The Common Vein Copyright 2010
Introduction
The diagnosis of pregnancy begins with a clinical history.
History
“When was your last menstrual period?”
A missed menstrual period is often the first sign of pregnancy. When a woman becomes pregnant, the last menstrual period is also used to determine the approximate due date.
“Have you recently experienced any nausea/vomiting?
Breast fullness/tenderness?
Increase in urinary frequency?”
These all may be symptoms of early pregnancy.
A full medical history and physical is necessary when evaluating a woman who may be pregnant. A menstrual history, sexual history, and history pf past pregnancies is also an important part of the evaluation.
“Have you ever been pregnant?
How many times?
How many children do you have?”
Doctors usually abbreviate a woman’s obstetrical history using the GP abbreviation. G stands for gravida and indicates the number of pregnancies. P stands for para and represents the number of births. For example, a woman who has one child and is pregnant for the second time would be G2P1. An expanded abbreviation using more numbers may also be used to give further detail.
“Have you ever had a problem during pregnancy?
Have you ever had a miscarriage or lost a pregnancy?”
In the expanded abbreviation the G is still followed by the number of pregnancies, and the P is followed by four numbers: the number of term births, the number of premature births, the number of spontaneous or elective abortions, and the number of living children. For example the aforementioned pregnant woman with one living child born at term would be G2P1001.
Laboratory Testing:
A urine or serum HCG test is a reliable test for pregnancy and will be positive around the time of a woman’s missed menstrual period.
Using transvaginal ultrasound the sac may be seen at ß-hCG levels as low as 800 mIU/mL, but should be identified by identified when the level is 2,000 mIU/mL. (Paul)
Using transabdominal technique the gestational sac should be visualized when the at ß-hCG levels is approximately 3,600 mIU/mL (Nyberg, Dashefsky)
Imaging:
Ultrasound
A gestational sac may appear on ultrasound as soon as 5 weeks into gestation and confirms the diagnosis of pregnancy.