What is asymmetrical enlargement of uterus in lateral implantation is called?

Appeared in: KPSC Staff Nurse - 2021

Explanation

Piskacek's sign is the term for the asymmetrical, irregular, and softened enlargement of the uterus that occurs in early pregnancy.
This uneven shape is caused by the implantation of the embryo in the lateral wall or one of the cornua (corners) of the uterus.
The area of implantation grows more rapidly than the rest of the uterus, creating a palpable bulge on one side.
It is typically detected during a bimanual examination around 7-8 weeks of gestation.

Option A: Hegar's sign is the softening of the uterine isthmus (the lower uterine segment), not an asymmetrical enlargement of the uterus.
Option B: Osiander's sign refers to the increased pulsation felt in the lateral vaginal fornices due to increased uterine blood flow. It is a vascular sign, not a change in uterine shape.
Option D: Palmer's sign involves regular, rhythmic, painless uterine contractions felt during a bimanual examination. It relates to uterine activity, not its shape.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Probable signs of early pregnancy as background academic context rather than a clinical decision trigger.
Recognizing these probable signs of pregnancy is a key skill for nurses and midwives during early antenatal assessment to establish a presumptive diagnosis of pregnancy.
It is crucial to remember that these are probable signs, not positive (conclusive) signs. They strongly suggest pregnancy but can also be caused by other conditions like uterine fibroids, which necessitates confirmation with positive signs like ultrasound visualization of the fetus.
What if? If the uterine enlargement was symmetrical and soft, it would be a general probable sign of pregnancy, but not specifically Piskacek's sign. If the uterus felt hard and irregularly enlarged, conditions like uterine fibroids would be a more likely differential diagnosis.

How to Approach the Question

This is a factual recall question testing knowledge of obstetrical terminology.
First, identify the key descriptor in the question stem: 'asymmetrical enlargement of uterus.'
Next, systematically review the definitions of the four signs provided as options.
Recall that Hegar's sign is about softening of the isthmus, Osiander's sign is about vaginal pulsation, and Palmer's sign is about uterine contractions.
Recognize that Piskacek's sign specifically describes an uneven or asymmetrical shape of the uterus due to lateral implantation.
Match the key descriptor from the question to the correct definition to select the answer.

Concept Tested & Keywords

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

Practise the full KPSC Staff Nurse - 2021

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