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Pyloric stenosis as seen on ultrasound in a 6-week-old [13] Diagnosis is via a careful history and physical examination, often supplemented by radiographic imaging studies. Pyloric stenosis should be suspected in any infant with severe vomiting. On physical exam, palpation of the abdomen may reveal a mass in the epigastrium.
Fundal height, or McDonald's rule, is a measure of the size of the uterus used to assess fetal growth and development during pregnancy. It is measured from the top of the mother's uterus to the top of the mother's pubic symphysis.
On a physical exam, some uterine muscle tightening may be palpable, but there should be no palpable contraction in the uterine fundus and no cervical changes or cervical dilation. [1] Braxton Hicks contractions do not lead to birth. [1] More concerning symptoms that may require assessment by a healthcare professional include: [1]
The anomaly scan, also sometimes called the anatomy scan, 20-week ultrasound, or level 2 ultrasound, evaluates anatomic structures of the fetus, placenta, and maternal pelvic organs. This scan is an important and common component of routine prenatal care . [ 1 ]
The fundus may be monitored because a rising fundus can indicate bleeding. An ultrasound may be used to rule out placenta praevia but is not diagnostic for abruption. [ 8 ] The diagnosis is one of exclusion, meaning other possible sources of vaginal bleeding or abdominal pain have to be ruled out in order to diagnose placental abruption. [ 5 ]
Although hematometra can often be diagnosed based purely on the patient's history of amenorrhea and cyclic abdominal pain, as well as a palpable pelvic mass on examination, the diagnosis can be confirmed by ultrasound, which will show blood pooled in the uterus and an enlargement of the uterine cavity.
An atonic uterus can feel soft, "boggy" and/or enlarged. [2] Bleeding from the cervical os is also common. If the atony is localized to one area of the uterus, the upper, fundal region may still be squeezing while the lower uterine segment is non-functional. This can be difficult to see with a cursory abdominal examination and easily overlooked.
The volume of amniotic fluid typically increases until 36 weeks and starts decreasing after 40 weeks in post-term gestations. [4] For this reason, discrepancies between fundal height measurements and gestational age can be a clinical indication of amniotic fluid abnormality and should be evaluated by ultrasound.