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 about interesting position one can only guess, since there are no special clear 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:

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 at 2-3 weeks of 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 find out about your situation quickly, it is better to ask for a blood test for human hormone. If, in principle, you are not in a hurry, then you can use regular test, and 3 weeks after the absence of menstruation, the gynecologist will be able to tell you for sure whether you are pregnant.

First signs of pregnancy before delay

Signs of pregnancy can be divided into three large groups, the diagnostic value of which is different. In ascending order they can be arranged as follows - doubtful, probable and reliable signs.

Signs of pregnancy

Doubtful signs are those symptoms that may indicate the possibility of pregnancy (these are the first signs of pregnancy before a missed period), the doctor determines the probable signs himself and they are more likely to confirm the diagnosis of pregnancy. Reliable signs have the greatest diagnostic value, since they are based on the feeling of fetal movements, its heartbeat and palpation of its parts, that is, they indicate what is developing inside little man, but they appear on later pregnancy.

Hormonal basis of pregnancy

Development ovum always associated with certain hormonal changes in the mother's body. It is these hormonal influences that cause the observed dubious signs of pregnancy before the delay of menstruation. However, it should be taken into account that similar manifestations may also occur. hormonal disbalance(violation of the ovarian-menstrual cycle according to the type of persistence corpus luteum), therefore, it is not possible to establish a final diagnosis based on these signs alone.

What are these changes? First of all, they relate to progesterone, which has the common name “pregnancy hormone”. After conception, the body's production of this hormone sharply increases in order to ensure normal development embryo, provide it with an optimal level of nutrition and oxygen delivery. But progesterone can affect not only the uterus, but also other organs.

It is with its influence on other organs that the appearance of the first signs of pregnancy is associated. Thus, progesterone affects the nervous system, peripheral organs, etc. After some time, the production of another hormone begins - human chorionic gonadotropin, which is formed in the chorion (subsequently the chorion gives rise to the placenta). These are the two main hormones that cause signs of pregnancy to appear even before your period is missed.

Questionable signs of pregnancy

The first signs before a missed period include perverted appetite, perverted sense of smell, nausea, vomiting, drowsiness, increased fatigue, irritability, headache, frequent painless urination, increased salivation (production of saliva), frequent mood swings, increased pigmentation, decreased blood pressure below normal levels, etc.

These signs are the basis for further diagnostic search, the purpose of which is to establish the fact of pregnancy and the place of implantation (introduction) of the fertilized egg (in the uterus or outside it, in which case only intrauterine pregnancy is considered the norm).

As a rule, the first signs of pregnancy after a delay and the signs of pregnancy in the first days of a delay are not much different from each other. Let's talk about them in more detail.

Nausea and vomiting during pregnancy

What are the first signs of pregnancy before a delay? So, a woman complains of nausea in the morning, and vomiting may occur. If vomiting occurs up to 2 times a day, then this is regarded as normal, otherwise it should be considered as a symptom. early toxicosis requiring treatment. The development of these symptoms has a central mechanism, which is associated with irritation of the vomiting center in the medulla oblongata.

Various stimuli can act as strong odors, pathological condition gastrointestinal tract (chronic gastritis, enteritis, colitis). They affect the vomiting center, which becomes more sensitive during pregnancy due to the influence of progesterone.

However, nausea and vomiting can occur not only in pregnant women, but also in non-pregnant women. The cause of their appearance may be intestinal infection, gastritis, peptic ulcer, food poisoning etc. Therefore, in such cases it is necessary to carry out differential diagnosis. A urinary pregnancy test can be used for this. quantitation level of human chorionic gonadotropin in the blood and ultrasonography.

Perverted sense of smell and taste

Primary signs of pregnancy before delay also include changes in taste and olfactory preferences. Everyone knows the fact that pregnant women experience cravings for certain types of food. Most often these are herring, pickled cucumbers and tomatoes, that is, a commitment to salty and sour foods. Some women crave sweets very much during pregnancy, although they had not noticed this before. The reason for everything is the same influence of hormones on the medulla oblongata. They are rearranging his regular work.

The increased sensitivity of pregnant women to various odors leads to the appearance or intensification of nausea, so pregnant women, as a rule, do not use perfume and often ventilate the room in which they are located.

Arterial hypotension

Hypotension, or low blood pressure, is a sign of pregnancy after and before a missed period. A drop in blood pressure below normal levels is associated with the antispasmodic effect of progesterone. First of all, it manifests itself in relation to the uterus, but vascular smooth muscles are also sensitive to this influence of this hormone. Against the background of progesterone, calcium cannot contact calmodulin, which leads to the absence of actomyosin contraction of vascular smooth muscle cells.

