Discoloration of the anterior vaginal wall due to vascular congestion is called?

DSSSB Public Health Nurse - 2015

Obstetrics & Gynaecology

Easy

Appeared in: DSSSB Public Health Nurse - 2015

Explanation

Chadwick's sign is the correct term for the bluish or purplish discoloration of the vaginal mucosa, cervix, and vulva.
This sign is caused by increased vascularity and hyperemia (increased blood flow) in the pelvic region, which is a physiological response to the hormonal changes of early pregnancy.
According to Williams Obstetrics, this augmented vascularity prominently affects the vagina and cervix, resulting in the characteristic violet color known as Chadwick's sign.
It is considered a presumptive sign of pregnancy and can be observed during a pelvic exam as early as 6 to 8 weeks after conception.

Option B: Osiander's sign refers to the increased pulsation felt through the lateral fornices of the vagina, which is also due to increased blood flow to the uterus. It is a palpable sign, not a visual sign of discoloration.
Option C: Goodell's sign is the significant softening of the vaginal portion of the cervix. While also caused by increased vascularity, it describes a change in tissue consistency (texture), not color.
Option D: Homan's sign is completely unrelated to the signs of pregnancy. It is a clinical sign used to assess for deep vein thrombosis (DVT), where pain in the calf is elicited upon dorsiflexion of the foot.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Presumptive signs of pregnancy as background academic context rather than a clinical decision trigger.
Recognizing presumptive signs like Chadwick's sign is a fundamental skill for nurses and midwives in early pregnancy detection during routine physical examinations.
It is crucial to differentiate these normal physiological changes of pregnancy from pathological causes of discoloration, such as bruising from trauma or inflammation from infection.
What if? If a non-pregnant patient presented with similar bluish discoloration, a nurse should consider other causes of venous congestion or cyanosis, such as a pelvic mass compressing blood vessels, and ensure further investigation is initiated.

How to Approach the Question

First, identify the key terms in the question: "discoloration," "vaginal wall," and "vascular congestion."
This is a factual recall question testing your knowledge of the specific signs of pregnancy.
Systematically review the options provided and recall the definition of each sign.
Chadwick's sign is defined as a bluish discoloration. Match this definition with the question's description.
Eliminate the other options by recalling their definitions: Osiander's sign (pulsation), Goodell's sign (softening), and Homan's sign (DVT test).
Confirm that Chadwick's sign is the correct term for a visual color change due to vascular congestion in the vagina.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 39-58