Chadwick Sign is the Presumptive Sign of Pregnancy Seen in the Vagina
The correct answer is D. Chadwick sign, which describes the bluish-violet discoloration of the vaginal mucosa and cervix that occurs during pregnancy.
Understanding the Anatomic Locations of Each Sign
The key to answering this question correctly is recognizing where each sign is anatomically located:
Hegar sign - This is a uterine sign characterized by softening of the lower uterine segment, detected on bimanual examination 1
Piskacek sign - This is also a uterine sign referring to asymmetric enlargement of the uterus at the implantation site 1
Goodell's sign - This is a cervical sign describing softening of the cervix during pregnancy 1
Chadwick sign - This is specifically a vaginal and cervical sign, described as cervical cyanosis or a bluish hue of the cervix and vaginal mucosa visible during speculum examination 1
Clinical Significance of Chadwick Sign
The bluish-violet discoloration results from increased vascularity and venous congestion in the pelvic organs during pregnancy 2
This sign can be visualized during routine speculum examination of the cervix and vaginal walls 1
Chadwick sign is classified as a presumptive sign of pregnancy (along with amenorrhea, nausea, breast tenderness) rather than a probable or positive sign 1
The vascular changes affecting the vaginal mucosa are part of the profound physiologic adaptations to pregnancy, with the vaginal mucosa showing a characteristic violaceous appearance 2
Clinical Examination Context
During speculum examination in pregnancy:
The cervix should be completely visualized to assess for lesions and the presence of cervical cyanosis (Chadwick sign) 1
The vaginal walls should be inspected for discharge, lesions, and color changes 1
This bluish discoloration is a normal developmental finding that helps support the clinical diagnosis of pregnancy when combined with other signs and symptoms 1