Pregnancy uterine (definition of the term)

Pregnancy uterine (definition of the term). To determine the duration of pregnancy and the date of delivery, use information about the time of the last menstruation, the date of the first fetal movement and the data of an objective examination of the pregnant woman. - A normal pregnancy lasts 280 days, i.e. 40 weeks, or 10 obstetric months, counting from the first day of the last menstruation. In some women, pregnancy may last less or more than this period (see Pregnancy postponed).

Determination of the gestational age by the size of the uterus: 1) at 6 weeks, the uterus is somewhat enlarged, spherical, there are signs of Snegirev, Genter, Horwitz-Geghar; 2) at 8 weeks the uterus reaches the size of a female fist, its bottom at symphysis level, Piskachek's sign appears; 3) at 12 weeks, the uterus is the size of a male fist, its bottom is one finger above the symphysis; 4) at 16 weeks the bottom of the uterus is in the middle of the distance between the bosom and the navel; 5) at 20 weeks noticeably increases the abdomen, the bottom of the uterus is located two fingers below the navel, there are movements of the fetus and his heart tones are heard; 6) at 24 weeks of the uterus at the navel; 7) at 28 weeks the bottom of the uterus by two transverse fingers above the navel; 8) at 32 weeks, the umbilicus is flattened, the uterus bottom is defined between the navel and the xiphoid process; 9) at 36 weeks the bottom of the uterus reaches the xiphoid process and costal arches; 10) at 40 weeks the bottom of the uterus descends to the level that was in the 32-week pregnancy. In primiparas, the head is fixed in the pelvic inlet, whereas in the moles, it remains mobile above the entrance to the pelvis.

For practical obstetrics, the diagnosis of 32 weeks of pregnancy is very important, since during this period pregnant women receive prenatal leave. This term can be determined by the date of the last menstruation, the first movement of the fetus (at 20 weeks in the primiparous and in 18 weeks in the re-parent), the size of the uterus at the first appearance in the antenatal clinic (in the early appearance the diagnosis is more accurately established). In addition, the height of the uterus above the womb, the ratio of the presenting part to the entrance to the small pelvis, the length of the fetus measured by the tasometer, the size of the frontal-anatomical size, the abdominal circumference, the biparietal size of the fetal head, measured with ultrasound, are taken into account.

The most simple way to establish a period of antenatal (and postpartum) leave is to use a special calendar (Table 15).

Various formulas are proposed for determining the duration of pregnancy. The formula of Skulsky:
X = (2L-5) / 5
Where X - the desired period of pregnancy; L is the length of the fetus in centimeters in the uterus when measured with a tazometer; 2 - coefficient of doubling; 5 (numerator) -the thickness of the walls of the abdomen and the walls of the uterus in centimeters; 5 (in the denominator) is the number by which the length of the fetus is divided to obtain the gestation period. For example:
X = (2x22.5 -5) / S = 40/5 = 8
Where 8 is the number of obstetric months, or 32 weeks of pregnancy.

Rules of using the calendar. First, the date of the first day of the last menstruation is established in the pregnant woman, and then the necessary dates are found on the same line. For example, at the beginning of menstruation, 20.07 prenatal leave for 56 days should be given from 01.03, and delivery expects 26.04. If the birth is normal, the woman should start working after 56 days of 21.06, and with pathological births - 05.07.