Diagnosis of early

Pregnancy

Lecturer Liu Wenhui

Sophie liu
The Department of Gynecology &
Obstetrics in Zhongnan Hospital
Contents
Intruction
Manifestions of early pregnancy
Helpful examinations of early pregnancy
Differential diagnosis of early pregnancy
 Objectives
Master the Definition of pregnancy
Master the Manifestions of early
pregnancy
Master pregnancy test and other helpful
examinations especially ultrasonography
 Case
Name : Mary Sex:Female
Age :30 Occupation:Teacher
She has married for one year,now She has
following symptoms:cessation of
menstruation,nausea and vomiting,urinary
frequency and urgency;
She has following signs: enlargement of
uterus,softening of the cervix, softening of the
cervicouterine junction
Which problem has she ?How can you help
her?
Introduction
Sexual reproduction is
the union of the nuclei
of the female sex cell
(ovum) and the male
sex cell (sperm cell)
that results in the
creation of a new
individual
 Pregnancy
Definition:
Growth and developmental process in a
women from fertilization through
embryonic and fetal period to
birth;gestation or conception
Sexual reproduction is
the union of the nuclei
of the female sex cell
(ovum) and the male
sex cell (sperm cell)
that results in the
creation of a new
individual
From now on
 末次月经
(LMP)
预产期
(EDC)
Early
pregnancy
The third 早期妊娠
trimester 12 周
晚期妊娠 末

The second
trimester
27 周 中期妊娠
末

妊娠全过程为 40 周（ 280 天） , 分 三
How to Diagnose the early Pregnancy ?
Manifestations of early
Pregnancy
A.Symputoms

Amenorrhea :no menstruation flow or

cessation of menstruation (The cyclical
loss of sanguineous fluid from the uterus in
mature women. The usually duration of the
menstrual cycle is 3-5 days. The average
amount of blood lost is 30-80ml)
10 days or more after the time of
expected onset of the menstrual period
Nausea with or without
vomiting(morning sickness)
Nausea is an unpleasant
sensation in the stomach and
a tendency to vomit
 Urinary frequency and urgency
Begins about 6th week ,and
disappears about 12th week

2-cell stage
Morula 桑葚胚

Blastocyst 囊胚 day 7

Implanting
blastocyst
囊胚植入
hCG
Endometrium 子宫内膜
The breast: Accessary Organ of Reproduction
2nd development ,1st is in adolesence
Pain slightly
 Attention other
symputoms!
Uterine bleeding: this may be related to
inbed or implantation
Conception may occur without prior
menstruation before menarche
Nursing mother may become pregnant
during lactation
 B.Signs
Breast changes
(enlargement,
Montgomery)
Montgomery

Hegar’s sign:
softening of the
cervix, softening of
the cervicouterine
junction (Bimanual
palpation 双合诊 )
 other
Examinations
 Clinical test
Pregnancy test

2-cell stage
Morula 桑葚胚

Blastocyst 囊胚 day 7
Implanting
blastocyst
囊胚植入
hCG
Endometrium 子宫内膜
Be detected in
plasma or urine by
8-9 days after 着床前后 HCG 的变
化
ovulation
Blood or urine test to
detect the presence
of HCG
Get a peak at about
8 to 10 weeks
Then declines slowly
and maintains low
level at about 100 to
130 days until
delivery
Steps :
Pelvic ultrasonography

A.35day all sac visible

5wk Embryo and Yolk
B.42day all heart beat
Sac
detectable

7wk Embryo and Yolk Sac

asal body temperature （ BBT ） ：

A small increase in body temperature during the

luteal phase of the menstrual cycle last over 3
weeks
 Pregestin test
Use of pregestin 20mg every day for
three or five days
Withdrawal of pregestin
Within 7 days may bleeding or not
(pregnant)
 Cervical mucus examination

steps
Celluar appearance
Celluar appearance Palm leaf pattern
Differential diagnosis
of pregnancy
 Myomas(fibroids)
Belign tumor in the uterus
Changes of menstruation
Very firm and irregular
(Bimanual palpation 双合
诊)
Pregnancy test is negative
No embyro in the uterine
cavity
 Ovarian tumor
Pregnancy test is negative
No embyro in the uterine cavity
Found midline ,displacing the
nonpregnant uterus to the side or
posteriorly
 Ectopic pregnancy

1.Pregnancy test is positive

2.No embyro in the uterine cavity
!!:90%of ectopic pregnancy occur in the fallopian
tubes(tubal pregnancy),rupture of the ectopic pregnancy
within the fallopian tube can lead to massive
hematosapinx.
Surgeons remove the implant and
preserve the fallopian tube before
rupture occurs.
Laproscopy
Questions ?
 True or false

If a women fells nausea and

vomitong ,she is pregnant .
A pregnant women”s LMP is 12/9-
2007,her EDC is 7/9-2008.
HcG levels double approxiamately
every 72 houys in early pregnancy.
The uterus is enlarged ,the women is
pregnant.
Which manifestions are there in early
pregnancy?
Which examinations are helpful to
diagnose early pregnancy?
Early pregnancy

The second trimester and the

third trimester
 n!
te n tio
r a t
y ou
f or
you
a n k
Th