The news of pregnancy often comes as a surprise.

There are a number of probable and reliable signs that should be noted:

1. Delayed menstruation. The very first and most famous sign of pregnancy. During this process, endometrial detachment occurs, which can be fatal for the child in the first trimester. Therefore, nature “eliminated” such a “threat” during pregnancy, but it should be noted that approximately 20% of women may have spotting in the first months. It is for this reason that they find out about the child already in the second trimester of pregnancy. But for the sake of fairness, it is worth noting that this sign may also indicate problems with women's health, which means you need to consult a doctor to determine the exact cause.

2. Probable way determine pregnancy - do a test. Modern pharmacies offer a wide selection of this device. It takes 5 minutes for the test to show the result. Moreover, this method has a reliability of 95%. To be on the safe side, 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 can show pregnancy already on the 7-10th day of fertilization. And it is a more reliable method than a simple test.

3. Going 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 enlarged the uterus is.

4. The most reliable sign of pregnancy is considered to be increased basal temperature. If there is a fetus, the vaginal temperature will be above 37 degrees. It was this method that was one of the first to determine an interesting position 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 temperature indicators in a woman.

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

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

In any case, it should be remembered that all of the above factors may indicate an interesting situation, but they may also warn of the beginning of some probable illness. Therefore, you should not engage in self-diagnosis and self-medication, but it is better to consult a specialist as soon as the first probable signs listed above appear.

The birth of a child is a real miracle. But usually it is preceded by a not entirely easy nine months. Each woman experiences this condition differently, and not everyone experiences the same sensations. There are also dubious signs of pregnancy, which are also called presumptive. These include symptoms that may be caused by the “interesting position” of a woman, or may be caused by other reasons. Some women who are expecting a baby experience these symptoms almost from the moment they become pregnant, while others have no symptoms at all.

Questionable signs of pregnancy

Questionable signs of pregnancy include:

1) Nausea. In medical terminology - toxicosis. It occurs mainly in the early morning and lasts up to several hours. Typically, toxicosis is present in the first months of expecting a baby. Along with nausea, there may also 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 foods. There are several ways to combat toxicosis. Frequent meals (snacks) can help prevent nausea. But you shouldn’t go heavy on cookies or sandwiches; fruits, dried fruits, and homemade crackers would be an ideal option. In case of particularly severe toxicosis, it may be necessary to slightly change the diet and diet, and sometimes consult a doctor.

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

3) Emotional imbalance, that is frequent shifts moods. This can often happen over a period of several hours. On emotional condition expectant mother The words and actions of others have a great influence. They sometimes cause completely unpredictable reactions. A woman can be offended and cry even from any careless word or even glance. Various melodramas and even television news also cause a storm of emotions.

A woman gives birth once or twice in her life, less often - more. But she experiences anxiety about whether she is pregnant or not, probably dozens of times in her life. And I am very surprised that in our age technical progress This issue is still not that simple.

Sometimes you can only guess about an interesting situation, since there are no special bright signs. But it is important to find out about pregnancy early in order to understand your situation and improve proper nutrition, start taking vitamins. Signs of pregnancy can help you understand this issue a little.

All signs of pregnancy can be classified into:

Doubtful;
- probable;
- reliable.

Questionable signs of pregnancy:

1. A woman’s food preferences change, even to the point of food perversions. She can refuse Kiev cutlets, potatoes with mushrooms and soups. And get addicted to Korean cuisine, eat all the pickles, and even dream about a piece of chalk. And in the morning I suffer from nausea.

2. A woman begins to suffer from certain odors that she previously liked. Favorite perfumes begin to irritate, air fresheners are thrown away, and cooking and eating becomes a problem.

3. Emotional instability: sometimes happy, sometimes sad, sometimes everything starts to irritate, sometimes absolute indifference to what is happening.

4. Pigment spots may appear on the face, the nipples and areolas may darken, and a line on the stomach stretching from the navel to the groin.

Possible signs of pregnancy:

1. Menstruation did not come on time.

2. The breasts may begin to hurt, and when squeezed, colostrum appears from the nipples.

3. The gynecologist can see during examination that the cervix and vagina have become cyanotic, and the size, shape and consistency of the uterus have increased.

4. Pharmacy pregnancy tests indicate positive results.

Reliable signs of pregnancy:

1. An ultrasound reveals a fertilized egg in the uterus.

2. The midwife can distinguish fetal heart sounds.

3. When examining the blood, the human hormone choriogonin is detected.

The first signs of pregnancy appear 2-3 weeks after the absence of menstruation. A delay in menstruation without other signs of pregnancy does not mean anything. Their absence can be influenced by too many reasons: from illness, stress and fatigue to climate change. If menstruation is not on time, you can measure your morning temperature. To do this, the thermometer should be inserted to a depth of 2 cm into the rectum and held for up to 7 minutes. If for several days the temperature exceeds 37, then this may be for a reason.

If you want to know about your situation quickly, it is better to ask for a blood test for human hormones. If, in principle, you are not in a hurry, then you can use a regular test, and 3 weeks after the absence of menstruation, the gynecologist will be able to tell you for sure whether you are pregnant.

Diagnosis of pregnancy (doubtful, probable, reliable signs pregnancy)

The presence of pregnancy is established on the basis of doubtful, probable and reliable signs.

Doubtful signs include: changes in taste and olfactory sensations, changes in appetite, as well as objective: from the outside nervous system(drowsiness, irritability, vegetative reactions), the appearance of age spots on the face, white line of the abdomen, nipples, nausea, vomiting.

Possible signs include: cessation of menstruation, enlargement of the mammary glands, release of colostrum, enlargement and changes in the uterus, positive biological and immunological reactions.

Of the signs indicating a change in the shape and consistency of the uterus in connection with pregnancy, the most important are the following.

