If a woman of reproductive age presents with a missed menstrual period, and she was not diagnosed with absolute infertility, the doctor should consider the possibility of her being pregnant.
4.1. HISTORY
Early detection of pregnancy was a major concern from ancient times. In Ancient Egypt a pregnancy test involved giving a woman some crushed melon mixed with the milk of a woman who had born a male child. If the concoction made her sick, she was considered pregnant. Ancient Jews made a woman walk on soft grass to find out if she was pregnant. In their opinion, a woman with a child left deeper imprints. Midwives of Ancient Greece showed considerable knowledge on the subject; they based their decision about pregnancy on absence of menstruation, low appetite, salivation, nausea, emergence of yellow spots on the face. Hippocrates (460-377 BC) (Fig. 4.1) believed a missed period to be the first sign of pregnancy.
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Fig. 4.1. Hippocrates (460-377 BC)
Soranus of Ephesus (1st century AD) established the following signs of pregnancy: delayed menstruation, engorgement of mammary glands, cutaneous vessels of the breast become convoluted acquiring a bluish coloration; there is an urge to vomit; there are dark circles under the eyes and sometimes yellow spots on the face; the abdomen distends in the course of time, and the pregnant woman can feel the fetus moving inside.
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From the obstetric point of view, early diagnostics of pregnancy is necessary for the optimum management of the patient.
Clinical examination of a pregnant or puerperal woman involves findings of the woman's family, medical and reproductive history, general somatic and special obstetric investigations.
Upon early diagnostics of pregnancy the doctor has a number of advantages: