How Soon Can A Doctor Detect Pregnancy By Pelvic Exam?

When there’s a possibility you might be pregnant, a pelvic exam^[1] can be the first thing your doctor recommends. By looking for a range of different signs, different symptoms, a medical professional can gauge how likely a woman is to be pregnant.

None of the signs that may be noted are definitive signs of pregnancy. However, they are often the first clues that indicate more testing is called for. 

How Soon Can A Doctor Detect Pregnancy By Pelvic Exam?

Symptoms of pregnancy are usually grouped into presumptive, probable, and proven signs. The only way to absolutely prove someone is pregnant is through a test performed by a doctor or when a baby pops out. Presumptive and probable signs are strong indicators and are the first things a doctor will look for. Of course, the more signs that appear together, the more likely they point to pregnancy.

Signs of pregnancy that might be detected through a pelvic exam include:

• Vaginal changes such as color and firmness
• Changes in the size and position of the uterus
• Abdominal changes that correspond to the changes in the uterus
• Cervical changes such as softening and the formation of a mucous plug

Presumptive Signs Of Pregnancy

Presumptive symptoms^[2] are the ones that you’ll notice yourself and are the reasons you make a doctor’s appointment. Some of the most common presumptive symptoms are:

Missing Your Period

Missing your period, clinically known as amenorrhea, is the clearest symptom. However, there are a few different reasons you might miss your period, not just because of pregnancy. Stress, anemia, and excessive exercise can all also lead to a missed period. Also, about a fifth of women will see some spotting while pregnant.

Vomiting And Nausea

 While it does frequently occur in the morning^[3], newly expectant mothers may feel nauseous at just about any time. As a symptom, it will show up around week 6 of your pregnancy. Some women will have problems with nausea throughout the pregnancy, but for many, it will clear up after the first trimester.

Fatigue That Is Unusually Severe

Feeling the need to urinate frequently is common with newly pregnant women, as is unusually severe fatigue.

Breast Changes

The size, shape, and coloration of the breasts may change throughout the pregnancy.  They will often get temporarily larger, feeling full or tingly. As the pregnancy progresses there will be an enlargement of the Montgomery glands, which are the bumps on the areola. The areola will usually darken and the breasts may overall become more sensitive or tender. 

Skin Changes

A few temporary changes to the skin may also indicate pregnancy. One is the linea nigra, which is a black line that may appear on the belly, running from top to bottom. This will usually fade soon after pregnancy. Some women develop something called the ‘Mask of Pregnancy’, more technically called chloasma. It mostly affects the forehead, chin, and cheeks, creating dark splotches. Stretch marks, which are caused by both hormones and weight gain, are likely to be more permanent.

Chadwick’s Sign

 This is one of the signs that may be noticed during a pelvic exam. The lining of the vagina changes color, darkening as the veins in the area become more visible. Chadwick’s Sign can usually be seen around the 6th week of pregnancy. 

Probable Signs Of Pregnancy

Probable signs^[4] are the sort of things a doctor or nurse is looking for.  They may not be things you notice or that interfere with your day. However, a woman’s body changes in some specific ways when getting ready for a baby that a doctor can look for.

Some of the signs a medical professional might look for include:

Uterine Changes

The uterus will grow much larger and shift position during the course of a pregnancy. A pelvic exam might include looking for Hegar’s sign, which is a softening of the lower uterus, just above the cervix. 

Abdominal Changes

As the uterus grows in size the abdominal muscles loosen to give it room. Skin changes such as the linea nigra and stretch marks are also things a doctor might look for.

Cervical Changes

The cervix undergoes several changes in preparation for pregnancy that a doctor might notice during a pelvic exam. The mucous plug is formed in the cervix to seal the uterus and protect it from contamination. Goodell’s sign, which is a softening of the cervix, usually appears during the 6th week of pregnancy. 

Basal body temperature, your resting body temperature, can also be a good indicator of pregnancy. It’s most useful when you have a record of your basal body temperature to compare against. A doctor might also be able to palpate the fetus, and actually feel it slightly in a pregnant woman’s abdomen. 

Each of these signs can have several different causes, however. There may be very little real doubt, but usually, a doctor will ask for a couple of tests to absolutely confirm a baby is on the way.

Knowing For Sure

There are generally two tests that are considered to prove when someone is pregnant if there is any real doubt. Blood tests^[5] can be used just a few days after conception. Ultrasounds provide the opportunity to directly check on the baby’s size, and health, and confirm the due date. Most often both will be used to confirm the pregnancy and check on baby’s health.

Blood Test

The blood tests you get at the doctor’s work on the same broad principle as a home pregnancy tests^[6], which uses urine to detect hCG. They are both looking for a hormone called human chorionic gonadotropin, or hCG if that’s too many syllables. This hormone is produced after a fertilized egg implants itself in your uterus is implanted in the uterus, so it’s a reliable indicator of pregnancy.

It’s possible for a blood test to be positive even if the woman is not actually pregnant, though it’s fairly rare.  

Ultrasound

To confirm pregnancy and monitor the baby’s development, most women will be given an ultrasound^[7] during their first trimester. As the name implies, ultrasound uses waves of sound bouncing around your body to form an image. Ultrasounds are used for a lot of things, but they are generally best known for taking a baby’s first picture, confirming the estimated due date, and size of the fetus.

There are two types of ultrasound that may be used. 

• Transvaginal: This is what is most likely to be used in the first trimester. This type of ultrasound uses a wand placed into the woman’s vagina.
• Transabdominal: When you see an ultrasound on a TV show, this is what they are depicting. A wand is applied to the abdomen to get an image. This is used in later pregnancy.

There are more reliable ways to detect pregnancy, but a pelvic exam can be the first step. In many cases, it’s a routine part of regular medical care. Doctors use it to monitor your reproductive health and as a way to diagnose potential problems. For both of those reasons, finding some of the signs we’ve described may be the first real confirmation of a possible pregnancy.

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