• 1. Enlarged uterus. It is determined starting from the 5th-6th week of pregnancy: the uterus increases in anteroposterior size (becomes spherical), and later in its transverse size. By the end of the 2nd month of pregnancy, the size of the uterus corresponds to the size of a goose egg; at the end of the 3rd month, the fundus of the uterus is at or slightly above the symphysis.
• 2. Horwitz-Hegar symptom. When examined, the pregnant uterus is soft, the softening is especially pronounced in the isthmus area. During a two-handed examination, the fingers of both hands touch in the isthmus area with almost no resistance. The sign is characteristic of early pregnancy and is clearly identified 6-8 weeks after the start of the last menstruation
• 3. Snegirev’s sign. The pregnant uterus is characterized by variability in consistency. The soft pregnant uterus, under the influence of mechanical irritation during a two-handed examination, becomes denser and contracts. After the irritation stops, the uterus again acquires a soft consistency.
• 4. Piskacek's sign. The early stages of pregnancy are characterized by asymmetry of the uterus, caused by a dome-shaped protrusion of its right or left corner, which corresponds to the site of implantation ovum. As the fertilized egg grows, this asymmetry gradually disappears.
• 5. Gubarev and Gaus sign. Indicates slight mobility of the cervix in the early stages of pregnancy, which is associated with significant softening of the isthmus.
• 6. Genter's sign. Due to the softening of the isthmus in the early stages of pregnancy, the uterus is bent anteriorly and a comb-like thickening occurs on the anterior surface of the uterus along the midline. However, this thickening is not always detected.

Reliable signs: ultrasonic. When using a transvaginal sensor, visualization of the fetal egg in the uterine cavity is possible even with a two to three day delay in menstruation with a regular menstrual cycle, i.e. at 4-5 weeks obstetric period pregnancy. At 5 weeks of pregnancy, fetal cardiac activity begins to be determined. Movement of the fetus, its palpable parts.

To diagnose early pregnancy, level determination is also used. human chorionic gonadotropin human blood serum. During a normal pregnancy, hCG can be detected in the blood serum on the 5th day after implantation of the egg into the uterine mucosa and its peak lasts until 8-9 weeks of pregnancy.

- these are due to the current pregnancy sensations in a pregnant woman ( complaints), changes in her body and symptoms that the doctor identifies during examination. Signs of pregnancy differ depending on the timing of pregnancy, their objectivity and reliability, the presence of one or more embryos in the uterus, the sex of the child, the pathological course of pregnancy, as well as the location of the fertilized egg ( in or outside the uterus).

Pregnancy occurs after the implantation of a fertilized egg ( embryo) into the wall of the uterus. This process is called implantation. From this moment on, the woman is considered pregnant, and she begins to show signs of an “interesting situation.”

Pregnancy causes the following changes in the female body:

• anatomical changes– the uterus and mammary glands enlarge, changes female figure;
• physiological– menstruation disappears, all organs begin to work more actively, changes hormonal background.

Signs of pregnancy are a consequence of these changes and can be determined during examination using laboratory tests ( chemical changes) and instrumental diagnostic methods.

What are the signs of pregnancy?

Signs of pregnancy can be subjective and objective. Subjective signs are felt by the woman herself; they may be associated with other pathologies or arise as a result of self-hypnosis, so they are not considered reliable. Objective signs are detected during examination by the woman herself or by a doctor, as well as during laboratory tests and instrumental studies. Objective signs do not always mean that a woman is definitely pregnant; some pathologies can cause such changes, or the sign can be overestimated by the doctor. Therefore even objective signs pregnancies differ in their reliability.

Depending on the reliability, all signs of pregnancy are divided into the following groups:

• dubious signs– are not associated with changes in the woman’s genitals or mammary glands, these are sensations that a woman experiences when pregnancy occurs;
• probable signs are symptoms associated with changes in the genitals and mammary glands, identified through routine examination, tests and gynecological examination (they are called probable because they can occur in some other situations not related to pregnancy);
• reliable signs– indicate the presence of a fetus inside the uterus, detected during examination and research by a doctor, as well as using instrumental diagnostic methods.

Even if only 1 reliable sign of pregnancy is detected, this is considered sufficient to diagnose pregnancy. The remaining probable and doubtful signs are of value only when they are combined, since all these signs can be observed not only during pregnancy. This is especially important to consider in cases where a woman really wants to get pregnant.

Doubtful and probable signs of pregnancy can be confused with the following pathologies:

• Violation menstrual cycle. If a woman is not protected, but her cycle is irregular ( menstruation is either delayed or occurs earlier), then a delay in menstruation due to hormonal imbalance can be mistaken for pregnancy. Irregular periods can be observed with tumors of the genital organs, diet ( fasting). That is why a delay in menstruation can only be considered a sign of pregnancy in combination with its other signs ( engorgement of the mammary glands, release of colostrum, signs revealed during a gynecological examination and, most importantly, with a positive pregnancy test).
• Vegetative-vascular dystonia ( neurosis, neurocirculatory dystonia) . Violation of the nervous regulation of vascular tone and the function of various organs leads to dizziness and fainting, irritability, fatigue, and sleep disturbances. Dizziness and fainting can also occur during pregnancy, especially in women prone to neuroses and suffering from anemia ( low levels of hemoglobin and red blood cells in the blood). That is why irritability and other symptoms cannot be associated solely with pregnancy.
• Diseases of the stomach, intestines, pancreas and gall bladder. These diseases cause symptoms such as nausea and vomiting. Nausea and especially vomiting are the most well-known signs of pregnancy; they appear with a frequency of 46% in all pregnant women, but ordinary gastritis, intestinal irritation, poisoning and other diseases should be excluded digestive system that cause such symptoms. It is characteristic that usually during pregnancy, vomiting does not bring relief, while in case of stomach pathology, removing food from it significantly alleviates the symptoms.
• Deficiency of vitamins, minerals and anemia. These diseases are accompanied by changes in taste and smell - they become distorted or there is a desire to eat “something unusual” ( chalk, hair, salty or sweet).
• Inflammation of the bladder and kidneys. These diseases are accompanied by frequent and painful urination, due to irritation of the bladder walls or an infection affecting the kidneys.
• Mastopathy. Mastopathy is a hormonal disease of the mammary glands, which is characterized by the proliferation of glandular tissue or ducts of the mammary gland against the background of hormonal imbalance. Mastopathy also causes engorgement of the mammary glands and even quite intense painful sensations associated with swelling of the gland.

Such a sign as fetal movement, which is felt by the mother herself, is not considered reliable. Firstly, a woman may mistake intestinal contractions for fetal movement, and secondly, fetal movements are not felt until 18–20 weeks of pregnancy ( during the first pregnancy - at 20 weeks, and during subsequent ones - 2 weeks earlier).

