Softening of the lower uterine segment just above the cervix is called

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2023

Obstetrics and Midwifery Nursing

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2023

Explanation

Hegar's sign is a probable sign of pregnancy characterized by the softening and compressibility of the lower uterine segment or isthmus.
This sign is elicited during a bimanual pelvic examination, where the examiner can feel the softened isthmus between the fingers in the vagina and the hand on the abdomen.
The softening is so pronounced that the cervix and the body of the uterus may feel like separate structures.
It is typically detectable between the 6th and 8th weeks of gestation.

Option B: Chadwick's sign refers to a color change, not a change in tissue consistency. It is the bluish or purplish discoloration of the cervix, vagina, and vulva.
Option C: Osiander's sign relates to vascular pulsation, not softening. It is the increased pulsation felt in the lateral vaginal fornices due to increased blood flow to the uterus.
Option D: Palmer's sign refers to uterine contractions, not the consistency of a specific uterine segment. It describes regular, rhythmic uterine contractions that can be felt during a bimanual examination in early pregnancy.

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 Hegar's sign, is a fundamental skill in antenatal care. It helps in forming a presumptive diagnosis of pregnancy, prompting further confirmatory tests.
It is crucial for nurses to understand that Hegar's sign, along with other probable signs, is not definitive proof of pregnancy. Conditions like uterine fibroids can sometimes mimic this sign. Confirmation requires positive signs such as ultrasound visualization of the fetus or detection of a fetal heartbeat.
What if? - If a woman presents with Hegar's sign but her urine pregnancy test is negative and she has irregular bleeding, the nurse should consider other gynecological conditions like a soft uterine fibroid or adenomyosis and facilitate further investigation, rather than assuming a non-viable pregnancy.

How to Approach the Question

This is a factual recall question that tests knowledge of obstetrical terminology.
First, identify the key phrase in the question stem: "softening of the lower uterine segment just above the cervix."
Next, systematically review each option and recall its definition.
Option A, Hegar's sign, is defined as the softening of the lower uterine segment.
Option B, Chadwick's sign, is a color change (bluish discoloration).
Option C, Osiander's sign, is an increased pulsation.

Concept Tested & Keywords

QHkOIaKrserPGAzJfGS8sS

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

E6 Obstetrics Williams p. 10-27