Diagnosing Pregnancy the Old-Fashioned Way

Probable Evidence of Pregnancy

An examiner determines that the patient is likely pregnant based on these symptoms:

• Enlargement of the abdomen, presumably due to increase in size of the uterus. The uterus can usually be felt through the abdomen after 12 weeks. This sign is more obvious in abdomens that have been "pre-stretched" with a previous pregnancy.



• Changes in the uterus (the size, shape, and consistency): When the uterus becomes soft, usually at six weeks, it is referred to as "Hegar's Sign." Softening of the cervix usually occurs at about the same time and is called "Goodell's Sign."



• Braxton Hicks contractions: These are irregular and unorganized contractions of the uterus.



• Ballottement: This is a mid-pregnancy sign in which the fetus can be pushed from the mother's abdomen and felt to bounce back.

Positive Signs of Pregnancy

These are without-a-doubt signs that you are, in fact, going to have a baby!

• Fetal heartbeat: Identification of the fetal heart beat separate and distinct from that of the mother. Distinguishing the two can be done by taking the mother's pulse while listening to the fetal heart.



• An examiner hearing blood swishing through the umbilical cord, (the "funic") is as meaningful as hearing the actual fetal heart. On the other hand, blood passing through the dilated uterine blood vessels, (the "uterine soufflé") is associated with the maternal pulse.



• Perception of fetal movement by the examiner.



• Recognition of the fetus by X-ray or ultrasound.

Of course, modern diagnostic techniques make a lot of the presumptive and probable signs and symptoms obsolete, quaint, and of historical interest only. Yet I get many questions every day in which a woman cites this symptom or that and then asks, "Can I be pregnant?" Depending on which of the three groups a woman can identify with, she will at least have an answer of some sort, whether it is: "Maybe," "Probably," or "Most definitely!"