Possible signs of pregnancy can be detected using the following tests:

• palpation of the mammary glands;
• examination of the external genitalia and vagina;
• examination of the vagina and cervix using mirrors ( special gynecological instrument);
• two-handed gynecological examination;
• pregnancy test.

An examination by a gynecologist is carried out on a gynecological chair, which has footrests. The woman lies down on this chair so that her buttocks are located on the edge of the chair, and places her legs on the supports. This position allows the gynecologist to perform a two-handed ( bimanual) examination of the vagina and cervix. Pregnancy changes the uterus. It is these changes that the obstetrician-gynecologist should identify. Identifying these signs also makes it possible to establish approximate period pregnancy, however, they are not reliable signs, since the uterus can be enlarged due to other reasons.

With a two-handed examination, the gynecologist identifies following signs pregnancy:

• enlarged uterus– at 5–6 weeks of pregnancy, the uterus acquires a spherical shape ( non-pregnant pyriform uterus), by the 8th week of pregnancy the uterus doubles in size, by 10 - three times, and by 12 - 4 times;
• ridge-like projection on the anterior surface of the uterus– determined by palpation during vaginal examination;
• asymmetry of the uterus ( increasing and changing its shape) – the area of ​​the uterus where the embryo has implanted bulges, so the uterus takes on an irregular shape, which is determined at 7–8 weeks of pregnancy and disappears by the tenth;
• softening of the isthmus of the uterus ( segment between the body of the uterus and its cervix) – occurs under the influence of the pregnancy hormone progesterone, determined by touch by the doctor, and due to the softness of the isthmus, the fingers of the doctor’s inner and outer hands converge in the area of ​​the isthmus, which is considered a sign of pregnancy;
• increased uterine contractility– while palpating the uterus, its response to such irritation occurs, and it becomes denser due to muscle contraction.

Depending on the size of the uterus, the timing of pregnancy is determined as follows:

• 5 – 6 weeks– spherical shape during two-handed examination;
• 8 weeks– the uterus is the size of a woman’s fist;
• 10 weeks– the size of the uterus corresponds to the size of the head of a newborn baby;
• 16 weeks– the uterus can be felt above the womb;
• 20 weeks– the uterus can be felt 3 transverse fingers above the pubis;
• Week 24– the uterus can be felt at the level of the navel;
• Week 28- uterus above the navel.

Signs of pregnancy on ultrasound

Pregnancy can be seen on ultrasound 3 weeks after conception. At this stage, an ultrasound shows a rounded formation in the wall of the uterus, which does not reflect the echo signal well, that is, it transmits it, and therefore has a black color ( this is called a hypoechoic structure) is a fertilized egg. From 4–5 weeks of pregnancy you can see the embryo; it has a positive echo signal ( white colors on echo). The diameter of the fertilized egg at this stage is less than 0.5 cm. Clearly distinguish future fetus it is possible when its size increases at least twice, that is, the diameter will be 1 cm. To do this, you need to wait until the 7th week of pregnancy. At week 9, the fetal head is visible separately. At this stage, contractions of the fetal heart can also be seen. By week 10, the entire uterine cavity is already filled with fertilized egg.

Ultrasound is performed in the usual way ( the sensor is placed on the abdominal wall) or through the vagina. Last method ( transvaginal ultrasound) allows you to detect the fertilized egg 1 - 1.5 weeks earlier than a regular ultrasound.

When do signs of pregnancy appear?

Depending on the time of appearance, signs of pregnancy can be divided into early signs of pregnancy and late signs pregnancy. Early signs pregnancy - these are signs that can be identified before the 12th week of pregnancy, that is, these are all doubtful and probable signs. Signs of late pregnancy are determined from 18 to 20 weeks of pregnancy, that is, they already include reliable signs. The very first signs of pregnancy can be detected even before your period is missed.

Before your period is missed, the following symptoms may indicate pregnancy:(first signs of pregnancy):

• Spotting that is red, pink or brown. These discharges occur due to implantation ( implementation) fertilized egg into the uterine wall. For implantation, embryo enzymes destroy the surface layer of the uterine lining in a limited area to make room for implantation. Such local destruction is accompanied by bleeding, blood is released from the genital tract in the form of spotting. This vaginal discharge lasts 1 to 2 days and is often perceived by a woman as menstruation.
• Maintaining elevated body temperature before menstruation. A woman who is planning a pregnancy usually monitors changes in body temperature ( measured in the rectum) throughout the menstrual cycle. This is necessary to determine the period that is favorable for conception. Normally, before menstruation, a decrease in body temperature occurs, as the production of progesterone ( female sex hormone 2 phases of the cycle) gradually decreases. Progesterone affects the thermoregulatory center in the brain, causing an increase in body temperature. If pregnancy has occurred, the production of progesterone continues, and the body temperature remains at 37 - 38ºC.
• A sharp drop in body temperature. If, after the middle of the cycle, before the start of the next menstruation, a woman observes a 1-2 day sharp drop in temperature, then this may be a sign of pregnancy. This symptom is called implantation retraction. This retraction is explained by a temporary cessation of secretion of the hormone progesterone in the ovaries ( they have not yet received the signal that pregnancy has occurred and that they need to continue to secrete progesterone). There is another reason. During conception, estrogen is produced - this is the second female sex hormone, the effect of which is opposite to that of progesterone, it causes a decrease in body temperature.
• Nagging pain in the lower abdomen– occur simultaneously with spotting and are associated with the same process of implantation of the fertilized egg.
• Breast tenderness and engorgement– occurs due to hormonal changes due to pregnancy.

Signs of early pregnancy include:

• delayed menstruation;
• bad feeling;
• mood swings;
• dizziness;
• change in taste, smell;
• frequent urination;
• nausea, vomiting ( from 2 weeks of pregnancy);
• increased appetite ( from 4 weeks of pregnancy);
• drowsiness or insomnia;
• positive pregnancy test;
• appearance of the amniotic cavity ( cavity filled amniotic fluid ) on ultrasound, a thin strip inside this cavity, which is the future embryo ( detected 3–4 weeks after conception).

Signs of late pregnancy include:

• listening to the fetal heartbeat;
• detection of the fetus on ultrasound;
• palpation of large parts of the fetus;
• fetal movement felt by the doctor.

