What are probable signs of pregnancy

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The sooner you recognize early signs of pregnancy in a patient, the sooner you can begin taking measures to care for the mother and the baby.

Although the primary sign of pregnancy is a missed period, many women experience other symptoms before noticing changes in their menstrual cycle. Pregnancy symptoms fall into three categories — presumptive, probable, and positive — depending on the likelihood of pregnancy.

If you’re a nursing student, you’ll want to make sure you fully understand the early signs of pregnancy and distinguish between presumptive, probable, and positive pregnancy symptoms. We’ll walk you through everything you need to know.

Presumptive, probable, and positive signs of pregnancy

You might have heard about presumptive, probable, and positive signs of pregnancy — but what exactly do these mean?

Presumptive signs of pregnancy are usually noted by the patient and indicate a possibility of pregnancy. While presumptive symptoms imply early pregnancy in most cases, factors like PMS, stress, and illness may also cause these symptoms.

On the other hand, probable signs of pregnancy have the most likelihood of indicating pregnancy. Cervical changes, mild uterine cramping, softening of the cervix, quickening, Braxton Hicks contractions, and a positive pregnancy test are the most common probable signs to watch out for. It is possible to have a false positive on a home pregnancy test, which is why it’s classified as a probable sign.

To confirm pregnancy, health care providers look for positive signs of pregnancy. These include a fetal heart rate (or fetal heartbeat) and fetal movement on an ultrasound, heart sounds by a doppler, and hCG (a hormone secreted by the placenta shortly after incubation) in a urine sample.

11 Presumptive signs of pregnancy

Not every expecting woman will experience symptoms. Still, most women typically develop some classic presumptive symptoms during their early pregnancy — hormonal imbalances, nagging anxiety, and body changes are to blame.

Here are the most common presumptive signs of pregnancy to look for during an assessment:

Amenorrhea

For most women, the absence of menstruation (amenorrhea) is the first presumptive sign they’ve entered the early stages of pregnancy. Amenorrhea, however, may be caused by other factors, including early menopause, stress, malnutrition, anorexia, irregular menstrual cycles, endocrine imbalances, anemia, diabetes, or medications.

Fatigue

A woman’s body undergoes many transformations and hormonal changes during pregnancy. It’s common for a patient to feel tired while expecting, especially in the first 12 weeks of pregnancy when levels of the hormone progesterone soar. The goal for first-trimester fatigue is to help pregnant women cope by sharing information and developing an activity-rest program.

Increase in urinary frequency

During the first weeks of pregnancy, expecting moms might feel like they’ve been spending more time in the restroom than out of it. You can blame frequent urination on human chorionic gonadotropin (hCG), which increases the blood flow to the pelvic area and increases the softening of the cervix — known as Goodell’s sign.

Nausea, with or without vomiting

Due to the changes in hormones during the first trimester, nausea is a common pregnancy symptom and affects 70% to 80% of pregnant women. Although pregnancy nausea is often referred to as “morning sickness,” it can occur at any time of day.

Breast enlargement

As breasts prepare to make breast milk to feed the newborn, expecting mothers will notice their breasts getting fuller, larger, and heavier. They may also experience tenderness or pronounced nipples.

At the same time, the areola may become darker in color and could grow in size. Breast tenderness is also a common symptom during PMS; therefore, it would be too early to confirm pregnancy if breast changes are the only presumptive sign.

Heartburn

Heartburn is a burning feeling in the throat or chest caused by stomach acid or food traveling toward the throat. Hormonal changes during pregnancy cause the valve between the stomach and the esophagus to reflux, making heartburn a common presumptive pregnancy symptom.

At the same time, the growing uterus puts pressure on the stomach, causing an increased bloating sensation. As a nurse, suggesting a few dietary and lifestyle changes can help prevent and relieve symptoms in patients.

Lightheadedness

An increase in hormones during the first weeks of pregnancy leads to the dilation of blood vessels, which may cause lightheadedness. Although hormonal changes typically cause dizziness, they might signal more serious health issues in some women — such as infection, a blood clot, insulin resistance, or high blood pressure.

Elevated basal body temperature (BBT)

Basal body temperature (BBT) is the body’s lowest resting temperature, usually measured with a thermometer first thing in the morning. A woman’s reproductive hormones play a significant role in BBT; fertility awareness programs typically track the pattern to aid in pregnancy.

After ovulation, BBT increases and drops again if pregnancy doesn’t happen; therefore, an elevated basal body temperature might indicate an early pregnancy or ovulation.

Food cravings

Food cravings and aversions are common presumptive signs of pregnancy. Common types of foods craved by pregnant women include chocolate, ice cream, fruit, juice, milk, yogurt, cheese, and cream, among others.

Mood swings

Mood swings are another early, presumptive sign of pregnancy. Hormonal changes, the physical discomfort of pregnancy, sleep deprivation, and the upcoming post-baby life changes are factors that send pregnant women on an emotional rollercoaster. The good news for moms dealing with emotional ups and downs is that mood swings are only temporary.

