On the first prenatal visit, examination of the woman’s internal genitalia reveals a bluish coloration of the cervix and vaginal mucosa. The nurse documents this finding as:
A.
Chadwick’s sign
B.
Goodell’s sign
C.
Hegar’s sign
D.
Homan’s sign
The Correct Answer and Explanation is:
The correct answer is A. Chadwick’s sign.
Explanation:
Chadwick’s sign is a clinical indicator observed during the early stages of pregnancy. It refers to the bluish or purplish discoloration of the cervix, vaginal mucosa, and sometimes the vulva. This color change is due to increased blood flow and vascular congestion in the pelvic area, which occurs as a result of elevated levels of estrogen during pregnancy. The increased blood flow makes the mucous membranes in these areas appear darker than usual.
Chadwick’s Sign:
- Timing: Chadwick’s sign typically appears around the 6th to 8th week of pregnancy, although it can be seen a bit earlier or later.
- Significance: This sign is one of the earliest physical indications of pregnancy and is often noted during a pelvic examination. It is a result of the physiological changes that occur in response to pregnancy, particularly the increased vascularity of the pelvic organs.
- Clinical Relevance: The presence of Chadwick’s sign helps healthcare providers confirm pregnancy and assess the progression of early gestational changes. However, it is not definitive on its own and should be considered alongside other diagnostic methods, such as a urine pregnancy test or ultrasound.
Differentiation from Other Signs:
- Goodell’s Sign: Refers to the softening of the cervix, which usually becomes noticeable around the 4th to 6th week of pregnancy. This sign is also a result of increased blood flow and hormonal changes, but it is different from Chadwick’s sign in that it involves cervical texture rather than color.
- Hegar’s Sign: This sign involves the softening of the lower uterine segment and is usually detectable around the 6th to 12th week of pregnancy. It is important for assessing the early changes in the uterine structure but does not pertain to the coloration of the cervix or vaginal mucosa.
- Homan’s Sign: This is a test used to detect deep vein thrombosis (DVT) and involves dorsiflexing the foot to see if it causes pain in the calf. It is not related to pregnancy signs.
In summary, Chadwick’s sign is a classic early sign of pregnancy related to the bluish discoloration of the cervix and vaginal mucosa due to increased blood flow.