You can find out the sex of the child using ultrasound data. This can usually be done between 12 and 16 weeks of pregnancy. However, the doctor cannot always do this accurately, even in later stages due to the position of the fetus. At the same time, there are many signs or signs, as well as the feelings of the woman herself during pregnancy, which indicate that a boy or girl is growing in her stomach. These signs are mainly due to the level of sex hormones. If the parents managed to conceive a boy, then the female body will have more male sex hormones, which are necessary for the growth of a male fetus. It is the ratio of male and female sex hormones that determines exactly what phenomena will occur in the body of a pregnant woman, in addition to the main signs of pregnancy.

Gender of the child by signs during pregnancy

Signs of multiple pregnancy

A multiple pregnancy is a pregnancy with more than 1 fetus. Probability multiple pregnancy increase with age, more often if one of the future parents had twins in the family, as well as if the pregnancy resulted from IVF. Parents usually find out about the presence of twins through an ultrasound, but there are other signs that indicate a pregnancy with twins or triplets.

The following signs indicate a multiple pregnancy:

• the size of the uterus does not correspond to the duration of pregnancy;
• the circumference of the abdomen and its “height” are much larger than expected for this period;
• the doctor feels more than 3 large parts of the fetus;
• When listening with a stethoscope, 2 heartbeats are detected, which differ from each other in frequency and best point listening, and between them there is a zone of “silence” where tones are not heard;
• the difference in the heart rate of twins is more than 10 beats at different points, which is determined by a special apparatus ( cardiac monitor);
• when determining the level of hCG in the blood, its level is 2 times higher;
• tendency to edema of the lower extremities ( heavy load on internal organs and especially on the kidneys);
• rapid onset fatigue;
• more severe toxicosis ( severe nausea and vomiting, severe engorgement of the mammary glands);
• tendency to constipation;
• early movement fetus ( If a woman usually feels the baby’s movements from 18 to 20 weeks of pregnancy, then in case of multiple pregnancy – from the 15th week).

They call it frozen undeveloped pregnancy when the normal course of pregnancy is disrupted and embryo development stops in its early stages or fetal death occurs in late stages of pregnancy. In this case, parts of the fertilized egg, embryo or fetus continue to be in the uterine cavity.

Signs of a frozen pregnancy include:

• low level of hCG in the blood ( hormone secretion stops);
• The uterus on ultrasound and when palpated by a doctor has smaller sizes than it should be this period pregnancy ( at any time);
• absence of yolk sac ( in the early stages) or the embryo itself inside the fertilized egg;
• absence of fetal heartbeats ( at 7–8 weeks of pregnancy);
• absence of fetal movements according to ultrasound ( up to 22 weeks of pregnancy).

Signs of pregnancy after IVF

IVF or in vitro fertilization is fertilization outside the female body, followed by the introduction of embryos into the uterine cavity. Signs of pregnancy after IVF do not differ from those during pregnancy naturally. The main point to pay attention to is the possibility of a false-positive pregnancy test and the timing of the appearance of signs of pregnancy.

The embryo is introduced into the uterine cavity on days favorable for its implantation, that is, penetration into the wall of the uterus. However, find out exact date This implantation is not possible. This can happen within a few hours or up to a week after the embryo transfer procedure. Implantation itself lasts up to 3 days. The timing of the appearance of signs also depends on the “age” of the embryos. Sometimes three-day-old embryos are implanted, and sometimes five-day-old ones. If three-day-old embryos are introduced into the uterus, then signs of pregnancy may appear several days later than with the introduction of five-day-old embryos.

Thus, you should expect the first signs of pregnancy after IVF 12 to 14 days after the embryos are introduced into the uterus. After 12–14 days, the woman should take a pregnancy test. The usual pregnancy test is done on the 14th day after embryo transfer, and a blood test on quantitation HCG – on day 12. The fact is that before IVF, hCG is used to stimulate the ovaries, and using the test earlier than 2 weeks can lead to a false positive result, that is, the appearance of two stripes in the absence of pregnancy. If the hCG test after IVF is positive, it is repeated 2 days later. The success of IVF and pregnancy can be confirmed 3 weeks after the embryos are inserted, when the woman undergoes an ultrasound scan.

An ectopic pregnancy is a pregnancy in which the fertilized egg implants outside the uterine cavity. To outside intrauterine pregnancy include cases of attachment of the fertilized egg to the ovaries, the wall of the fallopian tube, organs abdominal cavity, as well as in the cervical canal, in the additional uterine horn ( with a congenital defect), in the mesentery of the uterus and inside its ligaments.

With an ectopic pregnancy, the woman initially experiences the same symptoms as with normal pregnancy– doubtful and some probable ( for example, a positive pregnancy test). Signs of an ectopic pregnancy itself are detected 5–7 weeks after conception.

Signs of an ectopic pregnancy include:

• severe pain in the lower abdomen;
• shoulder pain ( occurs reflexively due to nerve irritation);
• pain during bowel movements;
• bleeding from the genital tract;
• severe dizziness.
• painful formation that can be felt in the area of ​​the uterine appendages;
• detection of the fertilized egg outside the uterine cavity according to ultrasound data.

The doctor suspects an ectopic pregnancy in cases where, against the background of a positive pregnancy test, there is no fertilized egg in the uterine cavity.

If an ectopic pregnancy is suspected, an ultrasound of the uterine appendages and abdominal cavity is urgently performed, and then a laparoscopic examination. Laparoscopy is a method of examining the abdominal organs using a tube with a camera at the end. It is inserted through a puncture on the anterior abdominal wall. Advantage this method is that diagnostic test if necessary, proceeds to a surgical operation and allows you to remove an ectopic pregnancy, preventing life-threatening complications for the woman.

Signs of false pregnancy

False pregnancy is considered mental illness. It is also called an imaginary or imaginary pregnancy. It is associated either with a woman’s great desire to become pregnant, or with a great fear associated with an unwanted pregnancy after sexual intercourse. In both cases there is strong self-hypnosis. A woman may experience doubtful and some probable signs of pregnancy - taste perversion, nausea, vomiting, abdominal enlargement, delayed menstruation, pigmentation, weight gain. The woman may even feel that the fetus is moving. She usually mistakes intestinal contractions for fetal movement. In very rare cases gynecological examination and bimanual examination may reveal changes in the shape and consistency of the uterus. Typically, these changes are associated with a woman’s hormonal background, which can “adapt” to the idea of ​​pregnancy instilled in her.