Shortness of breath

As pregnancy progresses, walking up the stairs or carrying out a routine task may seem exhausting for many women. Shortness of breath is a common symptom for expecting mothers, occurring in 60% to 70% of healthy pregnant women. Although dyspnea in pregnancy is typically harmless, difficult breathing is associated with more serious pregnancy complications in some cases.

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There are a number of different signs of early pregnancy. Some are presumptive, which means that they indicate that you might be pregnant; some are probable and others are absolutely positive.

Presumptive signs

3-4 Weeks Pregnant

Breast Changes - Discomfort, tenderness or tingling and a feeling of fullness is sometimes noticed by women as early as the first week after conception, because the blood supply to your breast is increasing. This is a presumptive sign

Missed period – If you are sexually active and have had a regular menstrual cycle in the past, a missed period is a fairly reliable sign of pregnancy. However, other factors can contribute to a woman’s period showing up late. Stress and hormonal imbalance can affect the regularity of a woman’s cycle as can illness.

Nausea and Vomiting – these are common early symptoms of pregnancy. Nausea affects about 70% to 85% of pregnant women and vomiting affects about 50%. Only a small percentage of women experience nausea in the morning and many suffer from it throughout the entire day. Of course there might be other reasons why a woman might be experiencing vomiting. Gastroenteritis and urinary tract infections can both cause these symptoms and so these will need to be ruled out.

6 – 12 Weeks Pregnant

Skin changes – Once you are pregnant your body releases increased levels of the pigment, melanin which will affect the colour of your nipples making them darker in appearance. This phenomenon will provide an aid to the baby finding the breast at birth. We know that newborn babies are able to see contrasting black and white colours easily and that they actually have a preference for looking at dark circles on lighter backgrounds!

Increased urination – If you find yourself on the toilet more, you might be pregnant! More frequent urination in early pregnancy can last until the 16th week and is caused by rising levels of the pregnancy hormone Human Chorionic Gonadotrophin (hCG), which changes the capacity of your bladder. Your blood volume will also start to rise and your kidney’s will be working harder to flush waste products out of your body.

However, if you are feeling discomfort when urinating, you might have a urinary tract infection.

Probable signs

8 weeks onwards

Increased vaginal discharge – You might notice an increase in vaginal discharge. These discharges most commonly originate from the cervix and when it occurs due to pregnancy, it is known technically as Goodell’s Sign. The discharge is thin, white, and relatively odourless. There may be other reasons for increased vaginal discharge involving infections, in this case it may be more yellow in colour and have an unpleasant odour.

Positive signs

4 weeks onwards

Human Chorionic Gonadotrophin (hCG) – This is the pregnancy hormone which is produced first of all by the fertilised egg once it implants into the wall of the uterus around Day 6 after ovulation. Once the embryo has implanted, and the baby’s placenta begins to form, hCG levels increase rapidly. If you have hCG in your urine or blood, you are pregnant.

Day 1  Conception – the sperm fertilizes the egg in a fallopium tube. The sperm forms a paternal pronucleus which comes to rest beside the maternal pronucleus of the egg. The contents combine and the egg divides into two identical cells called a zygote.

Day 2 The cells of the zygote divide again. The zygote travels down the fallopium tube towards the uterus and begins to produce minute amounts of Human Chorionic Gonadotrophin (hCG)

Day 3 The cells of the zygote divide again and again and becomes a morula, which continues to release minute amounts of Human Chorionic Gonadotrophin (hCG).

Day 4 The cells of the morula continue to divide and develop into a blastocyst and arrives in the uterus.

Day 5 The cells of the blastocyst burst out of the egg casing – hatching!

Day 6 The blastocyst continues to hatch out of the egg casing and begins to attach itself to the wall of the uterus.

Day 7 The blastocyst attaches deeper into the uterine lining and begins to implant.

Day 8 Implantation continues.

Day 9   Implantation is complete, the blastocyst begins to organise its cells into those which will become the baby and those which will become the placenta and membranes. hCG levels rise sharply.

Day 10   Human chorionic gonadotropin (hCG) continue to rise and begin to enter the blood stream.

Day 11   Fetal development continues and hCG continues to be secreted in greater quantities

Day 12  Fetal development continues and hCG continues to be secreted in greater quantities

Day 13  Levels of hCG are now high enough to detect a pregnancy

Home pregnancy tests are designed to detect levels of hGC in your urine. If you use a home pregnancy test and you are pregnant, when the amount of hCG in your urine reaches the specified sensitivity level of a given test brand, you will receive a positive result.

A positive pregnancy test will display a "control line" and a "test line". The control line indicates that you have used the test correctly. The test line tells you whether you are pregnant or not.

5 – 6 weeks

Visible gestational sac and fetal heart beat on ultrasound – As early as 5 weeks, an ultrasound will be able to detect the baby’s gestational sac and the pulsation of its tiny little heart.