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Pregnancy is a physiological condition in which a fertilized ovum develops inside the uterus until childbirth. Recognition of pregnancy is an important aspect of maternal health nursing because early identification allows timely antenatal registration, appropriate investigations, nutritional counselling, preventive care, identification of high-risk conditions, and preparation for safe delivery. The signs and symptoms of pregnancy vary from woman to woman and may differ according to the stage of pregnancy. They are commonly classified into presumptive, probable, and positive signs. Presumptive signs are subjective symptoms experienced by the woman. They suggest the possibility of pregnancy but are not sufficient to confirm it because similar symptoms may occur due to other physiological or pathological conditions. The most common presumptive sign is amenorrhea, or absence of menstruation. In a woman with previously regular menstrual cycles, a missed period is often the first indication of pregnancy. However, menstruation may also be absent because of stress, hormonal disorders, excessive exercise, nutritional problems, illness, or other causes. Nausea and vomiting are also common early symptoms of pregnancy. They are frequently referred to as “morning sickness,” although they may occur at any time of the day. They usually begin during the early weeks of pregnancy and often improve by the end of the first trimester. The symptoms are thought to be associated mainly with hormonal changes, particularly increased levels of human chorionic gonadotropin and estrogen. Severe and persistent vomiting may lead to dehydration and nutritional deficiencies and requires medical assessment. Breast changes are another important early symptom. The breasts may become enlarged, tender, heavy, or painful because of hormonal stimulation. The nipples and areola become more prominent, and the ______ ___ _________ ______ ____ ____ _____ ___ _____.
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