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The most frequent complaints and questions about pregnancy. I trimester. What is the first trimester of pregnancy? First trimester of pregnancy belly

Terms of the 1st trimester

Pregnancy test showing two lines? Congratulations! In our calendar you will find out everything about what will happen to your body and how the child will develop. Necessary medical examinations, features of the diet and daily routine, permissible physical activity and other useful, important information for the expectant mother and her loved ones are waiting for you!

Pregnancy is counted in two ways.

Obstetric gestational age It is counted from the 1st day of the last menstruation: from this day, the egg begins to mature, which will be fertilized by the sperm. The total duration of the obstetric period is, and it is on him that doctors are guided when they are pregnant. Ultrasound results are also interpreted based on the obstetric count.

True, or embryonic, gestational age is counted from the day of ovulation and conception, and therefore it is shorter than obstetric. Doctors do not use this method of counting, since without medical supervision it is impossible to determine with absolute accuracy on which day of the menstrual cycle ovulation occurred and conception occurred.

The waiting time for a baby, as you know, is 9 months, and this period is usually divided into three equal parts: the 1st, 2nd and 3rd trimester.

The 1st trimester includes the 1st, 2nd and 3rd months of pregnancy and lasts from the 1st to inclusive.


What happens in the body of the expectant mother

The 1st trimester is both a happy and a difficult time for a pregnant woman. Her well-being, her body is changing, and these changes must be accepted (of course, discussing everything that worries with the obstetrician-gynecologist and other doctors).

Nausea in the morning. Toxicosis is the most famous symptom of pregnancy. It is familiar to 60-80% of expectant mothers and is caused by hormonal changes. Also, nausea can be provoked by a deficiency of vitamins and minerals or a sharp drop in blood sugar levels. Toxicosis begins on the 2nd or 4th pregnancy, ends on the 12th-14th. If an unpleasant symptom lasts longer or overtakes late in pregnancy, medical attention is needed. If vomiting is more than 5 times a day, then a doctor's supervision is also required to avoid the threat of miscarriage due to dehydration.

Digestive problems. Due to hormonal games, expectant mothers can have a strong appetite, and its complete absence, and constipation (this is generally a common problem during pregnancy, a dangerous threat of miscarriage), and diarrhea. And food addictions, reaction to smells also change.

Weight gain. The approximate rate of weight gain in the first trimester is 1-2 kg. This indicator varies taking into account the individual characteristics of the health of the pregnant woman: shortage, overshoot or the norm on the scales, the doctor decides.

More frequent urination. Throughout pregnancy, the urge to go to the toilet will be more frequent: the more the uterus increases in size, the more it presses on the bladder. Changes in the hormonal background also affect: an increase in the level of progesterone in the blood provokes more consumption and, accordingly, the release of fluid.

Bloody issues. A small discharge of blood from the vagina occurs in 75% of pregnant women at term. It means that the fetus has undergone implantation - fixed in the uterus. Important! Spotting bleeding may indicate an ectopic pregnancy, severe bleeding may indicate a miscarriage, medical assistance is needed.

breast swelling. The mammary glands slightly increase and become more sensitive (up to painful sensations), as before the onset of menstruation. So the body of the expectant mother begins preparation for breastfeeding.

Feeling tired and drowsy, fainting and pre-syncope. Again, a consequence of hormonal changes in the body, in particular an increase in the production of progesterone, which affects the blood vessels, causing spasms, congestion and a decrease in blood pressure.

How a child develops

Along with the joy of realizing that you are expecting a baby, anxiety arises for him: the first 3 months are the most dangerous in terms of miscarriage statistics and the most important for the formation of a child’s health.

1st month. After sexual intercourse, fertilization occurs - the fusion of male and female germ cells (sperm and egg) in the fallopian tube. The resulting new cell - the zygote - enters the uterus and is fixed in it. An embryo is formed with the rudiments of the skeleton and muscles, the digestive tract, the cardiovascular, nervous, urinary systems, as well as the placenta and umbilical cord. By the end of the month, the size of the embryo is 4-5 mm.

2nd month. The embryo shows the rudiments of arms and legs with fingers. The neck, the rudiments of the sense organs, the genital organs are formed. The brain begins to coordinate the work of other organs, a heartbeat appears, the stomach secretes gastric juice, the liver performs the function of hematopoiesis. At the end of the second month, the embryo is already considered a fetus. Its size reaches 25-30 mm, while the size of the head is equal to half the "growth" of the fetus.

