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Chapter 4. Diagnostics of pregnancy. Bstimation of gestational age and expected date of delivery. Methods of examination

If a woman of reproductive age presents with a missed menstrual period, and she was not diagnosed with absolute infertility, the doctor should consider the possibility of her being pregnant.

4.1. HISTORY

Early detection of pregnancy was a major concern from ancient times. In Ancient Egypt a pregnancy test involved giving a woman some crushed melon mixed with the milk of a woman who had born a male child. If the concoction made her sick, she was considered pregnant. Ancient Jews made a woman walk on soft grass to find out if she was pregnant. In their opinion, a woman with a child left deeper imprints. Midwives of Ancient Greece showed considerable knowledge on the subject; they based their decision about pregnancy on absence of menstruation, low appetite, salivation, nausea, emergence of yellow spots on the face. Hippocrates (460-377 BC) (Fig. 4.1) believed a missed period to be the first sign of pregnancy.

Fig. 4.1. Hippocrates (460-377 BC)

Soranus of Ephesus (1st century AD) established the following signs of pregnancy: delayed menstruation, engorgement of mammary glands, cutaneous vessels of the breast become convoluted acquiring a bluish coloration; there is an urge to vomit; there are dark circles under the eyes and sometimes yellow spots on the face; the abdomen distends in the course of time, and the pregnant woman can feel the fetus moving inside.

From the obstetric point of view, early diagnostics of pregnancy is necessary for the optimum management of the patient.

Clinical examination of a pregnant or puerperal woman involves findings of the woman's family, medical and reproductive history, general somatic and special obstetric investigations.

Upon early diagnostics of pregnancy the doctor has a number of advantages:

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