Which of the following is/are the confirmatory/positive signs of pregnancy?

DSSSB October 2024

Obstetrics and Midwifery Nursing

Easy

Appeared in: DSSSB October 2024

Explanation

Auscultation of fetal heart sounds is a positive sign of pregnancy, providing definitive, objective proof of a fetus.
Positive signs are those that are directly attributable to the fetus and cannot be caused by any other physiological or pathological condition.
Other positive signs include visualizing the fetus via ultrasound and an examiner palpating distinct fetal movements.

Option A: Amenorrhea (missed period) and morning sickness are presumptive signs. They are subjective symptoms reported by the woman and can be caused by other factors like stress, hormonal imbalances, or gastrointestinal issues.
Option B: Breast discomfort and fatigue are also presumptive signs. While very common in early pregnancy, they are non-specific symptoms that can occur with many other conditions.
Option C: Goodell's sign (softening of the cervix) and Chadwick's sign (bluish discoloration of the vagina/cervix) are probable signs. Although they are objective findings on examination, they can be caused by other conditions that increase pelvic vascularity, such as pelvic congestion or tumors.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of signs of pregnancy (Presumptive, Probable, and Positive) as background academic context rather than a clinical decision trigger.
Accurate patient education is crucial. A nurse must explain that while a missed period and a positive home test are strong indicators, only positive signs confirm pregnancy, which guides appropriate counseling and initiation of prenatal care.
Understanding this classification helps the nurse in differential diagnosis. If a patient has presumptive/probable signs but negative positive signs, other causes must be investigated, such as an ectopic pregnancy, hydatidiform mole, or non-pregnancy-related issues.
What if? A patient calls the clinic excited about a positive home pregnancy test (a probable sign) but is also experiencing sharp, one-sided pelvic pain. The nurse's priority shifts from simply confirming pregnancy to screening for a potential ectopic pregnancy, which is a medical emergency.

How to Approach the Question

First, identify the core of the question: It asks for 'confirmatory/positive' signs of pregnancy.
Recall the three categories of pregnancy signs: Presumptive, Probable, and Positive.
Define each category in your mind. Presumptive signs are what the woman feels (subjective). Probable signs are what the examiner sees but could have other causes (objective but not definitive). Positive signs are undeniable proof of a fetus (definitive).
Analyze each option and classify it. Options A and B are subjective symptoms, making them presumptive.
Option C lists clinical signs (Goodell's, Chadwick's) that are objective but not 100% specific to pregnancy, making them probable.
Option D, hearing a fetal heartbeat, is direct evidence of a fetus that cannot be faked or caused by another condition. This is a positive sign.

Concept Tested & Keywords

Concept Tested: Classification of signs of pregnancy (Presumptive, Probable, and Positive)
Stem keywords: confirmatory signs, positive signs, pregnancy
Lead-in keywords: Which

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