Doubtful signs of pregnancy. Signs of pregnancy: Probable and reliable signs of pregnancy

To establish pregnancy during examination, the doctor is helped by the presence of distinctive signs, which can be divided into 3 groups:

• Conjectural.
• Probable.
• Reliable.

Important It should be remembered that a number of diseases (endocrine pathology, taking certain drugs, etc.) can mimic some of the symptoms of pregnancy.

Alleged signs and their description

Presumable signs include a change in the subjective feelings of a woman in connection with pregnancy:

1. Nausea and vomiting. Occurs mostly in the morning on an empty stomach. Usually passes after a light snack, without getting out of bed. In the event that vomiting is repeated repeatedly during the day, as well as from day to day and disrupts general well-being, it is necessary to consult a doctor, since this condition is a pathology and requires treatment (sometimes stationary, depending on the severity);
2. Change in appetite. Often during pregnancy, a woman has a desire to eat certain foods and not to eat others. This is the normal state. It must be remembered that there are pathological taste preferences (the desire to eat chalk, etc.), which may indirectly indicate certain diseases;
3. Change in olfactory sensations(aversion to tobacco smoke, the smell of alcohol);
4. Violations of the functions of the nervous system: drowsiness, irritability, tearfulness, insomnia, sudden mood changes. In this case, the support of loved ones is necessary to reduce the severity of such symptoms without medical intervention;
5. Increased urination. It occurs due to the pressure of the growing uterus on the bladder. With an increase in the duration of pregnancy, the symptoms increase somewhat, there are nocturnal urges to urinate. It must be remembered that urination should not be uncomfortable and even more painful (which is a sign of a urinary tract infection);
6. Appearance(on, on the face, nipple area). Often during pregnancy, there are also striae(striations on the skin). As a rule, this is due to changes in the hormonal background and skin characteristics, and more often occurs with a large fetus, polyhydramnios;
7. Increasing the volume of the abdomen due to the growing uterus.

In some women, a change in subjective sensations is not observed, especially in the early stages.

Information The above signs are not strictly specific to pregnancy, so you should not rely on them alone when making a diagnosis.

Possible symptoms and their description

Probable signs are changes in the woman's body due to pregnancy, which are determined primarily in the genitals and mammary gland. It should be noted that these signs may be a symptom of a number of gynecological diseases (for example, hormone-producing tumors).

1. Cessation of menstruation (amenorrhea) in healthy women of reproductive(childbearing) age. Amenorrhea can be a symptom of gynecological diseases (menstrual irregularities due to changes in hormonal levels, etc.), as well as with strong psycho-emotional overload, with sudden weight loss, after severe illness;
2. Breast enlargement, which occurs due to hormonal changes and preparation for lactation(breastfeeding). Sometimes, more often in the second half of pregnancy, a small amount of colostrum can be released from the nipples;
3. Cyanosis(cyanosis) mucous membrane of the vagina and cervix, which is determined by examining the genital tract in the mirrors;
4. Change in the size, shape and consistency of the uterus. An increase in the size of the uterus during examination can be determined from the 5-6th week of pregnancy (earlier in thin patients). It grows with increasing gestational age, and also softens (especially in the isthmus). A change in the size, shape and consistency of the uterus can also be observed in various gynecological diseases (myoma, adenomyosis, etc.).

When delaying menstruation, you should first of all do, based on the definition chorionic gonadotropin(hCG is one of the hormones of pregnancy) in the urine. This analysis can be carried out at home necessarily with the morning portion of urine. If there is a positive test (2 bright stripes), pregnancy can be assumed. You can also use the definition in the blood of a woman. Chorionic gonadotropin is produced from the beginning of pregnancy, has its maximum by 11-13 weeks, and then gradually decreases. The lack of proper dynamics in the level of hCG is alarming, as it may indicate the presence or pregnancy. The norms of chorionic gonadotropin in the blood are given in the table.

* HCG norms are different for each laboratory. In the second half of pregnancy, hCG already, as a rule, does not have an important clinical significance.

To establish the localization and dynamics of the development of pregnancy also allows ultrasonography() in the early stages, which is possible already from 2.5-3 weeks of pregnancy (from about 5-7 days of delay). Ultrasound diagnostics is based on the determination of the fetal egg in the uterine cavity in the early stages, the determination of the embryo with the presence of its heartbeat after 5-7 weeks. Also, this method allows you to differentiate an ectopic or non-developing pregnancy. Often, ultrasound control in dynamics is also important.

Reliable signs - definitely pregnant!