As a result, they are constantly in a relaxed state. This phenomenon has a purely physiological orientation, as it ensures the normal development of the fetus. The vessels of a pregnant woman's body, especially the vessels of the fetoplacental system (mother-placenta-fetus system), lose the ability to respond by contraction to various damaging factors.

However, for some pregnant women such adaptive changes do not occur. This is fraught with development serious complications pregnancies, which include gestosis and placental insufficiency. The last complication is due to the fact that the placenta is not able to perform all its functions in full, and this is fraught with the development of fetal retention syndrome and its intrauterine hypoxia. Preeclampsia is a complication of pregnancy in which the body develops generalized vascular spasm and other changes leading to the appearance of edema, protein in the urine (proteinuria) and increased blood pressure. If left untreated, the consequences can be disastrous for both the mother and the fetus (death of the fetus, death of the woman, cerebral hemorrhage, massive bleeding, etc.).

Frequent urination

Frequent urination is one of the first signs of pregnancy in the first days of delay. It is important that this urination is absolutely painless, as it is associated not with pathological changes, but with hormonal changes. During pregnancy, blood flow to the urinary organs increases, micro- and macrocirculation in them increases, which leads to increased filtration of urine in the kidneys.

An increased amount of urine enters the bladder and causes it to stretch, which leads to more frequent urges to urination. Even at night, a pregnant woman has to wake up once or twice to go to the toilet.

But! It is important to know that frequent and painless urination can be a symptom of diabetes mellitus, which is also characterized by the appearance of thirst, especially after eating sweets. Pregnancy can be layered with diabetes, aggravating its course, especially if it was not previously diagnosed, therefore women at risk for pathology of carbohydrate metabolism (obesity, family history, autoimmune diseases) are necessarily prescribed a blood sugar test and glucose tolerance test, which reveals impaired glucose tolerance (this is a prestage of diabetes).

The nature of discharge during pregnancy

Usually in pregnant women, discharge from the genital tract has white look, they are thicker than before pregnancy. This nature of the discharge is associated with the influence of progesterone on the vaginal glands. The first signs of pregnancy before delay and discharge, which are described above, usually indicate the normal development of pregnancy, while the hormone content in the body is also balanced. However, in addition to leucorrhoea, pregnant women may also have bloody issues. Most often they are associated with increased uterine tone and can lead to miscarriage, which requires timely treatment. Treatment consists of prescribing antispasmodic, hemostatic (hemostatic) drugs and hormonal support in the form of prescribing duphaston, utrozhestan or progesterone.

These drugs, in addition to reducing uterine tone, have the ability to regulate immune disorders, which are very often detected during complicated pregnancy. Thus, the presence of spotting and the first signs of pregnancy before a missed period necessarily requires a thorough diagnosis in order to confirm the fact of pregnancy and begin therapy aimed at maintaining pregnancy.

However, there may also be a situation when slight bleeding from the genital tract appears during the normal course of pregnancy. This is observed when the fertilized egg (implantation) penetrates the endometrium (uterine mucosa). Most often, implantation occurs on the 6th day after fertilization. These discharges do not require treatment.

During periods of maximum implantation of the fertilized egg, spotting may resume, but it is short-lived and associated with increased enzymatic activity of the product of conception. Most often this is a sign of a second pregnancy before a missed period.

Diagnosis of pregnancy using traditional methods

Popular signs of pregnancy before delay are utopian and have no evidence base. Previously, ancestors believed that pregnancy was indicated by a metallic taste in the mouth, “vascular spiders” in the décolleté area, snoring during sleep, etc. Now, of course, pregnancy is not diagnosed on their basis.

Thus, in the first few days from the moment of fertilization, it is extremely difficult to diagnose pregnancy. This is due to the fact that exact signs There is no pregnancy before a missed period. One can only say with a certain degree of probability that a woman is pregnant. The diagnosis can be clarified after one to two weeks using modern diagnostic methods.

Home » Articles » Pregnancy » Early signs pregnancySigns of pregnancy: doubtful, probable, reliable

Women's diseases - TREATMENT ABROAD – website – 2007

To find out if a woman is pregnant ancient Egypt she was given a drink made from a special herb (I will) and the milk of a woman who gave birth to a boy. If this drink caused vomiting, then the woman was pregnant, otherwise there was no pregnancy.

To determine pregnancy, the ancient Jews forced a woman to walk on soft grass: if a deep mark remained, then pregnancy existed.

