Which of the following is NOT a normal sign of pregnancy?

The choice of amniotic fluid (AF) as the option that is not a normal sign of pregnancy is insightful, as it highlights a common misunderstanding about what constitutes a "normal" sign. Amniotic fluid is not a sign in the same way that peripheral edema or changes in the cardiovascular system can be observed. Instead, amniotic fluid is a substance that surrounds the developing fetus and is essential for fetal development. It does not represent a sign or symptom that can be directly observed in the mother, unlike peripheral edema, which may manifest as swelling in the legs and feet due to increased fluid retention, or an increased pulse volume, which can occur due to changes in blood volume and cardiac output during pregnancy.

On the other hand, an ejection systolic murmur can occur in pregnant individuals due to the increased blood flow and changes in the cardiovascular system. This is considered a normal physiological change during pregnancy. Thus, the characteristics of amniotic fluid differ fundamentally from those of the physiological signs typically experienced or noted during pregnancy.