Signs are considered reliable, determining which, it is safe to say that there is a pregnancy. Most often detected in the second half of pregnancy. These include:

1. Palpable parts of the fetus. On examination, large (head, buttocks) and small parts (limbs) of the fetus are clearly distinguished;
2. Fetal heartbeat auscultated from the beginning of the second half of pregnancy (in thin women - from 18-19 weeks) The heartbeat is normally defined as rhythmic repetitive beats with a frequency of 120-160 per minute. It can also be registered with cardiotocography(the method is used from 28 weeks and consists in recording a heartbeat on a tape through a sensor installed on the anterior abdominal wall);
3. Fetal movements determined by the doctor during the examination of a pregnant woman.

Thus, the presence of one reliable sign allows us to speak with 100% certainty about the presence of pregnancy. The presence of presumptive and probable signs requires monitoring in dynamics and often additional examinations (ultrasound, determination of hCG).

Reliable signs of pregnancy in its first days are not as numerous and not as noticeable as many women believe. Let's try to take a closer look at those changes in the mental and physical state, the sudden appearance of which should be paid attention to.

1. Delayed menstruation- This is the very first symptom of a possible pregnancy. Menstruation is, in fact, a detachment of the endometrium, which occurs as a result of cyclic hormonal changes in a woman's body. During the period of bearing a child, any, even a slight detachment of the endometrium can become fatal, cause severe bleeding and fetal death. Normally, the expectant mother does not have periods until childbirth. Yes, and after childbirth, bloody discharge has a slightly different nature. The menstrual cycle is restored no less than 6 weeks after childbirth, and breastfeeding women may not have regular bleeding during the entire lactation period - up to 2 years, on average.

But it is worthwhile to understand that although we are talking about the absence of menstruation, as about the first signs of pregnancy, reliable signs can also indicate other things that are not related to an interesting state of affairs. For example, the absence of menstruation is often observed in adolescent girls and in women before menopause, delays can occur due to certain medications, stress, illness, reproductive system diseases, etc.

2. After the onset of the first reliable sign of pregnancy described above, you can start looking for other symptoms. And the second proof of approaching motherhood can be ... pregnancy test! Probably all modern women have already learned to use them. This is a very convenient and affordable way of self-diagnosis, especially for those women whose cycle is not regular (they won’t go to the doctor once a month!). And then 5 minutes and everything is clear. The simplest test strips cost about 15 rubles - no more than a loaf of bread. Cheap tests, as a rule, have a lower sensitivity to the determination of chorionic gonadotropin in the urine, but their properties are quite enough if 2-3 weeks have passed after conception, that is, the delay has already begun. Some ladies use tests with high sensitivity and before the delay. In principle, the correct result can be obtained with their help even 2-3 days before the likely start of the next menstrual cycle. However, the first signs of pregnancy are reliable signs that, as a rule, begin to be felt and manifested at least 2-3 weeks after conception.

Unfortunately, self-diagnostics can make mistakes. And they arise due to non-compliance with the conditions described in the test strip instructions. In more rare cases, errors may be due to the fact that the test was stored under unacceptable temperature conditions and due to the expiration date.

3. If you want an even more accurate diagnosis - take hCG blood test. In this way, you can find out about your situation even before other reliable signs of pregnancy appear. False-positive results are extremely rare and they are not associated with errors of laboratory assistants, but with the presence of a serious disease in a woman, for example, colorectal cancer, cancer of the uterus, kidneys, etc. HCG can be increased with cystic mole, which is also a dangerous pathology or due to taking medications containing this hormone. A false positive result also occurs within a few days / weeks after an artificial or spontaneous abortion.

Chorionic gonadotropin can be determined using a blood test as early as 7-10 days after conception. From these days, the level of this hormone begins to increase exponentially. So, at 1-2 weeks, the level of hCG (mU / ml) is 25-300, and at 2-3 (already after the start of the delay and the appearance of other reliable signs of pregnancy) - 1500-5000. Decreased readings may be due to the development of the fetus outside the uterus or a stop in its development. Often, hCG begins to decline sharply with a true threat of spontaneous abortion, with a threat of miscarriage, that is. But you should not monitor the level of human chorionic gonadotropin just for the sake of interest or your own reassurance. In some cases, even with a normally developing fetus, there are jumps in indicators in one direction or another. An ignorant woman, who daily looks out for the first signs of pregnancy, of which not all are reliable signs, this state of affairs can be frightening.