Midwives Ancient Greece already possessed considerable knowledge. Thus, to determine pregnancy they were based on a number of objective signs: absence of menstruation, lack of appetite, drooling, nausea, yellow spots on the face. At the same time, they also resorted to such ridiculous means: they rubbed a red stone in front of a woman’s eyes, and if dust got into her eyes, the woman was considered pregnant, otherwise pregnancy was denied.

Even Hippocrates (460-377 BC) had many false and erroneous ideas about pregnancy. In particular, he believed that pregnancy could be recognized by the eyes, but at the same time, he considered the cessation of menstruation to be one of the first signs of pregnancy.

From all of the above it is clear that questions have worried people since ancient times.

Soranus of Ephesus (1st century AD) established the following signs of pregnancy:

• periods are delayed
• swell mammary glands, and the vessels of the skin of the mammary glands become tortuous, acquire a bluish tint and swell
• there is a urge to vomit
• appear under the eyes dark circles and sometimes on the face yellow spots
• Over time, the belly increases and the pregnant woman begins to feel the movements of the fetus.

Today, the diagnosis of pregnancy is made on the basis of a survey, an objective examination of the woman and laboratory research methods.

Signs of pregnancy according to their diagnostic value they are divided into

• speculative
• probable, which appear relatively early
• reliable, usually detected with .

Among the presumptive (doubtful) signs pregnancies that appear early, although not in every pregnancy, but still have some diagnostic value, include the following:

• dyspeptic disorders, a feeling of heaviness in the epigastric region, salivation, nausea, morning vomiting on an empty stomach, changes in appetite or aversion to certain types of food (usually meat), the emergence of a special addiction to spicy and especially sour foods, constipation, desire to eat inedible substances, lime , chalk, clay, etc.
• functional disorders nervous system and mental health: mild irritability, increased sense of smell and hearing, tearfulness, isolation
• changes in metabolism: deposition of subcutaneous fat, especially on the abdomen, pigmentation of the nipples and areola, linea alba, and sometimes the face. The appearance of pregnancy stripes (scars).

All these signs are often found in pregnant women, but are not necessarily associated with pregnancy, and therefore are called presumptive.

To the number probable signs of pregnancy may include the following:

• cessation of menstruation in a healthy, sexually active woman of childbearing age
• congestion, bluish coloration of the mucous membrane of the vaginal opening, its walls and the vaginal part of the cervix
• an increase in the size of the uterus according to the period of delay of menstruation, a change in its regular form and consistency
• engorgement of the mammary glands and the appearance of colostrum in them.

All these signs in most cases actually characterize pregnancy, but sometimes they can also result from other reasons. For example, a delay in menstruation may be of a psychogenic nature; The cause of uterine enlargement is a growing tumor. Therefore, the listed signs of pregnancy are valuable not individually, but collectively.

To reliable (undoubted) signs of pregnancy include the following:

• identification of parts of the fetus by palpating the uterus; It is easiest to identify the round, dense part of the head, as well as the small parts of the handle and legs
• movement of the fetus, determined by the hand of the examiner
• Listening to the fetal heartbeat with a stethoscope or using a heart monitor.

These signs 100% confirm pregnancy, but are late, since they can only be noted from the end of the 4th or beginning of the 5th month of pregnancy. One of important points Diagnosis of pregnancy involves vaginal examination and palpation of the uterus, so this should be discussed in more detail.

The size of a normal non-pregnant uterus along the longitudinal axis is approximately 79 cm (in those who have not been pregnant, slightly less, in those who have given birth, slightly more). With the onset of pregnancy and during its development, the size of the uterus increases. Until the end of the third month of pregnancy, the uterus is still in the pelvic cavity and can only be felt during vaginal examination. Only after this period, no longer fitting into the small pelvis, the uterus emerges from it and can be palpated from the abdominal wall, and subsequently leads to a noticeable enlargement of the abdomen.

A normal non-pregnant uterus usually has pear-shaped, somewhat flattened in anteroposterior size. With the onset of pregnancy, in the process of its further development, the shape of the uterus changes. At first she accepts spherical shape, then somewhat asymmetrical, then again spherical and by the end of pregnancy ovoid. The acquisition of a spherical shape by the uterus, along with other signs, is very characteristic of pregnancy. A globular shape of the uterus can be observed as early as 56 weeks of pregnancy, and this shape can persist until approximately 910 weeks. Starting from 78 weeks of pregnancy, the uterus becomes asymmetrical, namely: one of its corners protrudes somewhat, as if bulging in comparison with the opposite side. The appearance of asymmetry is due to the fact that implantation of a fertilized egg in the uterine cavity usually occurs near the mouth of the tube through which the egg was transported. This feature of the shape of the uterus during this period of pregnancy was first noted by Piscacek and proposed by him as a diagnostic sign. Later, as pregnancy progresses, the asymmetry of the uterine body disappears, and then Piskacek’s symptom will no longer be detected.

