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Other historical factors related to ectopic pregnancies include prior tubal manipulation, pelvic inflammatory disease, previous ectopic pregnancy, tubal disease, use of an intrauterine device for contraception, fertility therapies, and tubal ligation.

Upon physical examination, one may find an enlarged uterus after bimanual examination, breast changes, and softening and enlargement of the cervix (Hegar sign; observed at approximately 6 wk).

When expectant management is chosen, most experts recommend beginning twice-weekly antenatal surveillance at 41 weeks with biophysical profile or nonstress testing plus amniotic fluid index (modified biophysical profile); induction may be deferred until 42 weeks if this surveillance is reassuring.

Postterm pregnancy is defined as that lasting beyond 294 days or 42 weeks' gestation.

2013;309(22): doi:10.1001/jama.2013.6295.e Table 1. Associations Between Maternal Body Mass Index in Early Pregnancy and Other Maternal Characteristicse Table 2.

Maternal Body Mass Index (BMI) in Early Pregnancy and Risks of Extremely, Very, and Moderately Preterm Delivery: Women With Information of Gestational Age Estimated Both by Ultrasound and the Last Menstrual Period (LMP)e Table 3.

Important aspects of the menstrual history must be obtained.

The woman should describe her usual menstrual pattern, including date of onset of last menses, duration, flow, and frequency.

In 2013, complications of pregnancy resulted in 293,000 deaths, down from 377,000 deaths in 1990.

B, Absolute risks attributable to body mass index (BMI) were estimated from ORs in the complete case analysis.

Y-axis scale shown in blue indicates range from 0% to 0.5%..

The diagnosis of pregnancy requires a multifaceted approach using 3 main diagnostic tools.

These are history and physical examination, laboratory evaluation, and ultrasonography.

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