By Paul John A. Vesagas, R.N., R.M.
Careline

IF YOU are an expectant mother, you’ve probably heard of over-the-counter pregnancy tests which are easily purchased from the nearest pharmacies. You may be thrilled to try it in order to confirm your suspicion of child-bearing, especially if it is planned, anticipated or wanted.

On the other hand, if the pregnancy is unplanned or unexpected, the desire may be borne beyond pricking that lingering curiosity. But don’t get your hopes too high as these do-it-yourself pregnancy kits may not really be conclusive in confirming or ruling out pregnancies and these handy tools aren’t as accurate as they may seem depending on certain circumstances.

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You may have missed your period this month and have been experiencing morning sickness, frequent urination and food cravings for some time but again these are poor indicators of pregnancy. The truth is you can have all the signs and symptoms of early pregnancy and yet you are far from being pregnant. Conversely, you can also have only a few of these signs and turn our definitely pregnant. So it all boils down to a single question, “How then do we know if a woman is pregnant or not?”

Actually, pregnancy is diagnosed based on both the signs and symptoms reported by the woman and the signs elicited by the health care provider—doctor or nurse-midwife. Furthermore, these signs and symptoms are classified into three groups: Presumptive, Probable and Positive.

Presumptive Signs of pregnancy are the least indicative of pregnancy as these could also indicate health conditions other than child-bearing. They are largely subjective and the examining doctor or nurse-midwife cannot quantify objectively the signs reported by the woman. An example would be the absence of menstruation. One needs not enroll in Obstetrics to understand that a pregnant woman does not menstruate beginning the course of her pregnancy. However, a woman may have missed her menstrual period if she is in fatigue, stress, or having hormonal problem causing transient delay of menses. Also, if the mother has been breastfeeding, it could also delay the return of menses after giving birth. Another example would be morning sickness or the nausea and vomiting reported by pregnant mothers early morning that occurs some time in between two to eight weeks after possible conception.

Now, it is important to bear in mind that conditions like food poisoning, tension, infection and a variety of disease may mimic the morning sickness experienced by pregnant mothers. Other conditions classified here include frequent urination, tingling, tender and swollen breasts, feeling fatigue all the time, enlargement of the uterus, appearance of melasma (areas of increased pigmentation on the face) and darkening of the skin from navel to pubis. I think the most rather deceiving presumptive sign would be a fetal movement felt by the woman that occurs during the 18th week of pregnancy.

Probable Signs of pregnancy are much like the presumptive signs described previously but they differ in such a way that they can be documented objectively by the examining doctor or nurse-midwife.

Unfortunately, they are still not positive in nature or diagnostic of pregnancy as they may also suggest other conditions. Examples include the softening of the uterus and cervix as palpated by the doctor or nurse-midwife 2-8 weeks post conception. Although these could be a more indicative of pregnancy still, they are not absolute signs as they may simply indicate a delay in the menstrual period. Intermittent painless contractions may also be felt by both the woman and the examiner but these may also be due to bowel contractions or simply periodic uterine tightening.

Perhaps the most famous example of probable signs would be the pregnancy tests utilizing samples of blood or urine which are done either in the laboratories or at home—in the case of OTC pregnancy kits. Regardless of the woman’s preference, these tests measure the level of a certain hormone—Human Chorionic Gnoadotropin (hCG)—produced by pregnant mothers. Should she opt for blood tests, results are almost 100% accurate as far as the existence of hCG hormone is concerned in contrast to urine tests which could yield a false-positive or false-negative results depending on certain circumstances.

But should results be positive upon the initial testing whether you are convinced or not, it is wise to start taking all precautionary measures as if you are pregnant. In that way, should you be positively pregnant as confirmed by your doctor, you would not have done anything which might prove deleterious to the health of the fetus like taking medications, drinking alcohol, smoking, etc…

If in the previous signs of pregnancy other conditions may cloud the diagnosis of pregnancy, the opposite holds true for Positive signs as no other conditions could mimic its existence. A woman is said to be positively pregnant if the doctor or nurse-midwife hears a fetal heartbeat upon auscultation, feels the fetus move and visualizes the fetus with the aid of an ultrasound. I guess the only drawback of eliciting for positive signs is the waiting time involved before the signs begin to surface. It takes at least a month for the embryo (soon-to-be fetus) to be visualized accurately via ultrasound. Similarly, it takes at least 10 weeks for heartbeat to be audible depending on the device used to hear it. Looking at the brighter side, waiting for the positive signs may prove worthwhile as they spare you all the worries of uncertainties.

So next time when a woman comes marching in the clinic asking whether she’s pregnant or not for as long as the positive signs have not yet surfaced, the safest answer would definitely be “MAYBE”.

(paul_careline@live.com).