No reliable signs of pregnancy during false pregnancy not detected. Ultrasound does not detect the fetus in the uterus, heartbeats cannot be heard, large parts of the fetus cannot be palpated. A pregnancy test is negative ( in rare cases with malignant tumors it can be positive). This condition requires treatment by a psychiatrist, but such patients are almost impossible to respond to psychotherapy.

Can a high temperature be a sign of pregnancy?

An increase in body temperature may be a sign of pregnancy. If a woman takes her temperature every day during her cycle internal organs (basal temperature) in the rectum, then she notices that after the middle of the cycle the body temperature rises to 37.2 - 37.5ºC, and then gradually normalizes. This phenomenon is explained by the production of the female hormone progesterone, which affects the thermoregulation center in the brain. When pregnancy occurs, this hormone continues to be produced ( it is necessary to maintain pregnancy), therefore, normalization of body temperature before the next menstruation does not occur. Body temperature lasts up to 12 weeks, and it can reach 38ºC.

What are the most reliable signs of pregnancy?

The most reliable signs of pregnancy are detected using ultrasound ( Ultrasound), and both in the early stages of pregnancy ( up to 12 weeks), and in later stages ( after 18 – 20 weeks). Ultrasound in the early stages detects either the embryo itself ( it still looks like a thin bright strip inside the cavity of the fetal egg), or elements of the fertilized egg ( cavity filled with liquid yolk sac ). At the 9th week of pregnancy, you can already see contractions of the fetal heart on an ultrasound and turn on the mode of listening to the heartbeat.

Reliable signs of pregnancy appear closer to 18 - 20 weeks of pregnancy. Ultrasound can detect signs of pregnancy as early as 3 weeks after conception.

Other reliable signs of pregnancy are:

• listening to a very rapid fetal heartbeat ( 140 beats per minute or more) using a regular stethoscope ( a tube);
• palpation of the head and other large parts of the fetus ( for example, legs) doctor;
• feeling of fetal movements by the doctor during examination.

It is important to know that the sensation of fetal movement cannot in any way be considered a reliable sign if it is felt not by a doctor, but by the woman herself. A woman may mistake the process of contraction of the intestinal walls for the movement of the baby ( sometimes even very strong contractions). If the doctor himself, during the examination, feels large parts of the fetus and at the same time feels its independent, as if in response, movements, then this is considered a reliable sign of pregnancy.

A positive pregnancy test is not a reliable sign of pregnancy because it detects the presence of a hormone in a woman's urine ( HCG – human chorionic gonadotropin), secreted by the membranes of the fruit, and not the fruit itself. This means that in some cases a pregnancy test may be falsely negative ( There is a pregnancy, but the hormone level is not yet high enough or the test was performed incorrectly) or false positive ( the test shows 2 lines, but the reason for the increase in hCG levels is not pregnancy).

Could abdominal pain be a sign of pregnancy?

Some women note nagging pain lower abdomen or stabbing sensations, which are explained by the implantation of a fertilized egg into the wall of the uterus. These symptoms appear 4–5 days after fertilization or 7–10 days after ovulation ( the process of releasing an egg from the ovaries mid-cycle). Usually abdominal pain is accompanied by slight bloody discharge from the vagina ( brown or Pink colour ). This bleeding is also associated with the process of implantation of the embryo, because it must create a bed for itself inside the wall, and for this it is necessary to slightly destroy the surface layer of the uterine mucosa and create a depression in it.

Abdominal pain can be a sign of more than just intrauterine pregnancy ( inside the uterine cavity), but also ectopic. In this case, they intensify, cause severe discomfort and disrupt the woman’s performance. At tubal pregnancy (inside the fallopian tube) there is a risk of pipe wall rupture, when ovarian pregnancy– bleeding. Such complications cause severe severe pain lower abdomen, state of shock ( fainting, drop in blood pressure), increased heart rate and require emergency surgery.

To avoid such complications, if your period is late and your pregnancy test is positive, if you experience abdominal pain, you should contact antenatal clinic see a gynecologist and do an ultrasound ( ultrasonography ) uterus.

On what day of the cycle do signs of pregnancy appear?

The first signs of pregnancy may appear as early as 7 days after ovulation ( this is the name of the day in the middle of the cycle when a mature egg is released), if conception occurred a few days before ovulation or on the day of ovulation. To identify these signs, you need to measure the basal temperature in the rectum, and also pay attention to the nature of the vaginal discharge. At successful conception and the introduction of a fertilized egg into the wall of the uterus, a change in hormonal levels occurs. The ovaries continue to secrete the hormone progesterone. This female sex hormone causes an increase in body temperature, therefore, during pregnancy, the second phase ( after ovulation) body temperature will remain at 37 – 37.5ºС until the day of the expected next menstruation and longer ( up to 12 weeks of pregnancy).

At the same time, a woman should know that for 1 - 2 days the body temperature can drop sharply and this does not mean that the pregnancy has been terminated. Before implantation ( implementation) embryo into the uterus female body still lives according to the old rhythm and does not know about successful conception, so progesterone levels may decrease. If this happens, the body temperature also drops, which is called implantation retraction. After the embryo is implanted into the uterus, progesterone production resumes and body temperature “jumps” again.

Even before the delay of menstruation, during pregnancy, nausea, vomiting, engorgement of the mammary glands, and changes in sexual desire may appear ( it usually disappears), dizziness. All these signs of pregnancy are observed 4 to 5 days after conception ( if a woman knows the exact day of conception) or 7–10 days after ovulation.

A pregnancy test should be taken 7 to 10 days after the expected day of conception. If the test is highly sensitive, it will show a positive result already at this stage, but in some cases this sign of pregnancy may appear only 12–14 days after conception.

Is it possible to have no signs of pregnancy during pregnancy?

Pregnancy is always accompanied by signs, but in the early stages a woman may not be aware of it, especially if she uses contraception or has irregular periods. In this case, pregnancy does not make itself felt for the time being. In addition, signs such as nausea, vomiting, weakness and others subjective feelings can be mistaken for an illness, a cold, or poisoning. A woman may attribute the disappearance of her period to stress or diet. The abdomen also does not increase until the 12th week of pregnancy, since before this period the uterus is still within the pelvis ( below the womb). Sometimes pregnancy is accompanied bloody discharge from the vagina. They are perceived by a woman as menstruation ( last 1 – 2 days), and she doesn't think about pregnancy.

Can signs of pregnancy occur while taking birth control pills?