Consistency with the onset of pregnancy it changes: it becomes much softer. Softening of the uterus occurs due to an increase in the size and number of muscle fibers due to the enrichment of the organ with blood, stagnation. Particular softening is noted in the area of ​​the uterine isthmus. Sometimes the softening is so pronounced that during examination the body of the uterus appears as if separated from the cervix. The second feature of the pregnant uterus is the variability of its consistency. When examining a pregnant uterus, its soft consistency is initially noted, but as the examination progresses, the uterus becomes denser. Such a change in the uterus at the time of examination is especially characteristic feature For .

Diagnose very early pregnancy usually internal obstetric examination is not always possible, since the main signs of pregnancy obtained in this case can be detected no earlier than 56 weeks of pregnancy. Before this period, pregnancy does not yet lead to noticeable changes in the uterus. Even with longer period sometimes there is no complete confidence in the accuracy of the data obtained. Meanwhile, it is often necessary to establish the presence of pregnancy before 5 weeks, for example, to perform a mini-abortion.

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

• Presumable.
• Probable.
• Reliable.

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

Presumable signs and their description

TO suggestive signs include change subjective feelings women in connection with pregnancy:

1. Nausea and vomiting. Occurs mainly in the morning on an empty stomach. Usually goes away after a light snack without getting out of bed. In the case when vomiting is repeated several times during the day, as well as from day to day and disrupts general health, it is necessary to consult a doctor, since this condition is a pathology and requires treatment (sometimes inpatient, depending on the severity);
2. Change in appetite. Often during pregnancy, a woman has a desire to eat some foods and not others. This is normal. We must remember that there are pathological taste preferences(desire to eat chalk, etc.), which may indirectly indicate certain diseases;
3. Changes in olfactory sensations(disgust for tobacco smoke, smell of alcohol);
4. Nervous system dysfunctions: 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 drug intervention;
5. Increased urination. It occurs due to pressure from the growing uterus on the bladder. As pregnancy progresses, the symptoms increase somewhat, and the urge to urinate at night appears. We must remember that urination should not be uncomfortable, much less painful (which is a sign of a urinary tract infection);
6. Appearance(on the face, nipple area). Often during pregnancy there are also striae(stretch stripes on the skin). Typically this is due to a change hormonal levels and skin characteristics and more often occurs with large fruit, polyhydramnios;
7. Increased abdominal volume due to a growing uterus.

For some women, no change in subjective sensations is observed, especially in the early stages.

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

Probable symptoms and their description

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

If menstruation is delayed, the first thing to do is based on the definition human chorionic gonadotropin(hCG is one of the pregnancy hormones) in the urine. This analysis can be carried out at home, always with a morning urine sample. In the presence of positive test(2 bright stripes) may indicate pregnancy. You can also use determination in a woman’s blood. Human chorionic gonadotropin is produced from the beginning of pregnancy, has its maximum at 11-13 weeks, and then gradually decreases. Lack of proper dynamics hCG level alarming, as it may indicate the presence or pregnancy. The levels of human chorionic gonadotropin in the blood are shown in the table.

* HCG standards are different for each laboratory. In the second half pregnancy hCG already, as a rule, no longer has important clinical significance.

It is also possible to establish the localization and dynamics of pregnancy development ultrasonography() in the early stages, which is possible already from 2.5-3 weeks of pregnancy (from approximately 5-7 days of delay). Ultrasound diagnosis is based on identifying the fertilized egg in the uterine cavity in the early stages, identifying the embryo with the presence of its heartbeat after 5-7 weeks. Also, this method allows you to differentiate between ectopic or undeveloped pregnancy. Ultrasound monitoring over time is often also important.

Reliable signs - definitely pregnant!

Signs are considered reliable; by identifying them, we can confidently say that there is a pregnancy. Most often detected in the second half of pregnancy. These include:

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

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

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

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

TO dubious signs include: changes in taste and olfactory sensations, changes in appetite, as well as objective: from the nervous system (drowsiness, irritability, autonomic reactions), the appearance age spots on the face, linea alba, nipples, nausea, vomiting.

TO probable 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 of the fertilized egg. 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, determination of the level of human chorionic gonadotropin in the blood serum is also used. 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.