Confirming Pregnancy and Establishing Gestational Age

-

 

Confirming Pregnancy and Establishing Gestational Age






Confirming Pregnancy

  1. Clinical Signs and Symptoms:

    • Amenorrhea: Absence of menstruation.
    • Morning Sickness: Nausea and vomiting, typically in the first trimester.
    • Breast Changes: Tenderness, enlargement, and darkening of the areola.
    • Increased Urination: Due to hormonal changes and increased blood flow to the kidneys.
    • Fatigue: Common in early pregnancy due to hormonal changes.

  2. Home Pregnancy Tests:

    • Urine Test: Detects human chorionic gonadotropin (hCG) hormone. Best taken after a missed period for accuracy.

  3. Clinical Pregnancy Tests:

    • Urine hCG Test: Similar to home tests but performed in a clinical setting.
    • Blood hCG Test: More sensitive than urine tests and can detect pregnancy earlier. There are two types:
      • Qualitative hCG Test: Confirms the presence of hCG.
      • Quantitative hCG Test: Measures the exact amount of hCG to help determine the gestational age.

  4. Ultrasound Examination:

    • Transvaginal Ultrasound: Can confirm pregnancy as early as 4-6 weeks gestation.
    • Transabdominal Ultrasound: Typically used after 6 weeks gestation.

Establishing Gestational Age

  1. Last Menstrual Period (LMP):

    • Naegele’s Rule: Calculates the estimated due date (EDD) by adding 7 days to the first day of the LMP and then adding 9 months.
    • Example: LMP on January 1 + 7 days = January 8, + 9 months = October 8 (EDD).

  2. Ultrasound Dating:

    • First Trimester (0-13 weeks):
      • Crown-Rump Length (CRL): Most accurate method in early pregnancy, with a margin of error of ±5-7 days.
    • Second Trimester (14-26 weeks):
      • Biparietal Diameter (BPD): Measurement of the fetal head.
      • Femur Length (FL): Measurement of the fetal thigh bone.
      • Head Circumference (HC) and Abdominal Circumference (AC): Used to assess fetal growth and development.
    • Third Trimester (27-40 weeks):
      • Measurements are less accurate for dating but are used to assess fetal growth and wellbeing.

  3. Physical Examination:

    • Uterine Size: Palpation of the uterus through the abdomen to estimate gestational age.
      • 8-10 weeks: Uterus size similar to a small orange.
      • 12 weeks: Uterus palpable above the symphysis pubis.
      • 20 weeks: Uterus reaches the level of the umbilicus.
      • 36 weeks: Uterus reaches the costal margin.

  4. Fundal Height Measurement:

    • From 20 weeks onward: The distance from the pubic bone to the top of the uterus (fundus) in centimeters roughly correlates with gestational age in weeks.
    • Example: A fundal height of 24 cm suggests approximately 24 weeks gestation.

  5. Fetal Heart Tones:

    • Doppler Ultrasound: Detects fetal heart tones around 10-12 weeks gestation.
    • Fetoscope: Detects fetal heart tones around 18-20 weeks gestation.

Summary

  • Confirming pregnancy involves clinical signs, home and clinical pregnancy tests, and ultrasound.
  • Establishing gestational age can be done using the LMP, ultrasound measurements, physical examination, fundal height, and detection of fetal heart tones. Accurate dating is crucial for monitoring fetal development and planning prenatal care.

Comments

Post a Comment

Popular posts from this blog

DEPRESSION- ENDOGENOUS & EXOGENOUS

-
Image
DEPRESSION- ENDOGENOUS & EXOGENOUS   1. Mr. chembe aged 30 years is brought to Chainama Hospital Ward X with history of profound sadness and suicidal ideations  for 2 weeks. On admission, the Doctor conducted a Mental State Examination and a diagnosis of Depresion is made  a)  Define Depression                                                                                          5 marks                                                                             b) Explain five (5) causes/predisposing factors of Depression                             25 marks c) outline  the differences between reactive and endogenous depression  20 marks d) Discuss how you are going to nurse Mr. chembe during his stay in hospital                                                                                                                           50 marks     Patient Case: Mr. Chembe at Chainama Hospital Ward X a) Define Depression (5 marks): Depression is a mood disorder characterize
Read more

SUBSATNCE ABUSE PRESENTATION 2.

-
  QUESTION  :  SUBSATNCE ABUSE Namwela Zanga aged 21 years has been brought to your mental health unit with history of  alcoholism for the past 3 years. He is reported to be regular consumer of a local beer brew. This has led to self-neglect and he can no longer eat his food. a)     Outline any five (5) theories of alcohol/substance abuse           20% b)     Outline five (5) Social effects of alcohol abuse                                 20% c)      Discuss the seven (7) phases of alcohol intoxication                    35% d)     Discuss five (5) ways of how alcohol abuse can be prevented  25% INTRODUCTION Worldwide substance use and abuse are significant problems for adolescents. They carry serious consequences such as assault and rape. Substance abuse involve use of psychological active substances which are potentially harmful to the individual. It i s generally agreed by most scientists that stress, conflicts and frustration are major factors in substance abuse. T
Read more

MANIA

-
Image
  Christabel Kabindama aged 23 yeras is brought to the psychiatric hospital amidst talking and shouting on top of her voice non-stop. She is accompanied by Mwaka Ng'ambi who said she is also unable to sleep and claims she owns Livingstone College of Nursing and have supper powers. After examinations a diagnosis of mania is made. DEFINE MANIA Mania is a mental condition with distinct period during which mood is abnormally and persistently elevated, expansive, or irritable. STATE THE PREDISPOSING FACTORS TO MANIA There is no specific known cause for mania. However, the predisposing factors are biopsychosocial in nature and includes the following: Biological factors Genetics. Mania is hereditary in nature. First degree relatives with these disorders are more likely to develop the mood disorder than people in the general population. Biochemistry. Research have shown that those with mania have too much of serotonin and epinephrine. Social factors Stressful life events, lack of social
Read more