1. Early pregnancy
(1) Symptoms and signs
1) Menopause: A woman of childbearing age with a history of sexual life whose menstruation is overdue for 10 days or more should be suspected of pregnancy. Menopause may be the earliest and most important symptom of pregnancy. However, it should be noted that menopause is not necessarily pregnancy.
2) Early pregnancy reaction: about half of women appear around 6 weeks after menopause Chilliness 、 dizzy 、 weak 、 Lethargy , drooling Anorexia Early pregnancy reaction refers to the appetite for acid or aversion to greasy, nausea, morning sickness and other symptoms. It usually disappears by itself around 12 weeks of gestation. 3) Frequency of urination: frequency of urination occurs in early pregnancy, which is caused by the increased anteverted uterus pressing the bladder in the pelvic cavity. After about 12 weeks of pregnancy, when the uterine body enters the abdominal cavity and no longer compresses the bladder, the frequency of urination will disappear naturally.
4) Breast changes: Since the 8th week of pregnancy, the breast gradually increases. The pregnant woman felt that her breast was slightly distended and painful, and the examination showed that the nipple and its surrounding skin (areola) were darkened, and there were Monteggia nodules around the areola.
5) Changes of reproductive organs: vaginal speculum examination was performed at 6-8 weeks of pregnancy, and the vaginal wall and cervix were congested, which was purplish blue. With the progress of pregnancy, the uterine body increases and becomes soft. When the uterine floor exceeds the pelvic cavity, it can be touched above the pubic symphysis.
(2) Auxiliary inspection
1) Pregnancy test: blood Urine HCG (human chorionic gonadotropin) positive can help diagnose early pregnancy. However, positive pregnancy test should not be taken as the only diagnostic basis, because sometimes false positive results may also occur. In addition, HCG in blood and urine was also positive in ectopic pregnancy and trophoblastic disease. Therefore, medical history, signs and ultrasonic results should be combined to avoid misdiagnosis. 2) Ultrasonography: B-mode ultrasound imaging is a fast and accurate method to check early pregnancy, and the main purpose is to exclude ectopic pregnancy and assess the gestational age. In the enlarged uterine contour, a circular halo from the amniotic sac is seen. The pregnancy ring can be seen at the first 5 weeks of pregnancy. If rhythmic fetal heart beat and fetal movement are seen in the pregnancy ring, early pregnancy and live fetus can be diagnosed.
3) Doppler instrument: after 12 weeks, in the enlarged uterine area, the rhythmic, single and high pitched fetal heart sound can be heard with the Doppler instrument, which can be diagnosed as early pregnancy and live fetus.
4) Basic body temperature measurement: For women with biphasic body temperature, the high temperature will not decrease for several days, and the possibility of early pregnancy is high. However, the basal body temperature curve can only reflect the function of corpus luteum, not the embryo.
2. Middle and late pregnancy
After the second trimester of pregnancy, uterus It is obviously enlarged, the fetal body can be felt, the fetal movement can be felt, and the fetal heart sound can be heard. It is easy to diagnose. (1) Symptoms and signs
1) Uterine enlargement: The uterus gradually increases with the progress of pregnancy. When examining the abdomen, it can help to determine the number of weeks of pregnancy by measuring the height of the fundus by hand and the length of the uterus above the pubis with a ruler. The height of uterine fundus varies with the distance between umbilical and pubic cord of pregnant women, fetal development, amniotic fluid volume, single or multiple births, etc.
2) Fetal movement: it is one of the good performances of the fetus. Pregnant women began to consciously move the fetus around 20 weeks of pregnancy. The more weeks of pregnancy, the more active the fetal movement, but the fetal movement slightly decreased at the end of pregnancy. Fetal movement is more than 3 times per hour on average.
3) Fetal heart sound: the fetus is diagnosed as live fetus after hearing fetal heart sound. The fetal heart sounds appear to be 110~160 times per minute. It is necessary to distinguish fetal heart sounds from uterine murmurs, abdominal aortic sounds, fetal movement sounds, umbilical cord and placental murmurs.
4) Fetus: After 20 weeks of pregnancy, the fetus can be touched through the abdominal wall. The tire head is round and hard, with floating ball feeling; The tire back is wide and flat; The fetal buttocks are wide and soft, slightly irregular in shape; The fetus has small limbs and irregular movements.
(2) Auxiliary inspection
1) Ultrasonography: B-mode ultrasound imaging can not only display the number of fetuses Fetal birth mode 、 Fetal presentation 、 Tyre orientation Whether there is fetal heart beat and placental position, and it can measure multiple diameter lines such as biparietal diameter of fetal head, and observe whether there is fetal surface abnormality. Ultrasonic Doppler method can detect Fetal heart sound Fetal movement sound, umbilical blood flow sound and placental blood flow sound. 2) Umbilical blood flow monitoring: it is one of the important methods to judge whether the fetus is in distress in utero.
3) Fetal ECG: At present, indirect method is commonly used in China to detect fetal ECG. The success rate is higher after 20 weeks of pregnancy. This method is non-invasive and can be used repeatedly.
4) Fetal heart monitoring: it is one of the important methods to judge whether the fetus is in distress in utero. There are three types of NST (non stress test), OCT (oxytocin provocation test) or CST (uterine contraction stress test) tests. According to the monitoring data, there are three types of results: reactive, non reactive and suspicious. It can be used repeatedly.