Reception birth control pills protects against unwanted pregnancy, but there are times when this method of contraception does not work and pregnancy occurs. Signs of pregnancy while taking birth control pills are no different from signs of pregnancy without taking these pills. The first signs of pregnancy can easily be confused with a cold, gastritis, or attributed to poor diet or stress ( even a delay in menstruation). Perhaps the most characteristic sign of pregnancy while taking birth control pills is breast changes. It becomes painful, enlarges, the circles around the nipples darken, the nipples become very sensitive, and discharge from the nipples is observed. This symptom is difficult to attribute to any other reason. Sometimes this occurs with severe hormonal imbalance, but in any case, such a sign forces the woman to take a pregnancy test and consult a gynecologist.

You should think about pregnancy while taking birth control pills. following cases:

• irregular intake pills, frequent missed doses, especially in the middle of the cycle;
• reception different types birth control pills ( they can neutralize each other's effects);
• diseases of the digestive system ( disrupt the absorption of the pill, and the level of hormones in the blood drops sharply);
• taking medications that may interfere with the effects of birth control pills;
• drinking alcohol while taking birth control pills.

Can there be signs of pregnancy while breastfeeding?

Pregnancy cannot occur in the first 4 to 6 weeks after birth due to the woman’s hormonal levels ( hormones for stimulating the ovaries are not yet produced, as during pregnancy), but a woman can become pregnant even in the first 6 months, even if she is breastfeeding. Breast milk produced when stimulated by the hormone prolactin. The same hormone simultaneously suppresses the function of the ovaries - the egg does not mature, therefore, if we consider breastfeeding as a method of contraception, then it can only be used for 6 months after childbirth and subject to certain rules. During this period, the woman should breastfeed the baby only, and at the request of the child. It is also important that the intervals between feedings do not exceed three hours during the day, and 6 hours at night, that is, it is mandatory to feed the baby once at night. If a child eats nutritional formula, he will eat less milk, which means that the process of milk production will become irregular and incomplete.

In all other cases, the work of the ovaries can resume during breastfeeding, the egg can mature and be released from the ovary, so the appearance of signs of pregnancy cannot be ruled out during breastfeeding.

Signs of pregnancy while breastfeeding include:

• Lack of menstruation. 1.5 months after giving birth, a woman may begin menstruation; they can be irregular and short. It is not possible to accurately calculate the onset of the next period. If a woman does not get her period after 6 months of breastfeeding, this may be a sign of pregnancy.
• Sore nipples. When pregnancy occurs, progesterone production increases sharply. This female hormone It is needed to relax the uterus, but at the same time it affects the mammary gland and increases the sensitivity of the nipples. If a nursing mother becomes pregnant again, she suddenly notices that feeding the baby has become quite painful due to irritability of the nipples.
• Increased appetite. New pregnancy During breastfeeding, a newborn requires more energy, so the woman feels constant hunger.
• Reducing the amount of milk. A “new” pregnancy again changes a woman’s hormonal background. If at breastfeeding The main hormone is prolactin, then during pregnancy it is progesterone. Progesterone suppresses milk production, so during pregnancy and breastfeeding, milk becomes less and less.
• Increase in basal temperature. Basal temperature is the temperature of internal organs, which should be measured in the vagina or rectum. This symptom also occurs under the influence of the hormone progesterone. It acts on the brain and increases body temperature to an average of 37.5ºC. However, during breastfeeding, when the temperature rises, an infectious process should be excluded as one of the causes of fever.
• White vaginal discharge. These discharges do not count characteristic feature pregnancy, however, when combined with other phenomena, they should pay attention. Has white discharge higher value during breastfeeding, since the hormonal background of a woman during breastfeeding does not cause changes in mucus characteristic of a non-pregnant woman during the menstrual cycle. The mucus of a non-pregnant and non-breastfeeding woman periodically becomes transparent, which indicates the release of a large amount of the hormone estrogen. This does not happen for a nursing mother, because the menstrual cycle has not yet started. Therefore, you should pay attention to any sudden changes in the color and consistency of vaginal discharge during breastfeeding.
• Stomach ache. During feeding, uterine contractions intensify. A woman may feel quite severe pain. This is also observed in the absence of pregnancy during the feeding period, but if pain is felt outside of feeding in the form of pulling sensations in the lower abdomen, then this may indicate pregnancy. Moreover, very severe pain can be associated with an ectopic pregnancy, so you should pay attention to this symptom Special attention.
• Changing the child's behavior. If a nursing mother becomes pregnant again, progesterone affects the function of the mammary glands. It can change the taste of milk - the baby usually does not like this, and he begins to cry and be capricious.

Signs of early pregnancy

Organization obstetric care

Questions for the lesson

QUESTIONS FOR THE CLASS:

The main tasks of the antenatal clinic

Legislation on labor protection for pregnant women and mothers

Specialized assistance in antenatal clinic

Clinical examination

Risk groups for perinatal and obstetric pathology

Consultation "Marriage and family". Work organization.

Medical and genetic assistance in antenatal clinics.

What are the generally accepted methods used to examine pregnant women?

What data obstetric history should be found out in pregnant women

Why is it important to find out fertility issues in the anamnesis?

The significance of previous extragenital diseases for the course of pregnancy and childbirth.

Questionable signs of pregnancy.

Research using mirrors.

Vaginal two-manual examination.

Possible signs of pregnancy.

Biological methods for diagnosing pregnancy.

Diagnostics late dates pregnancy.

Position of the fetus in the uterus.

Determination of the articulation, position, position, type and presentation of the fetus.

Techniques for palpation of the pregnant abdomen.

Assessment of fetal cardiac activity.

Auscultation of the pregnant woman's abdomen.

Reliable signs of pregnancy.

Determining the period of prenatal leave.

The size of the uterus and the height of its fundus at different stages of pregnancy.

The main tasks of the antenatal clinic.

The work of the antenatal clinic is based on a territorial-precinct principle.

The purpose of the antenatal clinic is to protect the health of mothers and children by providing qualified outpatient obstetric and gynecological care before, during pregnancy, and in the postpartum period, family planning and reproductive health services.