3rd month. Eyelids, rudiments of nails and hair, urogenital and anus openings are formed, ossified areas appear in the cartilaginous skeleton. The fetus already has facial expressions, can move arms and legs. The shape of the external genitalia can determine the sex of the unborn child. The length of the fetus is 7-8 cm, while the head remains large relative to the proportions of the body.


Nesting Story

If you have twins

Statistics say: for every 87-90 cases of pregnancy, there is one pregnancy with twins (according to other sources, 3 cases out of 100). For future parents, especially for mothers, this is double happiness and double responsibility. What is important to know?

Twins can be monozygous (and then twins will be born) and dizygotic (not one, but two mature eggs are fertilized, and born babies, even of the same sex, will not be outwardly copies of each other). The presence of fraternal twins is determined by ultrasound at the 4-5th week of pregnancy, identical - on;

With multiple pregnancy, the level of the hCG hormone in the body of the expectant mother is 2 times higher than during normal pregnancy;

In general, the well-being of the expectant mother twice does not differ from the state of health of those who are expecting one baby, although toxicosis, anemia, heartburn, back pain and weight gain may be more pronounced. The ideal weight gain with twins in 9 months should be at least 7 kg and not more than 18-20 kg;

The predisposition to multiple pregnancy is genetically transmitted (usually through the generation), and the chance of getting pregnant with twins is higher in women aged 30-40+. Scientists explain this by a safety net of the body, which is programmed by nature to continue the race. Also, the predisposition to the conception of twins is affected by the refusal of oral contraceptives against the background of their long-term use, infertility treatment, IVF;

Twins develop in utero at the same pace as babies with a singleton pregnancy, but, as a rule, they have less weight and size (however, they easily catch up with their peers in this parameter after birth). So, by the end of the 1st trimester, both fetuses reach 6 cm in length and weigh about 8 g each.

The first trimester is the period of pregnancy from the first day to 12 weeks. In the first 4 weeks of pregnancy, the most important events in the creation of a new life take place. The human embryo forms, the heart begins to beat, the ears and eyes begin to take shape. From the 5th to the 8th week of pregnancy, the organs of the embryo are formed. The fetus becomes more human-like, but the head is even larger than the body. The embryo is in constant motion, but the mother still does not feel it moving, because it is too small. At the same time, the rudiments of future milk teeth begin to form. By the end of the 8th week of pregnancy, the embryo moves into a new status, now it is called a fetus. On average, its height is from 14 to 20 mm, and its weight is about 3 g. From the 9th week of pregnancy, the ovaries in girls and the testicles in boys begin to develop. However, the sex of the child cannot yet be determined. By the 12th week of pregnancy, the legs and arms are already fully developed, which can be perfectly seen with the help of ultrasound.

Starting from the first trimester of pregnancy, a woman's body undergoes changes, the hCG hormone appears, which doubles every 3 days throughout the trimester. A woman also undergoes changes in behavior and eating habits. Many suffer from headaches, nausea and vomiting in the morning, women often feel tired.

Healthy nutrition of a woman in the first trimester of pregnancy

As a rule, most women suffer from nausea in the first trimester of pregnancy, so it is necessary to draw up a proper nutrition program for yourself, which will greatly help you get used to a special state of mind and body.

It is important for a pregnant woman to eat healthy foods to provide the baby with all the necessary substances and help him develop properly. Such nutrition will give a woman more strength and energy. In the first trimester of pregnancy, it is important to include meat, dairy products, fruits, vegetables, nuts, and grains in your diet. It is also important to drink plenty of water, it will help flush out toxins from the body. In women in position, addictions change greatly, and there is a craving for unhealthy food. Without a doubt, you can treat yourself, but within reason, because first of all you need to think about your future child.

Vitamins in the first trimester of pregnancy

Of course, it is advisable to start taking vitamins, even at the stage of pregnancy planning. But often pregnancy becomes an unexpected event for a woman, in which case the intake of vitamins should be started immediately, as it became known about such a joyful event. At the same time, it will be better if a doctor prescribes a vitamin-mineral complex for a pregnant woman, he knows exactly which drug is best suited.

The first trimester of pregnancy is the time when the process of laying all the vital systems and organs of the fetus takes place, which is why vitamins are necessary for a pregnant woman. They also ensure its normal development.

