Signs, Expected Due Date and Fundal height of Pregnancy

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I was with a lady yesterday, and she was telling me that she didn't know she was pregnant until the fetus was six months old. She indicated that she didn't notice any signs even though they were coming up regularly. I remember a time when one of my aunts got pregnant and she claimed she didn't know until my grandma broke the news to her on a visit. My grandma has a way of knowing a woman is pregnant at first sight and can probably guess how old the pregnancy is. I am not here today to discuss my grandma's supernatural powers of identifying pregnancy, it's not like most grandparents in Nigeria do know how to do that, most of them have that supernatural knowledge or skill to identify pregnancy and pregnant women when they see them. In this post, I will be looking at signs of pregnancy in women, Expected Date of Birth or Expected Due Date.


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To start with, I will be looking at the presumptive sign, probable signs, and positive signs. Let's pick them one after the other starting with the presumptive signs. Subjective or self-reported is what is attributed to this type of sign. These signs are not confirmed medically but based on subjective data, the woman believes or thinks she is pregnant. The first sign that most women wait for is Amenorrhea where they do not have their regular menstrual period. The next sign is Nausea and Vomiting. In Nigeria, this is one sign that parents take very seriously with young ladies. When a young lady who is sexually active starts to vomit, an average Nigerian parent instantly starts to consider pregnancy as a first option, it will take a negative pregnancy test at the hospital to prove them wrong (that is if the lady isn't pregnant). Another presumptive sign is Urinary frequency which is a result of hormonal changes in the first trimester, a Quickening in the stomach (stomach movement), fatigue, and Breast tenderness. Actually, in the hospital, the nurse or the doctor will expect that you tell them the signs you experience but will take into consideration Amenorrhea, Nausea and vomiting, and Quickening, and an increase in Urinary frequency will be seen as a symptom.

The Objective or probable signs of pregnancy are different from the presumptive signs of pregnancy and they include Goodell's sign (Cervical softening) but this sign can still be caused by the use of contraceptives or uterine tumor, another sign is Chadwick's sign which is a blue or purple birth canal which is as a result of increased blood flow to the area which is usually between 8 to 10 weeks of pregnancy. Another sign is Hegar's sign which is the softening of the lower segment of the Uterus. Ballottement is another sign which is also known as fetus against the finger, another way to identify pregnancy which is still objective is the Positive pregnancy HCG test which shows that an elevated level of HCG is a sign of pregnancy but then disease such as gestational trophoblastic disease can also lead to a high HCG. To prevent misinterpretation, it is advisable to do the test with the first Urine in the morning.

Positive signs are signs that show that a person is pregnant and not guesses. certain tests can lead to the confirmation of the signs, such as fetal heartbeat which is heard by a doppler device which is can be heard between 10 to 12 weeks. Ultrasound visualization of the fetus is also another test to confirm pregnancy positive signs, and fetal movement observed by HCP. When these tests are done are positive, then they show the positive signs of pregnancy.

When a pregnancy has been confirmed, it is paramount to know the EDB/EDD which is the Expected Date of Birth or Expected Due Date. It is important to know that the gold standard for identifying EDD is using Ultrasound. Also, Nagele's rule can be used. With Nagele's rule, the first day of the last menstrual period is based on the menstrual cycle, after which three months are removed from the date, after which seven days are added to the date to identify the date.


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EDB/EDD = 1st day of Last MP - 3 months + 7 days

Let me quickly discuss this before I end this post. During pregnancy, Uterine growth shows fundal height, and at 12 weeks, the fundal height is above the symphysis of the pubis. At 16 weeks, it is between the pubis symphysis and the umbilicus as it is heading to the umbilicus. At 20 weeks, the fundal height is already on the Umbilicus, and at 36 weeks, the fundal height is around the Xiphoid process. At 40 weeks, the fetus is around the pelvis and the fundal height will drop below the Xiphoid process.

Identifying pregnancy and understanding the delivery date or due date of the pregnancy is very important for both the pregnant mother and the medical practitioner.

Reference

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