Is this patient pregnant? Can you reliably rule in or rule out early pregnancy by clinical examination? .


Journal Article (Review)

This review addresses a common problem facing the clinician: "When treating or evaluating a woman of childbearing years, what is the value of historical or physical examination features in determining the probability of early pregnancy?" We focus on the clinical examination findings that may help the clinician rule in or rule out early pregnancy. Generally accepted indicators of pregnancy include amenorrhea, morning sickness, tender or tingling breasts, and, after 8 weeks' gestational age, an enlarged uterus with a soft cervix. We reviewed the value (ie, sensitivity and specificity) of these indicators, as well as home pregnancy test results, as predictors of the diagnosis of early pregnancy. The available evidence suggests that some historical features, when absent, are fair but not reliable for ruling out pregnancy. When diagnosing early pregnancy, the clinician should not rely on the clinical examination or a home pregnancy test-a laboratory test should be requested.

Full Text

Duke Authors

Cited Authors

  • Bastian, LA; Piscitelli, JT

Published Date

  • August 20, 1997

Published In

Volume / Issue

  • 278 / 7

Start / End Page

  • 586 - 591

PubMed ID

  • 9268281

Pubmed Central ID

  • 9268281

International Standard Serial Number (ISSN)

  • 0098-7484

Digital Object Identifier (DOI)

  • 10.1001/jama.278.7.586


  • eng

Conference Location

  • United States