Page 122 - ترم ثاني كتاب تمريض صحة الام الكتروني
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− 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.
3. Fetal signs:
− Ballottement: this sign depend on the presence of a solid body, that is the fetus
moving in a fluid medium (the amniotic fluid).
4. Appearance of striae gravidarum and Linea nigra.
(III) Special investigations
Done in doubtful cases because diagnosis of pregnancy is usually easy in the second
trimester.
a. Pregnancy tests.
th
b. Sonar or X-ray examination: the latter shows parts of fetal skeleton at 16 week
th
and the whole skeleton at 24 week. Sonar is preferred to avoid hazards of
irradiation. In fact X-ray examination is resorted to if ultrasound is not available.
Diagnosis in the third trimester (29-40 weeks)
The diagnosis is easy because all the sure signs of pregnancy are present and these
are:
1- Palpation of fetal parts
2- Palpation of fetal movements.
3- Hearing of FHS
4- Hearing of umbilical soufflé.
5- Seeing fetal skeleton by sonar or X-ray.
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