Which of the following signs is characterised by a bluish or purplish hue in the cervix, vagina and vulva during pregnancy?

Appeared in: BTSC 3 August 2025

Explanation

Chadwick's sign is the correct term for the bluish or purplish discoloration of the cervix, vagina, and vulva observed during early pregnancy.
This color change is a result of increased blood flow and congestion (hyperemia) in the pelvic region.
It is caused by elevated levels of the hormone estrogen.
This sign typically appears around 6 to 8 weeks of gestation and is considered a presumptive sign of pregnancy.

Option A: Cullen sign is bruising around the umbilicus (periumbilical ecchymosis), not the cervix or vagina.
Option B: Bryant sign is not a recognized term in obstetrics or gynecology.
Option D: Turner sign (or Grey-Turner sign) is bruising of the flanks, the area on the sides of the abdomen.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Presumptive signs of pregnancy as background academic context rather than a clinical decision trigger.
Recognizing presumptive signs of pregnancy, like Chadwick's sign, is a fundamental nursing skill that prompts further diagnostic testing (e.g., hCG tests, ultrasound) to confirm pregnancy.
It is critically important for nurses to differentiate normal physiological changes of pregnancy from pathological signs. Misinterpreting Cullen's or Turner's sign as a pregnancy-related change could delay diagnosis of a life-threatening hemorrhage.
What if? If a woman with a positive pregnancy test presents with abdominal pain and Cullen's sign, this is a medical emergency. It strongly suggests a ruptured ectopic pregnancy, requiring immediate surgical intervention, rather than being a normal finding.

How to Approach the Question

This is a factual recall question that tests your knowledge of the signs of pregnancy.
First, carefully read the question stem and identify the key description: 'bluish or purplish hue in the cervix, vagina and vulva during pregnancy'.
Next, evaluate each option based on your knowledge of medical terminology.
Recall the definition of Chadwick's sign as the bluish discoloration of the pelvic organs in early pregnancy due to increased vascularity.
Eliminate the other options by recalling their definitions: Cullen sign (periumbilical bruising), Turner sign (flank bruising), and recognizing that Bryant sign is an orthopedic term.
Select the option that directly matches the description provided in the question.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 39-58

Practise the full BTSC 3 August 2025

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