B vitamins are especially important for expectant mothers, first of all, we are talking about vitamin B9 (folic acid). It is folic acid that has a direct impact on the proper formation of the fetus. That is why its reception is indicated both in the period of preparation for pregnancy, and at its very beginning.

Also, B vitamins can prevent or reduce the effects of toxicosis during pregnancy. In addition, vitamin B9 in combination with vitamins B6, A, C, E helps prevent the process of abortion.

A pregnant woman also needs vitamin D and calcium: their deficiency can lead to such a disease in a newborn as rickets, or cause loss of teeth in a mother.

Tests in the first trimester of pregnancy

Certain tests and examinations help to monitor the condition of a pregnant woman and her child. That is why, from the moment pregnancy is determined, the expectant mother is under the constant supervision of specialists.

In the first trimester of pregnancy, it is necessary to carry out:

  • AIDS tests,
  • syphilis tests,
  • tests for hepatitis B and C;
  • a blood test to determine the Rh factor (if the mother's Rh factor turns out to be negative, and the father's is positive, the pregnant woman will have to take blood for antibodies once every three weeks);
  • blood test - general and biochemical;
  • urinalysis (should be done monthly to assess kidney function);
  • vaginal swab.

In addition to the above mandatory tests, additional tests can be carried out: for rubella, cytomegalovirus and herpesvirus infections, toxoplasmosis, chlamydial infection.

Ultrasound in the first trimester of pregnancy

The first trimester of pregnancy is the time when a pregnant woman undergoes her first ultrasound, usually at 10-12 weeks. Ultrasound in the first trimester can be performed in two ways:

  • transabdominally,
  • transvaginally (i.e. through the vagina, this method is used if it is not possible to obtain a clear image using the transabdominal method).

The main goals of ultrasound in the first trimester of pregnancy:

  • determine the number of fruits
  • determine the exact gestational age,
  • eliminate the risk of ectopic or missed pregnancy;
  • assess the state of the embryo and its development;
  • identify or exclude serious fetal malformations;
  • determine the risk of chromosomal abnormalities.

In addition, ultrasound in the first trimester of pregnancy is designed to evaluate the functional activity of the uterus, cervix, and ovaries. If necessary, the causes of vaginal bleeding, pelvic pain (if any are observed in a pregnant woman) can be determined.

Discharge in the first trimester of pregnancy

All the life of a woman is accompanied by certain discharges, and the period of pregnancy is no exception. Being under the influence of the hormone progesterone, during pregnancy, the discharge may acquire a whitish hue and intensify somewhat. But they can also be transparent. A woman should be alerted to discharge in the first trimester of pregnancy, accompanied by discomfort (itching or burning), characterized by an unpleasant odor or texture. This is an occasion to consult a specialist.

It is urgent to consult a doctor if the discharge has changed to a curdled consistency, acquired an unpleasant odor, and is also accompanied by itching or burning. In most cases, with such symptoms, after examining a pregnant woman, the diagnosis of candidiasis is confirmed, it is also known as thrush.

This disease in a pregnant woman is subject to mandatory and immediate treatment, since it can be transmitted to the fetus and lead to the development of serious pathologies in the child. Also, thrush can provoke a miscarriage.

Greenish or yellow discharge during pregnancy is usually a symptom of a sexually transmitted infection.

Brown discharge may indicate a missed pregnancy and the onset of rejection of the fetal egg when bleeding occurs. This is a very dangerous sign, indicating a high risk of miscarriage in the first trimester. In addition, with spotting, cervical erosion can also be suspected.

Sex in the first trimester of pregnancy

The onset of pregnancy changes the usual way of life of the couple. This also applies to sexual relationships. Many mothers are interested in the question of whether it is possible to have sex in the first trimester of pregnancy, and whether it will harm the fetus.

We hasten to assure that sex in the first trimester of pregnancy is not dangerous for the baby, if there are no contraindications, which the doctor will definitely announce. Otherwise, sex during pregnancy is even beneficial for both the baby and the expectant mother.

Pain in the first trimester of pregnancy

According to statistics, pain in the first trimester of pregnancy, to one degree or another, bothers most expectant mothers. Their character can be completely different. Most often, pregnant women complain of abdominal pain. As a rule, abdominal pain during pregnancy is the norm if they are small and short-lived, occur periodically and pass quickly enough.