The main tasks of the antenatal clinic:

Providing obstetric care to women during pregnancy, in postpartum period, preparation for pregnancy and childbirth;

Providing qualified obstetric and gynecological care to women of the assigned territory with gynecological diseases;

Providing counseling and services on family planning, prevention of abortion, sexually transmitted infections, implementation modern methods contraception;

Introduction into practice of modern diagnostic and treatment technologies at the outpatient stage;

providing women with medical, social and legal protection in accordance with the current legislation on the protection of motherhood and childhood;

Implementation of sanitary, hygienic and anti-epidemic measures to ensure the safety of medical personnel and patients and prevent the spread of infections;

Carrying out activities to improve the knowledge of sanitary culture of the population in the field of reproductive health.

According to the main objectives, the antenatal clinic carries out:

Providing outpatient obstetric and gynecological care, identifying women in the labor reserve group, preparing them for pregnancy and childbirth;

Dispensary observation of pregnant women;

Identification of pregnant women in need of timely hospitalization in day hospitals, pathology departments of pregnant maternity hospitals and other departments;

Psychoprophylactic preparation of pregnant women for childbirth;

Patronage of pregnant and postpartum women;

Family planning counseling and services;

Organization and conduct of preventive examinations of the female population, starting from adolescence, for the purpose of early detection of pathology reproductive system And secondary prevention malignant neoplasms of the reproductive system;

Medical examination of gynecological patients;

Performing minor gynecological operations (hysteroscopy, etc.);

Examination of temporary disability for pregnancy and childbirth, in connection with gynecological diseases;

Carrying out activities in the field of improving the sanitary culture of the population on various aspects of a healthy lifestyle;

Analysis of performance indicators, efficiency and quality of medical care.

Legislation on labor protection for pregnant women and mothers.

Legislation on labor protection for pregnant women and mothers.

The state pays special attention to the working conditions of women, which is reflected in Chapter 19 of the Labor Code of the Republic of Belarus “Features of regulating the labor of women and workers with family responsibilities.”

According to Article 262 Labor Code the use of women in heavy work is prohibited; at work associated with lifting and moving heavy loads manually, exceeding the maximum standards established for them; at work with hazardous working conditions, as well as at underground work, except for non-physical underground work or work on sanitary and consumer services.

The Labor Code of the Republic of Belarus regulates the following guarantees for women in connection with maternity:

prohibition of engaging in work in night time, to overtime work, work in public holidays, holidays and weekends and business trips for pregnant women and women with children under three years of age; women with children aged from three to fourteen years (disabled children up to eighteen years old) can be involved in night work, overtime work, work on public holidays and public holidays, work on weekends and sent on business trips only with their consent ;

reduction in production standards, standards of care for pregnant women in accordance with a medical report, or transfer to another job, easier and excluding the impact of adverse production factors, while maintaining the average earnings for the previous job;

if it is impossible to perform the previous job, women with children under the age of one and a half years are transferred to another job while maintaining the average earnings for the previous job until the child reaches the age of one and a half years;

a mother raising a disabled child under the age of eighteen, upon her request, is given one day off from work every month with payment in the amount of the average daily earnings at the expense of state social insurance funds and one day off from work per week with payment in the amount of the average daily earnings in the manner and on the terms determined by the Government of the Republic of Belarus;

a mother raising two or more children under the age of sixteen, upon her application, is given one day off from work every month with payment in the amount and on the terms provided for in the collective agreement;

a mother raising three or more children under the age of sixteen, a single mother raising two or more children under the age of sixteen, is given one day off from work per week with payment in the amount of average daily earnings in the manner and on the terms determined by the Government The Republic of Belarus;

women who have adopted a child under three months of age are granted leave of 70 calendar days from the date of adoption with payment of state benefits for this period social insurance;

at the request of a woman who has adopted a child, she is granted parental leave in the manner and under the conditions provided for in Article 185 of this Code; women with children under the age of one and a half years are provided, in addition to the general break for rest and nutrition, with additional breaks for feeding the child at least every three hours, lasting at least 30 minutes each; if there are two or more children under the age of one and a half years, the duration of the break is set at least one hour; at the request of the woman, breaks for feeding the child can be added to the break for rest and nutrition, or in aggregate form transferred both to the beginning and to the end of the working day (work shift) with a corresponding reduction; they are included in

work time and are paid according to average earnings; and reduce their wages for reasons related to pregnancy or the presence of children under the age of three, and for single mothers - with the presence of a child under the age of fourteen (a disabled child - up to eighteen years).

for pregnant women, activities associated with wet clothes and shoes are excluded; working in a draft, under conditions of sudden changes in barometric pressure - this applies to flight crews, flight attendants, etc.

the work processes and equipment used in which a pregnant woman is employed should not be a source of elevated levels of physical, chemical, biological and psychophysical factors.

the workplace should not expose pregnant women to harmful chemical substances; industrial aerosols; vibrations; ultrasound.

a woman should not constantly stand in one position; the total distance she covers per shift should not exceed 2 km. Constant work in a sitting, standing position or associated with continuous movement (walking) is excluded.

In addition, pregnant women should not be assigned work performed in a squatting, kneeling, bending position, with emphasis on the stomach and chest.

Special workplaces should be equipped for pregnant women, which provide for the performance of work duties in a free mode, allowing for a change of position at will.

women should not perform production operations related to lifting objects of labor from the floor; above the level of the shoulder girdle; with a predominance of abdominal muscle tension.

Permissible load values ​​for pregnant women:

when lifting and moving heavy objects in alternation with other work (up to 2 times per hour) - no more than 2.5 kg;

with continuous lifting and moving heavy objects during a work shift - no more than 1.25 kg;

the total mass of goods moved during each hour of a work shift at a distance of up to 5 m is no more than 60 kg;

the total mass of goods moved during an 8-hour work shift is no more than 480 kg. Thus, the current legislation of the country allows us to ensure a reliable system social protection mother, which includes economic, social and labor guarantees

and rights and creates specific conditions for their implementation.

Specialized assistance in antenatal clinics. Clinical examination.

In large antenatal clinics serving an area with a population of 40 thousand or more inhabitants (with 8 or more obstetric and gynecological departments), specialized obstetric and gynecological care rooms are organized:

prenatal diagnostic room;

cancer prevention room (cervical pathology);

cabinet of endocrine disorders and pathology of menopause;

family planning office;

miscarriage room.

If conditions exist, antenatal clinics organize a day hospital for pregnant and gynecological patients in accordance with current regulatory documents.

Risk groups for obstetric and perinatal pathology.

