What is the Chadwick sign in a pregnant patient?

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Last updated: April 8, 2025View editorial policy

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From the Research

Chadwick sign is a bluish or purplish discoloration of the vagina and cervix that occurs in early pregnancy, typically observed around the 6th to 8th week of gestation, and is considered one of the presumptive signs of pregnancy. This color change happens due to increased vascularity and blood flow to the pelvic organs during pregnancy, resulting in venous congestion of the vaginal and cervical tissues. The increased estrogen levels in pregnancy cause hyperemia (increased blood flow) to these areas, leading to the characteristic bluish-purple appearance.

Key Points

  • Healthcare providers can observe Chadwick sign during a speculum examination as part of prenatal care.
  • While Chadwick sign is a helpful indicator of pregnancy, it is not definitive on its own and should be considered alongside other pregnancy signs and symptoms, such as missed periods, positive pregnancy tests, nausea, breast tenderness, and other physical changes.
  • Some conditions like pelvic congestion or certain medications may occasionally cause similar discoloration, so clinical correlation is important.

Clinical Considerations

  • The provided evidence does not directly discuss Chadwick sign, but it is essential to consider it as part of the clinical evaluation of a pregnant patient, especially when assessing for vaginal bleeding or abdominal pain, as discussed in studies such as 1.
  • It is crucial to differentiate Chadwick sign from other causes of vaginal bleeding or discoloration, such as placental abruption, as described in 2.
  • A thorough understanding of the pathophysiology and clinical manifestations of pregnancy-related conditions is necessary for accurate diagnosis and management, as highlighted in 3 and 4.

References

Research

Placental Abruption: Pathophysiology, Diagnosis, and Management.

Clinical obstetrics and gynecology, 2025

Research

Anxiety associated with diagnostic uncertainty in early pregnancy.

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2017

Research

Vaginal bleeding in pregnancy.

American family physician, 1995

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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