Constant pulling pains in the lower abdomen, accompanied by irregular or, which is especially dangerous, regular bloody discharge are sure signs of a threatened miscarriage. In this case, a doctor must be called immediately.

Abdominal pain during early pregnancy with brown discharge most often indicates an ectopic pregnancy, which requires urgent surgical intervention.

Also in the first trimester of pregnancy, most women experience pain in the mammary glands. You shouldn't be afraid of them. Painful sensations in the breast of a pregnant woman are caused by the preparation of the mammary glands for the upcoming feeding of the child. During pregnancy, a woman's breasts increase in size and become painful, especially in the nipples. As a rule, the pain disappears during the second trimester of pregnancy.

But you should know that in the event that a woman in the process of self-examination finds any seals or formations in the breast area, you should immediately contact a mammologist.

The appearance of headaches is also not excluded in the first trimester of pregnancy. According to doctors, they are caused by a surge of hormones and an increase in the volume of circulating blood during this period. Stress, poor posture, changes in the daily routine, dehydration, excessive doses of caffeine, poor sleep, and low blood sugar can exacerbate headaches in the first trimester of pregnancy. From this follows the conclusion about how important it is for a pregnant woman to observe the correct lifestyle, nutrition, work and rest schedule.

Exercise in the first trimester of pregnancy

Regular exercise during pregnancy is the way to a healthy mother and baby. In addition, this is a good guarantee for the future: starting from the first trimester of pregnancy, a woman will not gain too much weight, which means that it will be easier for her by the end of pregnancy, and the birth process will be easier. Women who have threatened abortion or any pathology of its course should consult a doctor.

Exercises that are recommended for the first trimester of pregnancy: walking, swimming, cycling, special aerobics - any workout should be light. You should not get involved in running, horse riding, diving and other active sports should be canceled. Also, do not get carried away with exercises that require intensive participation of the abdominal muscles, this can provoke an abortion.

With the right exercise program, a woman will feel lighter and more energetic during pregnancy.

Flying during the first trimester of pregnancy

Many women are forced to fly during pregnancy, but during the first trimester it is worth being careful. You can decide that the fetus is still too small, and the flight will not cause him any harm, but this is if you have no problems with pregnancy. Do not forget that it is in the first trimester of pregnancy that the formation of the entire body of the future little man takes place, so it is important not to endanger it. Still, it is better to wait at least 13 weeks, when the second trimester begins.

But if you made a decision to fly during pregnancy, or circumstances do not require delay, you must approach the preparations for the flight with all responsibility. To do this, do the following:

  • Visit a gynecologist before traveling and consult with him about the flight. He may not recommend flying at all.
  • The possibility of nausea or pressure drop must be taken into account. Take all the necessary medicines with you to the salon. You also need to take care of comfort - comfortable clothes and shoes, an inflatable neck pillow and a small blanket, as there is often a shortage of them on planes.
  • It is advisable to take a seat near the aisle, because pregnant women experience frequent urge to urinate. In addition, if you start to feel sick, you will get to the toilet faster.
  • Pregnant women often have swollen legs, especially if they sit for a long time without moving, so take more walks around the cabin. If this is not done, there is a chance to "earn" varicose veins.
  • If possible, don't travel alone. Your traveling companion will help you with your luggage and will also support you if you feel unwell.

The most frequent complaints and questions during pregnancy. Translation into Russian doctor Meglei S.V.

First trimester.
What are the first symptoms of pregnancy?
Most often, a delay in menstruation indicates pregnancy, although in women with irregular cycles, the delay may not be related to pregnancy.
There is frequent urination, increased fatigue, nausea or vomiting, engorgement of the mammary glands.
Most of these symptoms are normal.
Most home tests are sensitive from days 9 to 12 of fertilization.
Doing the test helps dispel doubts.
A blood serum pregnancy test (performed in the laboratory) allows you to detect pregnancy from 8 to 11 days of fertilization.

How long after fertilization does the fertilized egg attach to the uterus?
The fertilized conceptus enters the uterus in the form of an embryo of 2-8 cells, and floats freely (floats) in the uterine cavity for about 90-150 hours (about 4-7 days after fertilization). Most embryos are implanted at the morula stage, when the embryo is made up of many cells. This happens on average 6 days after fertilization.
The new embryo causes changes in the endometrium called decidualization.
Then there are rapid physiological changes that establish the mother-fetus exchange. Medications taken before this time usually do not affect the fetus.

