. The diagnosis of diseases of women . Retroversion of a pregnant uterus, with fixation by adhesions binding the fundus to the rectum and sacrum. 130 SPECIAL DIAGNOSIS 4. Softening and Compressibility of the Lower UterineSegment- (Hegars Sign). Elicited by introducing one or twofingers into the posterior vaginal fornix and approximating thefingers of the hand over the abdomen as closely to the fingers inthe vagina as possible. The lower uterine segment may be com-pressed to the thinness of paper. Hegars sign may be elicited as early as the sixth week. Thesign may be impossible of demonstration
. The diagnosis of diseases of women . Retroversion of a pregnant uterus, with fixation by adhesions binding the fundus to the rectum and sacrum. 130 SPECIAL DIAGNOSIS 4. Softening and Compressibility of the Lower UterineSegment- (Hegars Sign). Elicited by introducing one or twofingers into the posterior vaginal fornix and approximating thefingers of the hand over the abdomen as closely to the fingers inthe vagina as possible. The lower uterine segment may be com-pressed to the thinness of paper. Hegars sign may be elicited as early as the sixth week. Thesign may be impossible of demonstration, because of the thickness Fig. 35. Anteversioflexion of the pregnant uterus at the end of the third month of pregnancy. and rigidity of the abdominal wall. Rectal palpation will be ofservice in these cases. Value of the Sign. Very reliable, though not a positive sign ofpregnancy. 5. Leucorrhcea often begins early and persists throughoutpregnancy. Value of the Sign. Negative. THE DIAGNOSIS OF UTERINE PREGNANCY 131 6. Changes in Position, Size, Form, and Consistency ofTHE Uterus. (a) Position: extreme anteversion. (h) Size of childs head at end of third month. (c) Form: increase in the anteroposterior diameter, becoming spherical at the end of the third month.{d) Consistency: soft and of the Sign. Highly presumptive. There are no positive signs of pregnancy in the first trimester exceptseeing the fetal structures and decidua, hut when two or more of theabove-named presumptive or highly probable signs are present thediagnosis of pregnancy amounts to a moral certainty. SECOND TRIMESTER. I. Subjective Signs. 1
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