The nurse is aware that an adaptation of pregnancy is increased blood supply to pelvic region thatresults purplish discoloration of vaginal mucosa known as?

1. A

   Ladin's sign

2. B

   Hegar's sign

3. C

   Goodell's sign

4. D

   Chadwick sign

Appeared in: Tripura CHO - 2021

Explanation

• Chadwick's sign is the correct term for the purplish-blue discoloration of the vaginal mucosa, cervix, and vulva.
• This color change is a direct result of increased blood flow and vascular congestion (hyperemia) in the pelvic tissues.
• It is caused by elevated levels of estrogen during early pregnancy.
• This sign is considered a presumptive sign of pregnancy and is typically observed by a healthcare provider during a pelvic examination around the 6th to 8th week of gestation.

Why Other Options Were Wrong

• Option A: Ladin's sign refers to a change in the texture (softening) of the uterus, specifically at the anterior midline where the uterus and cervix meet. It does not describe a color change.
• Option B: Hegar's sign is the softening of the lower uterine segment (the isthmus), which can be felt during a bimanual examination. It is a change in consistency, not color.
• Option C: Goodell's sign is the softening of the cervix itself. The cervix changes from a consistency similar to the tip of the nose to the softness of the lips. This is a tactile finding, not a visual color change.

Related Visual

Clinical Relevance

• Nursing practice connection: Knowing Presumptive signs of pregnancy helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
• Recognizing Chadwick's sign is a key assessment skill for nurses and midwives. It is one of the earliest clinical indicators of pregnancy, prompting further evaluation and patient counseling.
• While a normal finding in pregnancy, a bluish cervix in a non-pregnant patient could indicate pelvic congestion due to other causes, such as a pelvic mass, and warrants further investigation.
• Educating patients about these normal physiological changes can reduce anxiety and help them understand their bodies during pregnancy.

How to Approach the Question

• First, identify the key clinical finding described in the question stem: "purplish discoloration of vaginal mucosa."
• Recognize that the question is asking to name a specific sign of pregnancy.
• Mentally review the common presumptive and probable signs of pregnancy.
• Differentiate the signs based on the type of change (color vs. texture) and the anatomical location.
• Ladin's, Hegar's, and Goodell's signs all describe a softening of different parts of the uterus or cervix.
• Chadwick's sign is the only option that describes a color change (purplish/bluish) due to increased vascularity.

Concept Tested & Keywords

• Concept Tested: Presumptive signs of pregnancy
• Stem keywords: adaptation of pregnancy, increased blood supply, pelvic region, purplish discoloration, vaginal mucosa
• Lead-in keywords: known as
• Negative lead-in flag: false

Question ID

QAKm_PFUTdeypwHyXGrRzj

Copy ID

Reference Book

E6 Obstetrics Williams p. 39-58

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