Which pregnancy tests are more accurate?
Serum human beta chorionic gonadotropin (hCG) is a hormone produced by syncytiotrophoblast from the day of implantation and rapidly increases in the blood and urine of a pregnant woman.
The serum test for Choriogonin is the most sensitive and specific, with its help the hormone is detected in the blood of a woman on the 8th - 9th day of conception.
The test can be quantitative (hormone amount) or qualitative (simply: yes or no).
Urinary pregnancy tests differ in sensitivity and specificity, are based on the detection of particles of Choriogonin in the urine of a woman and detect hCG at a concentration of 2-5 mIU / mL.
Urinary pregnancy tests can give a positive result when the hormone level in the urine is 20 mIU/mL, which corresponds to 2-3 days before the expected period.
These kits are very accurate and affordable. The test is completed in 3-5 minutes. All kits work on the same principle - they detect the beta subunit of choriogonin using antibodies to it. False detection of pregnancy occurs with molar pregnancy (molar mole) or other placental pathology.
And also a pregnancy test can remain positive for some time after childbirth, miscarriage, abortion.
On the other hand, false-negative results can occur if the test manufacturing technology is violated by the factory, urine is too dilute, and certain medications are taken.
Other urine tests use the agglutination inhibition method.
Such a test requires that a drop of urine be mixed with antibodies to hCG and hCG itself on a latex base. If the test result is positive (there is pregnancy), then the mixture remains clean.
And if there is no hCG in the urine (the test is negative), then the latex particles agglutinate (stick together).
Such tests are more sensitive after childbirth, abortion, as they are not so sensitive during this period and confirm the absence of pregnancy more confidently.
Serum pregnancy tests can be based on different principles. The ELISA test (enzyme-linked immunosorbent assay = hormone-linked immunosorbent assay) is the most common test in laboratories.
This test determines the entire level of beta-choriogonin. It is performed using monoclonal antibodies associated with hCG; the second antibody is added in such a way that it also interacts with hCG and causes a color change. ELISA test is also called "sandwich".
Radioimmune assay (RIA) is still used in some laboratories.
This test adds radiolabeled anti-CHG antibodies to unlabeled CG in a blood sample.
The amount of unbound radiolabeled sample is then measured.
HCG levels double every two days in early pregnancy.
However, it should be noted that even a 33% increase can be seen in a normal pregnancy. The concentration of hCG rises to 60 - 70 days of pregnancy and then drops to low numbers by 100 - 130 days of pregnancy and no longer rises until the end of pregnancy.

Which of their home pregnancy tests is the best?
Most often, home pregnancy tests use the same principle and are the same in sensitivity.

How to calculate the estimated due date?
Pregnancy lasts an average of 281 to 282 days, according to most studies of normal pregnancy.
Naegele's rule is a mathematical formula that makes calculating due dates easy.
Find the first day of your last period, add 7 days and subtract 3 months. This will be the day and month of the expected birth.
This formula accurately predicts the due date for women with regular cycles.
If the exact day of conception is known, then the gestational age is counted from it, adding 2 weeks to the figure obtained.
The first trimester ends at 14 weeks and the second trimester ends at 28 weeks.

How can a woman know if she has an ectopic pregnancy?
Since pregnancy tests have become widespread, doctors often find out about an ectopic pregnancy even before clinical manifestations. The most common symptom of an ectopic pregnancy is cramps in the lower abdomen on one side. If a tube ruptures, the pain becomes very sharp and constant, and then spreads throughout the pelvis.
Other symptoms include brown vaginal discharge, light bleeding, or even heavy bleeding when a tube ruptures.
If the bleeding is so heavy that it has led to anemia, then the woman may experience dizziness and weakness.
Physical findings, pelvic ultrasound, hCG test are used to clarify this diagnosis. The quantitative hCG test is used to compare the amount of hCG in serum depending on the gestational age.
If the patient had a measurement of the amount of hCG in the blood serum, and it was measured again after 48 hours, then the increase in the concentration of hCG in a woman can be compared with the proper increase. Doubling the concentration of hCG in serum for 48 - 72 hours indicates a normally developing pregnancy. If the concentration does not increase, then the pregnancy is probably ectopic. If the patient is stable, then it is necessary to continue monitoring the concentration of hCG every 2 days.
A pelvic ultrasound can be performed to look for a fetal egg in the uterine cavity, formations in the tubes, or to identify blood flow with a color Doppler in the tubes.
A fetal egg in the uterine cavity excludes a tubal pregnancy, since the combination of a uterine pregnancy and a tubal pregnancy occurs in 1 in 30,000 uterine pregnancies.
For an accurate diagnosis of an abnormal pregnancy, a series of measurements of serum hCG is necessary. © ...

