Page 102 - كتاب تمريض نسا الاكتروني

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Diagnosis in the second trimester (13-28 weeks)

(I) Symptoms

1. Amenorrhea

2. Breast symptoms which become more marked.

3. Quickening: it is the first time at which the mother feels movements. In

multigravida, it usually occurs between the 16th and 18th week. In

primigravidae, it usually occurs between the 18th and 20th. This difference is

due to previous experience. The intestinal movements may be mistaken for fetal

movements.

4. Progressive abdominal enlargement.

 Morning sickness and frequency of micturition normally disappear after the 12th

week.

(II) Signs

1. Breast signs

2. Uterine signs:

− The uterus is felt abdominally as a soft or cystic swelling with a convex upper
border. It undergoes intermittent contractions which can be felt by abdominal

palpation (Braxton Hicks contractions).

− Uterine soufflé: it is soft blowing sound synchronous with the maternal pulse.

It is due to flow of blood in the dilated uterine arteries (may be heard in

presence of fibroids). It is usually heard near the lower part of the uterus.

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