4. Examination at the gynecologist. After 2-3 weeks after the start of the delay, the doctor can already quite accurately state the development of pregnancy based on the results of a gynecological examination. At this time, the uterus has already significantly increased (but visually it has not yet manifested itself in any way), the cervix has acquired a bluish tint. But still, sometimes doctors are mistaken, if you do not want to get into this small percentage - check for other reliable signs of pregnancy.

5. Increased basal temperature. Once upon a time, there were no hCG tests, pregnancy tests and ultrasounds. And then it was this sign, along with the delay in menstruation, that were the first and most accurate symptoms of an interesting situation. If conception did not occur, but there was ovulation, the temperature is kept elevated from the middle of the cycle and almost until its completion, after which menstruation begins. In the case of pregnancy, the temperature stays above 37 degrees, and there are no periods. It is very important to take measurements correctly. It is not recommended to measure the temperature after intercourse if the sleep before that was restless and short, with a cold, taking various medications, etc.

6. Pain in the lower abdomen and in the area of ​​the mammary glands. These are pretty reliable signs of pregnancy, observed in most expectant mothers. However, in some cases, pain in the mammary glands can signal any of their diseases. And the stomach may ache due to menstruation, which is simply delayed and will come soon, or because of the threat of a miscarriage. The second case can be confirmed by spotting spotting against the background of a low level of the “pregnancy hormone” for a given period, which we wrote about above. It can be difficult to determine what is the norm and what is the pathology for a pregnant woman for the first time. And therefore, for any ailments, it is better to immediately consult a doctor and not delay with registration for pregnancy.

7. Toxicosis. Perhaps it is on this characteristic symptom that we will finish describing the most reliable signs of pregnancy. Toxicosis does not always proceed as rapidly as they talk about it, write in newspapers and magazines. Nausea may occur only intermittently, and vomiting may not occur at all. And that's good anyway. But instead of such characteristic symptoms, unreasonable fatigue and depression often roll over the expectant mother. Many begin to suffer from insomnia, become irritable and capricious. But all these phenomena, as a rule, are treated with a calm home atmosphere and a vacation at work, which must be spent not near the TV, but somewhere in nature, if the time of year allows, of course. In extreme cases, we replace picnics with walks in nearby parks / squares.

These are the first signs of pregnancy - reliable signs are not so numerous, it will not be difficult to remember them.

The diagnosis of pregnancy is not in doubt only in a few cases: if you can determine the parts of the fetus, hear its heartbeat or feel movement, and with ultrasound, register the fetal egg. But all these signs appear only in the V-VI months of pregnancy. In the early stages, such a diagnosis is established based on probable and presumptive signs.

Professional diagnostics of pregnancy is carried out by an obstetrician-gynecologist.

Doubtful (suggestive) signs

Doubtful signs include general changes associated with pregnancy:

• Pigmentation of the skin of the face and areola;
• Changes in behavior: the appearance of emotional instability, fatigue, irritability;
• Exacerbation of olfactory sensations;
• Changes in taste sensations, as well as vomiting and nausea.

Likely signs

This group of signs includes changes in the genitals and the course of the menstrual cycle:

• Laboratory tests to determine the chorionic hormone (CH) in the blood and urine;
• Changes in the uterus (consistency, shape, size);
• Cyanosis (cyanosis) of the cervix and vaginal mucosa;
• The appearance of colostrum;
• Cessation of menstruation.

Reliable signs

• Palpation of the woman's abdomen and identification of body parts of the fetus;
• Feeling of fetal movements during ultrasound or palpation;
• Listening to the fetal pulse. Heart contractions are determined from 5-7 weeks using ultrasound, cardiotocography, phonocardiography, ECG, and from 19 weeks - auscultation. Pregnancy is confirmed if a beat rate of 120-140/min is heard.

Signs of pregnancy

Enlargement of the uterus. The uterus noticeably increases in size, starting from 5-6 weeks. At the end of the second month, it is the size of a goose egg.

Horvitz-Gegar sign. A sign of the uterus in position is its soft texture, this is especially pronounced in the isthmus. During examination, the fingers meet at the level of the isthmus without any resistance. This sign characterizes the initial stages of pregnancy.

Sign of Snegirev. The uterus with a fetal egg is able to change its consistency. If the softened uterus is acted upon mechanically during a two-handed examination, it becomes more dense and contracts, decreasing in size. After the cessation of exposure, it returns to its original consistency.

Piskacek sign. For the initial stages of pregnancy, the asymmetry of the uterus is characteristic, as a result of the dome-shaped protrusion of one of the corners. This happens at 7-8 weeks of the term. It is at the site of the protrusion that the egg is implanted. By week 10, the protrusion disappears.