When should a pregnant woman be registered for pregnancy and how often should she visit her OB/GYN?
Ideally, the patient should visit a gynecologist before conception.
If this does not happen, then the patient should visit a doctor as soon as she suspects pregnancy in order to adjust nutrition and habits to minimize the risk of malformations and complications of pregnancy. It is recommended to visit a doctor before 10 weeks of pregnancy.
Start taking the necessary vitamins, identify problems in the woman's health by passing some screening tests, it is better sooner than later. A physical examination and screening for sexually transmitted infections is usually done at the first visit.
Ultrasound is recommended for women who do not remember the date of menstruation with confidence or who have had irregular cycles.
A woman complaining of spotting, lower abdominal pain, or uncontrollable vomiting should seek help immediately.
In the first trimester and the beginning of the second trimester, visits to the doctor occur every 4 weeks. Most doctors recommend a visit every 2 weeks during the second trimester and once a week during the third trimester.
Patients who have not given birth by 40 weeks of pregnancy visit a doctor 2-3 times a week.

When should a woman undergo an ultrasound during pregnancy?
Each obstetrician-gynecologist has his own point of view on this issue. Pregnancy can be detected in the uterine cavity at the earliest at 5 weeks of gestation (amenorrhea) with a transabdominal probe and at 4.5 weeks of gestation with a transvaginal probe, which corresponds to a serum CG concentration of 1500-2000 mIU/mL.
An ultrasound in the first trimester will be prescribed for vaginal spotting, suspected ectopic pregnancy, and suspected errors in the gestational age for menstruation.
If the pregnancy is proceeding normally, then the first ultrasound will be scheduled at the beginning of the second trimester. An examination at 18 to 20 weeks is usually sufficient to detect most malformations and leaves the woman time to decide on the future of the pregnancy.
However, an examination a little later (at 22-24 weeks) will be more accurate and the probability of error in detecting malformations in the fetus is lower.(Note: in Israel and in most European countries, other terms of screening ultrasound are accepted: 11-14 weeks, 18-24 weeks, 32-34 weeks).
Monitoring of fetal growth and development is usually performed in the USA at the second study at 23-28 weeks of gestation.
Studies in recent years have shown more benefit when examining precisely at this time for malformations, since (1) malformations of the central nervous system, cardiovascular system and skeleton are more often missed when examining up to 23 weeks of pregnancy; (2) even if examination in pregnant women with an irregular cycle of 18-20 weeks helped to more accurately determine the gestational age, such women still did not have labor induced at 40 weeks.

What are the signs of a miscarriage?
The medical name for miscarriage is spontaneous abortion.
An abortion that is already in full swing is called "inevitable abortion" (in the CIS - "abortion in progress"). If an abortion occurred, but not all the tissues of the fetal egg came out, then this is an “incomplete abortion”, and if all the tissues come out, then this is a “complete abortion”.
Abortion is always "inevitable" if the cervical canal is dilated or if there is an outpouring of water in the first half of pregnancy.
Bleeding, tissue discharge, rupture of membranes with outpouring of water are signs of abortion.
However, not all women with bleeding during pregnancy will end their pregnancy with a complete miscarriage. After 20 weeks of gestation, fetal loss is no longer called a miscarriage, but premature birth (in the CIS from 28 weeks of pregnancy).
Nearly a quarter of women experience spotting at implantation.
Less than half of pregnant women who have spotting in the first trimester end up in a miscarriage.
Usually, spontaneous abortion is preceded by a decrease in the titer of hCG in the blood serum and the cessation of growth of the fetal egg and embryo according to ultrasound. Also, a woman may notice the disappearance of complaints that accompanied pregnancy (nausea, breast engorgement) before a miscarriage.
Most miscarriages are due to chromosomal abnormalities (90% in the first trimester and 33% in the second trimester).

