Question

Which of the following is a probable sign of pregnancy?

• A. Hegar sign
• B. Braxton Hicks contractions
• C. Osiander sign
• D. Goodell sign

Hint:

Softening of the cervix detected by the examiner — neither felt by the woman nor diagnostic.

Answer 1

The Correct Option is D

Step 1: Classify the signs of pregnancy. Clinical signs are grouped as presumptive (felt/reported by the woman, e.g. amenorrhoea, nausea), probable (detected by the examiner but not 100% diagnostic), and positive/diagnostic (fetal heart sounds, fetal parts, ultrasound visualisation of the fetus).

Step 2: Recall the probable signs. The classic probable signs are uterine/cervical changes elicited on examination: Hegar sign (softening of the lower uterine isthmus), Goodell sign (softening of the cervix), Osiander sign (increased pulsation in the lateral fornices), Piskacek sign (asymmetrical uterine enlargement), Chadwick/Jacquemier sign (bluish discolouration of the vagina), Palmer sign, and Braxton Hicks contractions (irregular painless uterine tightenings).

Step 3: Apply to the options. All four listed — Hegar, Braxton Hicks, Osiander and Goodell — are in fact probable signs. As the examiner has keyed Goodell sign (softening of the cervix at about 6 weeks due to increased vascularity), it is the intended answer and is correctly a probable sign.

Step 4: Reasoning for the key. Goodell sign is the textbook example most often singled out as a probable sign of pregnancy; it is not diagnostic because cervical softening can rarely occur from other causes, fitting the definition of a 'probable' (examiner-detected, non-conclusive) sign.

Key fact: Goodell sign = softening of the cervix, a probable sign of pregnancy.