The hormone responsible for maturation of mammary gland tissue is:

Choice A reason: Quickening is the first perception of fetal movement by the pregnant woman, usually felt between 16 and 20 weeks of gestation. However, quickening can also be confused with gas or peristalsis, which are normal digestive processes that cause sensations in the abdomen.

Choice B reason: Chadwick sign is a bluish discoloration of the cervix, vagina, and vulva due to increased blood flow during pregnancy. It can be observed by the examiner as early as 6 weeks of gestation. However, Chadwick sign can also be caused by pelvic congestion, which is a chronic condition of enlarged and dilated veins in the pelvis².

Choice C reason: Amenorrhea is the absence of menstrual periods, which is one of the most common signs of pregnancy. However, amenorrhea can also be caused by stress, endocrine problems, or other factors that affect the hormonal balance and ovulation.

Choice D reason: Goodell sign is the softening of the cervix due to increased vascularity and edema during pregnancy. It can be palpated by the examiner around 6 to 8 weeks of gestation. Goodell sign is not associated with any other condition besides pregnancy, unlike cervical polyps, which are benign growths of the cervical tissue that can cause bleeding or discharge.

Choice A reason: Urinary frequency is a common symptom of pregnancy, especially in the first and third trimesters, due to the increased pressure of the uterus on the bladder. It is not a sign of complication and does not need to be reported immediately.

Choice B reason: Rupture of membranes is the breaking of the amniotic sac, which can occur spontaneously or artificially before or during labor. It is a sign of impending delivery and can increase the risk of infection. It should be reported immediately to the health care provider.

Choice C reason: Heartburn accompanied by severe headache can indicate preeclampsia, a serious condition characterized by high blood pressure and proteinuria in pregnancy. It can lead to eclampsia, which is a life-threatening seizure disorder. It should be reported immediately to the health care provider.

Choice D reason: Decreased libido is a normal change in pregnancy, due to hormonal fluctuations, physical discomfort, and emotional stress. It is not a sign of complication and does not need to be reported immediately.

Choice E reason: Vaginal bleeding can indicate various complications in pregnancy, such as placenta previa, placental abruption, or miscarriage. It can pose a threat to the mother and the fetus. It should be reported immediately to the health care provider.