A nurse is performing a physical examination of a primigravid client who's 8 weeks pregnant. At this time, the nurse expects to assess:

• A. Hegar's sign.
• B. McDonald's sign.
• C. Ballottement.
• D. Chadwick sign.

Answer: (A)

During early pregnancy, the uterus and cervix undergo changes driven by hormones that you can detect on physical exam. One hallmark is the softening of the lower uterine segment, where the uterus meets the cervix. This is known as Hegar sign. It reflects softening and increased distensibility of the isthmus and is typically detectable around six to twelve weeks, making it a classic finding around eight weeks gestation when performing a bimanual examination.

Chadwick sign, a blue-violet discoloration of the cervix and vaginal tissue from increased vascularity, can also appear early, but it’s a visual change rather than a palpated uterine change. Ballottement is a sign that appears later when the fetus can be moved within the uterus, usually in the second trimester. McDonald sign relates to the uterus flexing more easily against the cervix and is another early finding, but the best-documented exam finding at this stage is the softening of the lower uterine segment.

So, at eight weeks, identifying a soft, compressible lower uterine segment confirms the expected early pregnancy change.