Diagnosis of pregnancy
Pregnancy in a woman lasts for an average of 280 days, i.e. 40 weeks. To determine the duration of pregnancy use different indicators:
- Date of last menstruation;
- Term of ovulation
- Data of the first visit to the doctor;
- The first stirring of the fetus;
- Objective data on the size of the uterus and fetus.
Each of these indicators has an unequal value and only their joint evaluation makes it possible to correctly determine the duration of pregnancy.
1. For menstruation, the gestation period is calculated according to the time elapsed since the first day of the last menstruation. He is determined, because in the first week of the cycle, pregnancy can not occur, because the maturation of the egg has not yet occurred.
2. It is more correct to determine the duration of pregnancy for ovulation - for this, by the first day of the last menstruation, add 10-14 days necessary for the maturation of the ovum and ovulation, after which the pregnancy is counted.
3. One of the most important indicators for determining the duration of pregnancy there is data of the first visit to the doctor, if it concerns an early pregnancy (up to 12 weeks). When vaginal examination of women in terms of the size of the uterus in the early stages of pregnancy can accurately with an error of 1-2 weeks to determine the length of pregnancy and from the first appearance to calculate the duration of this pregnancy.
4. When determining the gestational age, the date of the first stirring of the fetus, which the woman, pregnant for the first time, feels in 20 weeks, and the pregnant again earlier - 18 weeks is taken into account. Fetal movements are a subjective enough sign, often pregnant women take intestinal peristalsis for fetal movement, therefore this attribute should be considered as an auxiliary.
5. To determine the duration of pregnancy, data of objective research - determination of the size of the uterus, the volume of the stomach, the size of the fetus - are of great importance.
In the first months the gestation period is determined by the size of the uterus, which is determined during vaginal examination. The earliest time when it is possible to diagnose a pregnancy based on the definition of uterine size is 5 weeks:
- II obstetric month (8 weeks) the size of the uterus corresponds to the size of the goose egg;
- III obstetric months (12 weeks) reaches the head of the newborn and its bottom is at the level of the upper edge of the lumbar arch.
Starting from the IV month of pregnancy, the uterus's bottom is palpated through the abdominal wall and the length of the pregnancy is judged by the height of the standing of the uterine fundus above the womb.
- IV obstetric months (16 weeks) the bottom of the uterus is located on four transverse fingers above the symphysis (6-7cm).
- V obstetric months (20 weeks) the bottom of the uterus on two transverse toes below the navel (12-14cm).
- VI obstetric months (24 weeks) the bottom of the uterus at the level of the navel (20-24cm).
- VII obstetric month (28 weeks) the bottom of the uterus is located 2-3 fingers above the navel (24-28cm).
- VIII obstetric month (32 weeks) the bottom of the uterus is defined in the middle between the navel and the xiphoid segment (28-30cm). The navel begins to flatten. The abdomen is at the level of the navel - 80-85 cm.
- IX obstetric months (36 weeks), the uterus's bottom rises to the xiphoid process (32-34 cm) - this is the highest level of standing of the bottom of the pregnant uterus. Circumference of the abdomen in average 90cm. The navel is smoothed.
- X obstetric months (40 weeks) the bottom of the uterus descends to the level that was noted in the VIII obstetric months, i.е. up to the middle of the distance between the navel and the xiphoid process (28-30 cm). The navel protrudes. Circumference of the abdomen is 95-98 cm, the head is lowered, at the primordial it is pressed to the entrance to the pelvis or stands a small segment at the entrance to the pelvis.
At the same level of standing of the uterine fundus, the seventh and seventh months of pregnancy differ in the circumference of the abdomen (at VIII months the abdomen is apparently 80-85 cm, at X months - 95-98 cm), at the head position (at VIII months - high above the entrance to the pelvis, months is omitted, in the first-term fixed in the entrance to the pelvis), according to the condition of the navel (with VIII months - smoothing, with X months - protrusion).