(b) A primigravida usually cannot feel quickening until after 18 weeks.
(2) Once quickening has been established, the patient should be instructed
to report any instance in which fetal movement is absent for a 24-hour period.
(3)
Fetal movement early in pregnancy is frequently thought to be gas.
g. Skin Changes.
(1) Striae gravidarum (stretch marks). These are marks noted on the
abdomen and/or buttocks.
(a) These marks are caused by increased production or sensitivity to
adrenocortical hormones during pregnancy, not just weight gain.
(b) These marks may be seen on a patient with Cushing's disease or a
patient with sudden weight gain.
(2)
Linea nigra.
(a) This is a black line in the midline of the abdomen that may run from
the sternum or umbilicus to the symphysis pubis.
(b) This appears on the primigravida by the third month and keeps
pace with the rising height of the fundus.
(c)
The entire line may appear on the multigravida before the third
month.
(d) This may be a probable sign if the patient has never been pregnant.
(3) Chloasma. This is called the "Mask of Pregnancy." It is a bronze type of
facial coloration seen more on dark-haired women. It is seen after the sixteenth week of
pregnancy.
(4)
Fingernails. Some patients note marked thinning and softening by the
sixth week.
h. Fatigue. This is a common complaint by most patients during the first
trimester. Fatigue may also be a result of anemia, infection, emotional stress, or
malignant disease.
i. Positive Home Test. These tests may not always be accurate, however,
they are very effective today if they are performed properly.
MD0921
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