Increased pulsation felt in the lateral vaginal fornices due to marked vascularity is?

Appeared in: HPSSC - 2015

Explanation

Osiander's sign is a probable sign of pregnancy characterized by a palpable, increased pulsation in the lateral vaginal fornices.
This pulsation is due to the marked increase in blood flow through the uterine arteries in early pregnancy.
It is typically detectable by a healthcare provider during a bimanual examination around the 8th week of gestation.

Option A: This is the softening of the lower uterine segment (isthmus), not a pulsation.
Option C: This refers to the bluish or purplish discoloration of the vaginal mucosa and cervix due to venous congestion.
Option D: This is known as Goodell's sign, which is the softening of the cervix itself, not a pulsation in the fornices.

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.
Understanding the probable signs of pregnancy is essential for early assessment, though they are not definitive proof. They are primarily historical signs used before the advent of modern testing.
These signs, caused by hormonal changes and increased vascularity, prompt further investigation with positive signs like ultrasound or serum hCG testing to confirm pregnancy.
While these signs strongly suggest pregnancy, they can also be present in other conditions causing pelvic congestion, such as uterine fibroids or pelvic inflammatory disease.

How to Approach the Question

This is a factual recall question testing knowledge of obstetrical terminology.
First, identify the key phrase in the question: 'increased pulsation... in the lateral vaginal fornices'.
Next, recall the definitions of the different named signs of pregnancy provided in the options.
Match the key phrase 'pulsation in the fornices' to its correct definition, which is Osiander's sign.
Differentiate this from other signs: Hegar's (softening of the lower uterine segment), Jacquemier's/Chadwick's (color change), and Goodell's (softening of the cervix).

Concept Tested & Keywords

Concept Tested: Probable signs of pregnancy
Stem keywords: Increased pulsation, lateral vaginal fornices, marked vascularity
Lead-in keywords: is

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 7-12

Practise the full HPSSC - 2015

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