During pregnancy, the purplish discoloration of the vaginal mucosa is known as?

Appeared in: BSF Staff Nurse - 2015

Explanation

Chadwick's sign refers to the bluish or purplish discoloration of the vaginal mucosa, cervix, and vulva.
This sign appears in early pregnancy, typically around 6 to 8 weeks of gestation.
The discoloration is caused by increased blood flow (venous congestion or hyperemia) to the pelvic organs due to rising estrogen levels.
It is considered a probable sign of pregnancy, meaning it is a strong indicator but not definitive proof.

Option A: Hegar's sign is the softening and compressibility of the lower uterine segment (the isthmus), not a color change of the vaginal mucosa.
Option C: Ladin's sign is the softening of a spot on the anterior midline of the uterus at the junction of the uterus and cervix. It is a sign of softening, not discoloration.
Option D: Goodell's sign is the softening of the cervix itself. The cervix changes from a firm consistency (like the tip of the nose) to a soft one (like the lips), but this is a change in texture, not 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.
Recognizing the probable signs of pregnancy, like Chadwick's sign, is a fundamental skill for nurses during initial prenatal assessments. It helps in forming a presumptive diagnosis of pregnancy before it is confirmed by positive signs.
Nurses should educate patients that while these signs are highly suggestive of pregnancy, they are not conclusive. This manages patient expectations and emphasizes the need for confirmatory tests like ultrasound.
What if? If a non-pregnant patient presents with a bluish cervix (Chadwick's sign)? The nurse should recognize this as a sign of pelvic venous congestion, which could be caused by conditions like a pelvic tumor or inflammation, and ensure the patient is referred for further gynecological evaluation.

How to Approach the Question

First, identify the key clinical finding described in the question stem, which is 'purplish discoloration of the vaginal mucosa'.
Next, recall the definitions of the four signs of pregnancy listed in the options.
Differentiate between the signs based on whether they describe a change in color or a change in texture (softening).
Chadwick's sign is specifically related to a color change (bluish-purple) due to increased vascularity.
Hegar's, Ladin's, and Goodell's signs all relate to the softening of different parts of the uterus or cervix.
Match the finding of 'purplish discoloration' to its correct term, which is Chadwick's sign.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 39-58

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

Practise the full BSF Staff Nurse - 2015

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