Bluish discolouration of cervix during pregnancy?

Appeared in: VSSC Nursing Officer - 2021

Explanation

Chadwick's sign is the correct term for the bluish or purplish discoloration of the cervix, vagina, and vulva.
This color change is caused by increased vascularity (hyperemia) and venous congestion in the pelvic tissues due to the hormonal changes of early pregnancy.
It is one of the probable signs of pregnancy, typically observable by an examiner from about the 6th to 8th week of gestation.

Option A: Jacquemier's sign specifically refers to the bluish or purplish discoloration of the vaginal mucosa. While it is very similar to and often used interchangeably with Chadwick's sign, Chadwick's sign is the more encompassing term that includes the cervix and vulva.
Option B: Hegar's sign refers to the softening and compressibility of the lower uterine segment (the isthmus), which is a change in tissue consistency, not color. It is detected during a bimanual pelvic examination.
Option D: Goodell's sign is the significant softening of the vaginal portion of the cervix. This is a change in the texture of the cervix (from the consistency of the tip of the nose to that of the lips), not a change in color.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Probable signs of pregnancy as background academic context rather than a clinical decision trigger.
It is crucial for nurses to differentiate between presumptive, probable, and positive signs of pregnancy for accurate patient assessment and education.
While probable signs like Chadwick's sign strongly suggest pregnancy, they are not definitive. Conditions like hormonal imbalances or pelvic congestion can mimic these signs.
A positive pregnancy test (detecting hCG) combined with probable signs strengthens the diagnosis, but only positive signs (fetal heart sounds, ultrasound visualization, or fetal movement felt by an examiner) confirm it.

How to Approach the Question

First, identify the key phrase in the question: "bluish discolouration of cervix".
This is a factual recall question that tests knowledge of the specific medical terms for signs of pregnancy.
Review the options provided, which are all named signs associated with pregnancy.
Recall or look up the definition of each sign: Jacquimer's (vagina), Hegar's (lower uterine segment softening), Chadwick's (cervix/vagina/vulva discoloration), and Goodell's (cervix softening).
Match the key phrase "bluish discolouration of cervix" to its correct corresponding term, which is Chadwick's sign.
Confirm the other options are incorrect by comparing their definitions to the question's description.

Concept Tested & Keywords

QoZ3DJ4KtSm0zSEk2fWQoy

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 6-11

E6 Obstetrics Williams p. 39-58

Practise the full VSSC Nursing Officer - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.