnancy

  Essentials of Prenatal care

  Nutrition in Pregnancy

  Morning Sickness

  Spontaneous Abortion

  Recurrent (Habitual) Abortion

  Ectopic Pregnancy

  Preeclampsia-Eclampsia

  Third-trimester Bleeding

  Surgical Complications

  Hemolytic Disease Prevention

  Premature Labor Prevention

  Puerperal Mastitis

» » »



Health Centers





Diabetes









Health news
  


Health Encyclopedia

Diseases & Conditions

Drugs & Medications

Health Tools

Health Tools



   Health newsletter

  





   Medical Links



   RSS/XML News Feed



   Feedback






Add to Google Reader or Homepage
Clinical Obstetrics and Gynecology News, Headlines and Latest Stories on Health.am
Add to My AOL