OnExam

This sign is used in the clinical diagnosis of pregnancy. It is named after Ernst Ludwig Alfred Hegar, a German gynecologist. As modern labs and over-the-counter tests are now available to accurately confirm pregnancy, it is now of very little clinical usefulness.

The Sign and its Interpretation

  1. Hegar's sign is noted on bimanual examination
  2. Internal fingers placed behind the cervix (posterior fornix) and used to apply anterior pressure against lower portion of the uterus
  3. The examiner's external hand applies suprapubic pressure
  • The sign is positive when an area of softening is palpable at the uterine isthmus (between cervix and body of uterus)
  • If there is no area of softening, in the uterine isthmus, the sign is negative
  • No studies have looked at Goodell's sign alone, but one study which examined the utility of Goodell's Hegar, and Chadwick's sign found them to have a combined sensitivity of 18% and specificity of 94%

References

  1. Bastian LA, Piscitelli JT. Is this patient pregnant? Can you reliably rule in or rule out early pregnancy by clinical examination. JAMA. 1997;278:586-591
  2. Bastian LA, Brown HL. Diagnosis and clinical manifestations of early pregnancy. UpToDate 18.3. Topic last updated July 13, 2010.