The First Trimester:
Conception to 13 weeks.
Congratulations,
You are on an amazing journey. We are here to get you there safely!
First Prenatal Visit
Typically, we like to see patients at 8 weeks from your last period.
This gives us the earliest opportunity to establish viability.
Miscarriage is more common than you may realize. Between 10-25% of all pregnancies result in a miscarriage.
If you have a pregnancy that measures 8 weeks or above with a good fetal heart beat the risk of a miscarriage is less than 2.4%. This is the first “milestone”.
Week 10-12
We should be able to hear a heartbeat with the handheld doppler.
This is when you will get your first round of blood work:
Identifies anemia or a low platelet count
- Identifies Blood Type (A, B, AB, or O) and RH status (-/+)
- Identifies abnormal antibodies to red blood cell antigens
Identifies immunity to certain viruses as well as prior exposure to infectious agents that can adversely affect the developing fetus (Rubella, Hepatitis B, Syphilis, HIV CMV)
Optional Testing
This is a genetically inherited disease that results in abnormal mucous production affecting the respiratory and digestive tract. The test identifies carriers of the trait. If you and your husband are carriers, there is a 25% chance your child will have CF.
This is a screening test for Down Syndrome (trisomy 21) which is a chromosome disorder that results in intellectual disability and physical birth defects, such as heart defects. Children with Down Syndrome require special needs. A woman of any age can have a child with Down Syndrome. This occurs more frequently in women aged 35 or older, or with a family history or a previous pregnancy affected by Down Syndrome. While the providers here at County Obstetrics & Gynecology believe that every patient should have the option to have this test most insurance companies will not cover this test unless you are over the age of 35.
Learn More about…
..Common Symptoms in the First Trimester
FATIGUE
Fatigue is one of the most common symptoms of pregnancy, especially in early pregnancy, your body produces high levels of progesterone, which can make you feel more tired than normal. In high enough doses, progesterone can put you to sleep.
For many women, the extreme tiredness (fatigue) of the first trimester is quite a surprise. And it’s an especially hard transition for those who are normally go-getters with lots of energy.
Women who usually need only 6 hours of sleep at night often find they need nearly double that during these first weeks of pregnancy. And for others, daytime tiredness is paired with trouble sleeping deeply or for more than a few hours at night.
BREAST PAIN
Your breasts may provide one of the first symptoms of pregnancy.
After conception, your body launches into hyperdrive to prepare for breastfeeding with surges of pregnancy hormones including estrogen, progesterone, and prolactin. As a result, blood flow to your chest goes up. Your milk ducts begin to grow, and your breasts take on extra fluids, tissue, and fat.
You can see this effect as early as two weeks into your first trimester, making your breasts tender, tingly, or sore. Your breast change may feel fuller and heavier. Your breasts could even increase by a cup size—or a few. Your nipples also become larger and change in color.
NAUSEA, VOMITING, AND "MORNING SICKNESS"
“Morning sickness” is very common during pregnancy and can occur anytime during the day or night. It is related to the level of hormones of pregnancy or hCG, which peaks at 12-13 weeks, at which point symptoms should improve.
It is important to keep yourself well-hydrated during this time because dehydration will add to the symptoms of nausea and vomiting.
Things you can do to help these symptoms:
- Keep yourself well hydrate
- Sugar has an anti-nausea affect, alternate between water and fluids with sugar-white soda, Kool-Aid. Gatorade has electrolytes to hold water inside you.
- Try to avoid big meals, instead eat several small meals throughout the day
- Alternate your fluids with something dry, like bread or saltine crackers
Pregnant women also have a heightened sense of smell, so various odors – such as foods cooking, perfume, or cigarette smoke – may cause waves of nausea in early pregnancy.
Over the Counter Medication:
- Unisom: 12.5-25 mg at night and Vitamin B-6: 25 mg three times a day
- Herbal Ginger 250-300 mg here times per day Prescription mediation
Persistent nausea with vomiting should be reported so we can prescribe additional medication, as we want to prevent dehydration.
Prescription Medication
- Reglan
- Zofran
- Phenergan
GASTROINTESTINAL SYMPTOMS IN PREGNANCY
As previously mentioned, Progesterone levels are very high during pregnancy. Progesterone relaxes smooth muscle like your uterus.
Unfortunately, the GI tract from halfway down your esophagus to the anus is all smooth muscles. High levels of circulating progesterone slow the motility of the gastrointestinal tract. As a result, there is delayed emptying of the stomach, which increases the risk of heartburn.
Additionally, high levels of circulating progesterone slow the motility of the colon combined with the bodies demand to increase water re-absorption by the colon will cause constipation.
CONSTIPATION
Combat constipation by drinking plenty of water, getting daily exercise, and eating a fiber-rich diet.
- Laxative Fiber Supplements
- Metamucil
- MiraLAX
- Colace
- Dulcolax
- Laxative mineral base
- Milk of Magnesia
HEARTBURN
There is delayed emptying of the stomach, which increases the risk of heartburn.
- Antacids
- Rolaids
- Tums
- Maalox
- Mylanta
- H2 receptor agonists and proton pump inhibitors
- Prilosec
- Pepcid
- Zantac
- Prevacid
HEADACHES
Experiencing headaches at the onset of pregnancy is another common early sign of pregnancy. There are several reasons why pregnant women develop headaches.
- Some experts believe that it is the sudden rise of hormones in your body that causes headaches.
- Headaches during pregnancy may also be caused by an increase in blood flow. There is an approximately 50% increase in the circulating volume of blood while you are expecting.
- Women who suddenly stop their morning coffee and sodas may experience caffeine withdrawal headaches.
- Those who also suffer from nausea and vomiting in early pregnancy can become dehydrated.
- Additionally, because you’re moving more air, your sinuses may be over worked, and inflammation can lead to sinus headaches. Sinus headaches may be more likely because of the nasal congestion and runny nose that are common in early pregnancy. If you think it may by sinus related, try an antihistamine.
You can take:
- Tylenol for your headache.
- Antihistamine (for sinus headache)
When a headache is severe, or just doesn’t go away, or when you have dizziness, blurred vision, or changes in your field of vision, you should contact your healthcare provider.
VAGINAL BLEEDNG
Sometimes a small amount of spotting or vaginal bleeding is one of the first symptoms of pregnancy. Known as implantation bleeding, it happens when the fertilized egg attaches to the lining of the uterus – about 10 to 14 days after fertilization. This type of bleeding is usually a bit earlier, spottier, and lighter in color than a normal period and doesn’t last as long.
Some women also experience abdominal cramping early in pregnancy. These cramps are similar to menstrual cramps.
Miscarriage
Early pregnancy loss, also known as a miscarriage or spontaneous abortion, occurs in the first trimester of pregnancy and can occur in more than 10% of pregnancies. Sometimes this occurs so early in a pregnancy that it loss just looks like a period that came a little later than expected and a women may not have realize they were pregnant at the time.
The risk of miscarriage drops to less than 2.4% when we see a pregnancy that is over 8 weeks along with a heartbeat.
The most common symptoms of an early pregnancy loss are vaginal bleeding and cramping. Bleeding is heavy and often heavier than a period with increased cramping. If you experience these symptoms contact our office.
It is important to understand you cannot cause a pregnancy to miscarry. Having sex, working, exercise, falling, or being on the birth control pill at conception does not cause a miscarriage. Approximately 50% of all cases of early pregnancy loss are due to fetal chromosomal abnormalities.
Most women go on to have successful pregnancies. Recurrent pregnancy losses or recurrent miscarriages are rare.