Confirming diagnosis Alkaline pH of fluid collected from the posterior fornix turns Nitrazine paper deep blue. (The presence of blood can give a false-positive result.) If a smear of fluid is placed on a slide and allowed to dry, it takes on a fernlike pattern due to the high sodium and protein content of amniotic fluid.
Staining the fluid with Nile blue sulfate reveals two categories of cell bodies. Blue-stained bodies represent shed fetal epithelial cells, while orange-stained bodies originate in sebaceous glands. Incidence of prematurity is low when more than 20% of cells stain orange.
Physical examination also determines the presence of multiple pregnancies. Fetal presentation and size should be assessed by abdominal palpation (Leopold’s maneuvers).
Other data determine the fetus’s gestational age:
❑ historical: date of last menstrual period, quickening
❑ physical: initial detection of unamplified fetal heart sound, measurement of fundal height above the symphysis, ultrasound measurements of fetal biparietal diameter
❑ chemical: tests on amniotic fluid, such as the lecithin-sphingomyelin (L/S) ratio (an L/S ratio greater than 2 indicates pulmonary maturity); foam stability (shake test) also indicates fetal pulmonary maturity. Presence of phosphatidylglycerol (PG) in the fluid indicates that respiratory distress is unlikely.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Premature labor:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Premature labor is confirmed by the combined results of prenatal history, physical examination, presenting signs and symptoms, and ultrasonography (if available) showing the fetus’position in relation to the mother’s pelvis. Vaginal examination confirms progressive cervical effacement and dilation.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Premature ejaculation:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Physical examination and laboratory test results are usually normal because most males with this complaint are quite healthy. However, a detailed sexual history can aid immeasurably in diagnosis. A history of adequate ejaculatory control in the absence of precipitating psychological trauma should suggest an organic cause.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Low birth weight:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
As soon as possible, evaluate the neonate’s neuromuscular and physical maturity to determine gestational age. (See Ballard Scale for calculating gestational age, pages 488 and 489.) Follow with a routine neonatal examination.
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Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Premature rupture of the membranes:
Diagnosis
(Handbook of Diseases)
Characteristic passage of amniotic fluid confirms PROM. Physical examination shows amniotic fluid in the va-gina. Examination of this fluid helps determine appropriate management. For example, aerobic and anaerobic cultures and a Gram stain from the cervix reveal pathogenic organisms and indicate uterine or systemic infection. The alkaline pH of fluid collected from the posterior fornix turns nitrazine paper deep blue. (The presence of blood can give a false-positive result.) If a smear of fluid is placed on a slide and allowed to dry, it takes on a fernlike pattern due to the high sodium and protein content of amniotic fluid.
Staining the fluid with Nile blue sulfate reveals two categories of cell bodies. Blue-stained bodies represent shed fetal epithelial cells; orange-stained bodies originate in sebaceous glands. The incidence of prematurity is low when more than 20% of cells stain orange.
Physical examination also determines the presence of multiple pregnancies. Fetal presentation and size should be assessed by abdominal palpation (Leopold’s maneuvers).
Other data determine the fetus’s gestational age:
❑ historic: date of last menstrual period, quickening
❑ physical: initial detection of unamplified fetal heart sound, measurement of fundal height above the symphysis, ultrasound measurements of fetal biparietal diameter
❑ chemical: tests on amniotic fluid such as the lecithin-sphingomyelin (L/S) ratio (an L/S ratio greater than 2.0 indicates pulmonary maturity); foam stability (shake test) also indicates fetal pulmonary maturity.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Low birth weight:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
As soon as possible, evaluate the neonate's neuromuscular and physical maturity to determine gestational age. (See Ballard Scale for calculating gestational age.) Follow with a routine neonatal examination.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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