(4) Frequent urination is not a definite sign since other factors can be
apparent (such as tension, diabetes, urinary tract infection, or tumors).
d. Breast Changes.
(1) In early pregnancy, changes start with a slight, temporary enlargement
of the breasts, causing a sensation of weight, fullness, and mild tingling.
As pregnancy continues the patient may notice:
(a) Darkening of the areola--the brown part around the nipple.
(b) Enlargement of Montgomery glands--the tiny nodules or sebaceous
glands within the areola.
Increased firmness or tenderness of the breasts.
(d) More prominent and visible veins due to the increased blood
(e) Presence of colostrum (thin yellowish fluid that is the precursor of
breast milk). This can be expressed during the second trimester and may even leak out
in the latter part of the pregnancy.
(3) These breast changes can be more positive if the patient has not
recently delivered and is not presently breastfeeding.
e. Vaginal Changes.
(1) Chadwick's sign. The vaginal walls have taken on a deeper color
caused by the increased vascularity because of increased hormones. It is noted at the
sixth week when associated with pregnancy. It may also be noted with a rapidly
growing uterine tumor or any cause of pelvic congestion.
(2) Leukorrhea. This is an increase in the white or slightly gray mucoid
discharge that has a faint musty odor. It is due to hyperplasia of vaginal epithelial cells
of the cervix because of increased hormone level from the pregnancy. Leukorrhea is
also present in vaginal infections.
f. Quickening (Feeling of Life).
(1) This is the first perception of fetal movement within the uterus. It usually
occurs toward the end of the fifth month because of spasmodic flutter.
(a) A multigravida can feel quickening as early as 16 weeks.