Risk groups for obstetric and perinatal pathology.

Definition of risk perinatal pathology in the antenatal clinic it is carried out according to the system developed by O.G. Frolova and E.I. Nikolaeva (1980). Risk factors for perinatal pathology are divided into five groups:

socio-biological;

anamnestic (data from obstetric and gynecological history);

extragenital pathology;

complications of this pregnancy;

condition of the fetus.

Each factor is assessed in points, the points are summed up and if the sum is 10 or higher, there is high risk perinatal pathology; 5-9 points indicate average, 4 or less - low risk.

Consultation "Marriage and family".

Consultation "Marriage and family".

The main task is to provide specialized treatment, preventive and advisory assistance on medical aspects of family relationships.

Includes cabinets:

teenage gynecology office

barren marriage office

family planning office

psycho-somatic and psychological support room

gynecological endocrinology office

miscarriage room

menopause pathology room

medical genetic consultation

Medical and genetic assistance in antenatal clinics.

Medical and genetic assistance in antenatal clinics.

Medical genetic consultations are organized in regional centers. Their activities are aimed at prevention, timely detection and treatment of hereditary diseases, prevention of miscarriage and related complications for mother and child.

Pregnant women are subject to mandatory consultation at the medical genetic center if they have the following indications:

The pregnant woman is 35 years of age or more.

The presence of a chromosomal rearrangement or developmental defect in one of the spouses.

A history of children with hereditary diseases, congenital malformations, mental retardation.

The presence of the above pathology among relatives.

Consanguineous marriage.

Habitual miscarriage of unknown origin.

Adverse effects in early pregnancy (diseases, diagnostic or therapeutic procedures, medications).

Complicated course of pregnancy (threat of miscarriage from an early stage, not amenable to therapy, polyhydramnios).

Fetal pathology detected by ultrasound examination.

Changes in indicators of screening factors: alpha-fetoprotein, human chorionic gonadotropin, estriol, 17-hydroxyprogesterone.

The spouses have harmful occupational hazards.

Primary amenorrhea, menstrual irregularities of unknown origin.

It is preferable to refer patients for medical genetic consultation before pregnancy or in its early stages (6-8 weeks) with a detailed statement about the course of previous pregnancies, childbirth, the health status of the newborn, and the results of his examination.

Common methods of examining pregnant women.

What are the generally accepted methods used to examine pregnant women? What obstetric history data should be found out in pregnant women. Why is it important to find out in the anamnesis issues of reproductive function. The significance of previous extragenital diseases for the course of pregnancy and childbirth.

SURVEY– the main purpose of the survey is to identify factors that can negatively affect the course of pregnancy and fetal development. During the survey, the following information is revealed:

Age. For first-time mothers, the age group is determined: young primigravida- up to 18 years, age primipara - over 30 years.

Working and living conditions, profession, presence of occupational hazards.

Living conditions: number of people living with the pregnant woman, material security, living conditions, presence of animals in the apartment.

Previous somatic and infectious diseases: childhood infections, diseases of the cardiovascular, endocrine, genitourinary, respiratory systems, gastrointestinal tract, viral hepatitis, STIs, cancer, etc.

Previous blood transfusions, allergic reactions, surgeries, injuries.

Epidemiological anamnesis.

Bad habits(smoking tobacco, drinking alcohol, drugs).

Menstrual and sexual function. Reproductive function: number of previous pregnancies (duration, course, multiple pregnancies), number of births and abortions, intervals between pregnancies, complications during childbirth, complications after childbirth and abortion, weight of newborns.

Obstetric history provides valuable information for predicting obstetric complications, features of the course of pregnancy and childbirth. Complications from previous pregnancies and births, a short interval between births increases the risk of complications. In the case of a scar on the uterus after a CS, enucleation of a myomatous node, or suturing of a perforation, it is necessary to clarify the timing of the operation, the type of cesarean section (corporal or in the lower uterine segment), and the nature of the postoperative period.

Past diseases of the genital organs: inflammatory processes, infertility, menstrual dysfunction, uterine surgery, fallopian tubes, ovaries; STI.

Family history: the health status of family members living with the pregnant woman (tuberculosis, alcoholism, sexually transmitted diseases, smoking, etc.); heredity (multiple pregnancies, diabetes, oncological and mental diseases, hypertension, the presence of children in the family with congenital and hereditary diseases, etc.); the age and health status of the husband, the type and Rhesus of his blood, as well as the presence of occupational hazards and bad habits.

OBJECTIVE EXAMINATION

A pregnant woman is examined by an obstetrician-gynecologist, dentist, otolaryngologist, ophthalmologist, and, if necessary, by an endocrinologist, urologist, surgeon, and cardiologist. If indicated, medical genetic counseling is carried out.

An objective examination of a pregnant woman includes:

thermometry;

anthropometry (measurement of height, determination of body weight);

measuring blood pressure to diagnose hypertension;

determination of physique and pelviometry;

examination of the skin;

examination and palpation of the mammary glands;

examination and palpation of the abdomen;

palpation of the symphysis pubis;

study of the circulatory, respiratory, digestive, excretory, nervous and endocrine systems;

routine studies performed by doctors of other specialties.

• Doubtful, probable, reliable signs of pregnancy.

Doubtful, probable, reliable signs of pregnancy. Biological methods for diagnosing pregnancy. Diagnosis of late pregnancy.

Doubtful signs: changes in taste and olfactory sensations, changes in appetite, as well as objective signs in the form of changes in the nervous system (irritability, drowsiness, vegetative reactions), the appearance of pigmentation on the face, along the white line of the abdomen, on the nipples and in the peripapillary area, nausea, vomiting in the morning, etc.

Possible signs: cessation of menstruation; enlargement of the mammary glands and the release of colostrum from them when pressed, loosening and cyanosis of the vestibule of the vagina and cervix (Scrobansky’s sign);

enlargement and changes in the uterus. As pregnancy progresses, the size of the uterus changes. Changes in the shape of the uterus are determined by two-handed (bimanual) examination. Uterus non-pregnant women

has a pear-shaped shape, somewhat compacted in the anteroposterior dimension. With the onset of pregnancy, the shape of the uterus changes. Conventionally, you can use the following rule: at 8 weeks the body of the uterus increases 2 times compared to its original size, at 10 weeks - 3 times, at 12 weeks - 4 times.