Gaus and Gubarev observed barely noticeable mobility in the early stages of the cervix. This is mainly due to the softening of the isthmus.

Genter's sign. Early in pregnancy, there is an anterior inflection of the uterus, which is the result of increased softening of the isthmus, and the appearance of a protrusion in the form of a ridge-like thickening on the anterior part of the uterus in the midline. This protrusion is not always defined.

The diagnosis of pregnancy is mainly determined by clinical examination. But in some cases, laboratory methods are used. The essence of laboratory research is to determine substances specific to the body of a pregnant woman in biological fluids.

Signs of pregnancy are detected by the following methods:

• Examination with the help of mirrors;
• Inspection of the entrance to the vagina and external genital organs;
• Interview;
• Squeezing out colostrum and feeling the mammary glands;
• Examination of a woman (two-handed vaginal-abdominal or vaginal).

With the onset of pregnancy, the size of the uterus gradually increases. Metamorphoses also occur with the shape of the uterus. In a non-pregnant woman, it is pear-shaped, and the shape of the uterus with a fetal egg undergoes the following changes:

• 5-6 weeks - spherical shape;
• 7-8 weeks - asymmetric with a protrusion of one of the corners;
• 10 week - spherical;
• The end of pregnancy is the ovoid form.

Classification of modern methods for diagnosing pregnancy:

• biological;
• Immunological;
• Echographic (ultrasound diagnostics).

Immunological, as well as biological methods, consist in the determination of hCG. Any biological material is suitable for this, but most often urine. The synthesis of this hormone begins in the first days of conception and lasts until the birth itself with a maximum production on the 60-70th day after implantation. After its level falls somewhat and stabilizes before childbirth.

Among the immunological methods used today, the most widely known method is based on the suppression of the hemagglutination reaction. The method consists in the fact that antiserum (antibodies) is added to the ampoule, erythrocytes (antigen) with hCG and pregnant urine are added to it. The CG present in the urine binds to the antigen (antiserum), while the erythrocytes settle to the bottom, since they do not undergo agglutination.

If non-pregnant urine is administered, that is, without hCG, the agglutination reaction takes place and the erythrocytes are evenly distributed over the ampoule. 0.4 ml of phosphate buffer and two drops of pre-filtered morning urine are added to the ampoule.

All components are mixed and left for 2 hours at room temperature. After the prescribed time, according to the uniform distribution of erythrocytes, a conclusion is made about the absence of pregnancy, and according to the sediment at the bottom of the ampoule, about its presence.

Much more sensitive is the radioimmunoassay method. The most common method was the so-called double bodies. For the method, ready-made kits produced by various companies are used. The method makes it possible to determine CG as early as 5-7 days after implantation. The determination takes place in 1.5-2.5 minutes.

Today, there are also many test systems that allow the woman herself to quickly determine pregnancy at home.

Other diagnostic methods

Measurement of basal temperature. The initial months of pregnancy are characterized by a basal temperature slightly above 37°C. Measurements are taken in bed in the morning.

The study of cervical mucus. In the very early stages of pregnancy, the secret secreted from the cervix, when dried, does not contain large crystals.

ultrasound diagnostics. Such diagnostics are carried out starting from 4-5 weeks. In this case, the fetal egg is defined as a rounded formation located inside the endometrium, having a diameter of 0.3-0.5 cm. The first trimester is characterized by a weekly growth (0.7 cm) of the egg. By 10 weeks, the fetal egg fills the entire uterine cavity.

By 7 weeks, an embryo is visible in the cavity of the egg in the form of a separate formation up to 1 cm long. At this time, it is possible to visualize the area with mild motor activity and rhythmic fluctuations.

This is the heart of the embryo. The main task of biometrics of the first trimester is to determine the diameter of the egg and the KTP (coccygeal-parietal size) of the embryo. These values ​​are in strong correlation with the duration of pregnancy. The most informative method of ultrasound can be called transvaginal scanning. The transabdominal type of scanning is used only with a full bladder to create an "acoustic window".

