Pregnancy Symptoms (Nursing)

00:00 Welcome to antepartum care. In this module, we're going to discuss what happens during the very first antepartum visit. Now, what are the things that's really important when someone says "I think I'm pregnant" is determining how likely they might really be pregnant. And we use something called signs of pregnancy and we grouped certain symptoms to make that determination. Let's talk about what those are. The first one is a presumptive sign. So presumptive signs are usually subjective complaints that the patient may have. They may say "You know I haven't had my period in a few weeks" or they may complain about breast tenderness, feeling really tired, having to use the restroom fairly often, maybe nausea and vomiting might be something that they tell you about quickening which refers to the first time the patient perceives fetal movement or they may say, "You know what, I have a little baby bump here and I think that I might be pregnant." Those are all subjective complaints and we presume when someone says that, that they might be pregnant but it's not always the case.

01:11 Now let's move a little bit further on the assurance radar to probable signs. Probable signs are going to be objective symptoms that we actually can confirm through physical assessment that may say "Yup, you might be pregnant." That includes outlining the fetus. So if the examiner can feel the shape of the baby, that's a good possibility that there is a baby in there, but it could also be a tumor so it's not 100%. A pregnancy test may also be another way that we can try to confirm pregnancy. But certain types of tumors and cancers also give off hCG, which is the hormone we check for so that is also not 100%. Balloting the fetus just refers to sort of pushing on it. When you push on something that's ballotable, if you press it it will bounce back up against your hand. So again, this implies some things in the uterus but it may not be a baby. So, not 100%. Braxton Hicks contractions are contractions that the patient perceives, they don't change the cervix so it's not labor but they can definitely feel their uterus contracting. That's a little bit more of a sign, but still probable. The last 3 signs on the probable list we're going to look at in more detail in just a second; Goodell, Hegar, and Chadwick's. So hold that in your thinking cap for just a minute while we talk about positive signs of pregnancy. So positive signs means they're pregnant, no doubt, 100%, can't be anything else, not an alien, not a tumor, nothing. So, positive signs include being able to hear fetal heart tones. If you're able to recognize that there is a heartbeat in there, it's got to be a baby. Also, if we use an ultrasound to actually look and see, you may have seen pictures of wonderful baby pictures and you can tell the baby is sucking its fingers or doing something else. When you can see the baby, you know there is a baby there. Or, if the examiner can actually feel the shape of the fetus and the baby then kicks them, punches them, it does something like that then it's a baby. Because if it's a tumor, it usually doesn't kick back. So those are going to be positive signs. So we want to make sure we can break those signs into those groups so we can confirm 100% that someone is pregnant. Now I told you I would talk about those probable signs in a little more detail so here we go. So, Hegar's refers to the softening of the uterus. Think about the fact that all of these blood flow is now moving into the uterus and it's going to make the tissue much softer. So during a bimanual exam, the examiner can actually feel that the uterus is a little bit softer than it usually is. That's called Hegar sign. Now when we talk about the softness of the cervix itself, that's called Goodell sign. So it's good and soft. That's how I remember. And then Chadwick's refers to the color of the cervix. So because of all that increased blood flow, the cervix actually begins to look kind of blue. So, C for color, C for Chadwick's meaning that the cervix has now taken on a sort of blue tinge. That lets us know possibly this is a pregnant cervix.