The gestational age is determined by:

• by the last menstruation, counting the number of weeks (days) from the beginning of the last menstruation to the time the woman was examined. This method is not applicable for women who have an irregular menstrual cycle;
• by ovulation. Sometimes a woman can name the date of conception for various reasons (infrequent sexual intercourse, use of donor sperm, etc.)
• on the first appearance to the obstetrician. Registration involves a mandatory vaginal examination, according to the results of which, using the table, it is possible to name the gestational age with sufficient accuracy;
• on the first stroke. Primiparous women feel stirring from the 20th week, and multiparous - from the 18th week;
• according to ultrasound. In the first trimester, determining the term of conception according to ultrasound data gives more accurate results. Further, some inaccuracies are possible;
• also in the first trimester, a certain location of the uterus in the small pelvis is characteristic. Starting from the 16th week, the fundus of the uterus can be felt above the womb, and the period can be calculated using a centimeter tape, measuring the height of the fundus of the uterus above the womb.

The news of pregnancy often comes as a surprise.

There are a number of likely and reliable signs to note:

1. Delayed menses. The very first and well-known sign of pregnancy. During this process, endometrial detachment occurs, which in the first trimester can be detrimental to the child. Therefore, nature “eliminated” such a “threat” for the duration of gestation, but it should be noted that approximately 20% of women may have spotting in the first months. It is for this reason that a child is already known in the second trimester of pregnancy. But for the sake of justice, it is worth noting that this symptom can also indicate problems with women's health, which means that you need to see a doctor to determine the exact cause.

2. The most likely way to determine pregnancy is to take a test. In modern pharmacies, a wide selection of this device is presented. It takes 5 minutes for the test to show the result. Moreover, this method has a reliability of 95%. For reliability, it is recommended to do it in the morning and repeat it after 2-3 days. As a safety net, you can use a blood test for hCG. Such a test will be able to show pregnancy as early as 7-10 days of fertilization. And it is a more reliable way than a simple test.

3. A trip to the doctor. On the 12th day of pregnancy, a gynecologist can already determine it. With the help of palpation, it is possible to feel how much the uterus has increased.

4. The most reliable sign of pregnancy is increased basal temperature. In the presence of a fetus, the vaginal temperature will be above 37 degrees. It was this method that was one of the first to determine an interesting situation in those days when tests, ultrasound and various analyzes had not yet been invented. It is important to know that sexual intercourse or even restless sleep lead to an increase in temperature in a woman.

5. Enlargement of the mammary glands. The breast increases its volume in two cases: during menstruation or the beginning of pregnancy. And this is a sure sign. This syndrome can also be accompanied by pain in the glands, as they begin to rebuild in the very first months.

But it should be noted that a delay of 12 days is considered the norm, and the first reliable and probable signs of the presence of a fetus appear already from 2-3 weeks of fertilization.

In any case, it should be remembered that all of the above factors can indicate an interesting situation, but they can also warn of the onset of some probable disease. Therefore, one should not engage in self-diagnosis and self-treatment, but it is better to consult a specialist as soon as the first of the above likely signs appear.

The birth of a child is a real miracle. But usually it is preceded by not quite easy nine months. Every woman experiences this condition differently, and not everyone feels the same. There are even dubious signs of pregnancy, which are also called presumptive. These include symptoms that may be caused by the “interesting position” of the woman, and may be other reasons. Some women who are expecting have these symptoms almost from the moment they become pregnant, while others do not have them at all.

Doubtful signs of pregnancy

Doubtful signs of pregnancy include:

1) Nausea. In medical terminology - toxicosis. It occurs mainly in the early morning and lasts up to several hours. Usually, toxicosis is present in the first months of waiting for the baby. Along with nausea, there may be vomiting - both in the morning on an empty stomach, and after eating. This condition can be caused by strong unpleasant odors, odors of spices or fried. There are several ways to deal with toxicity. Frequent meals (snacks) can save you from nausea. But do not lean on cookies or sandwiches, fruits, dried fruits, homemade crackers will be ideal. With especially pronounced toxicosis, it may be necessary to slightly change the diet and diet, and sometimes consult a doctor.

2) Changes in taste, smell, eating habits ... Thanks to this process, a woman's taste preferences sometimes completely change. It happens that the dish that the expectant mother did not eat until she was in an “interesting position” becomes the most desired and beloved. And it happens the other way around. This can also affect the choice of perfumery - many women, having become pregnant, choose new scents of perfumes and deodorants, completely different from those they used before their "interesting position". But after the birth of a child, most often this perfumery turns out to be unnecessary - old preferences return.

3) Emotional imbalance i.e. frequent mood swings. This can often happen within a few hours. The emotional state of the expectant mother is greatly influenced by the words and actions of others. They sometimes cause completely unpredictable reactions. A woman can be offended and burst into tears even from any careless word and even a look. A variety of melodramas and even television news also cause a storm of emotions.