Are uterine cramps normal during pregnancy?
In early pregnancy, uterine cramps may indicate normal changes in the body of a pregnant woman associated with hormonal changes; later spasms can be explained by the rapid growth of the uterus.
But spasms that are different from spasms in a previous pregnancy, increased spasms, spasms combined with bloody discharge from the vagina, can be a symptom of an ectopic pregnancy, a threat of spontaneous abortion, a missed abortion (“missed pregnancy”).

Why do pregnant women feel tired?
Fatigue in early pregnancy is normal. With the advent of pregnancy, many changes occur in the body, and the pregnant woman feels these changes as fatigue and an increased need for sleep. Lowering blood pressure, lowering blood sugar levels, hormonal changes, metabolic changes, physiological anemia of pregnant women lead to general weakness in the pregnant woman.
A woman should check with her doctor if she needs to take any vitamins or iron supplements.
Other symptoms that are common during pregnancy and are not necessarily signs of disease are nausea, vomiting, increased waist circumference, rumbling in the intestines, frequent urination, increased heart rate, involuntary sighing, heart murmurs, swelling of the ankles, shortening of the breath.

Is it true that older fathers have a higher risk of having children with malformations?
To date, there is no medical evidence that older fathers have a higher risk of having a child with a chromosomal abnormality, while such a pattern has been proven for the age of the mother.
With age, the number of spermatozoa with structural abnormalities increases in men. There is an assumption that older fathers are 20% more likely to transmit autosomal dominant diseases to their offspring as a result of abnormal cell division. Autosomal dominant disorders include neurofibromatosis, Marfan syndrome, achondroplasia, polycystic kidneys.
The American Society for Reproductive Medicine recommends that sperm should not be collected from donors over the age of 50.
Any family with a history of congenital malformations should consult a geneticist.
To determine whether the spouses have a defective gene, it is necessary to inform the geneticist about all congenital malformations for the last 3 generations (generations).

What is the best way to recognize the presence of malformations in the fetus?
There are no absolute tests to detect fetal malformations; each test has its own advantages and disadvantages.
The earliest of these tests are only available in preparation for IVF (In Vitro Fertilization).
After the in vitro fertilization stage, before the blastocyst is placed in the uterus, a couple of cells are taken from it for a sample, and this is called “preimplantation genetic diagnosis”. Experimental methods include detecting fetal cells through the cervical canal or in the mother's bloodstream and performing a DNA analysis of these cells.
The next test involves an ultrasound examination of the fetus for congenital malformations.
In a chorionic biopsy, the doctor obtains a sample of cells from the placenta by inserting a needle through the abdominal wall or cervical canal.
It is performed at 10-12 weeks of pregnancy and the result is ready in 24-48 hours.
Amniocentesis is a procedure for obtaining fetal cells from amniotic fluid, performed at 14-18 weeks of pregnancy, the result is ready in 9-10 days.
An early amniocentesis can be performed at 11 to 14 weeks, and an embryonic karyotype can be quickly obtained by fluorescent in situ hybridization (FISH).
This early amniocentesis may be preferable when a severe hereditary pathology is expected. The earlier an amniocentesis or chorionic biopsy is performed, the higher the risk of spontaneous abortion.
The so-called "triple test" (alpha-fetoprotein, estriol, choriogonin) or "quadruple test" (alpha-fetoprotein, estriol, choriogonin, inhibin) of the blood serum of a pregnant woman can be performed at 15-20 weeks of pregnancy (ideally at 17-18 weeks).
These tests provide information about the possible increased risk of chromosomal abnormalities or birth defects in the fetus, but they do not specify the type of abnormality.
To obtain an accurate result, it is necessary to take into account the age of the mother and the number of fetuses.
Recently, new tests have also appeared, released by UltraScreen (GeneCare, Medical Genetics Center).
The test detects 2 proteins in the blood serum - free beta-CG and associated with pregnancy plasma protein (“pregnancy-associated plasma protein A” - PAPPA).
This blood test detects 68% of fetuses with Down syndrome and 90% of fetuses with trisomy-18 (Edwards).
Biochemical tests can be combined with ultrasonic measurement of the nuchal space thickness (NTT, or NT in English abbreviation), which is a collection of fluid under the skin of the occiput of the embryo.
This combination reveals 91% of cases of Down syndrome (trisomy-21) and 97% of cases of Edwards syndrome (trisomy-18).
The newer tests used in the first trimester are also aimed at detecting other proteins associated with pregnancy.
They are also preferably performed together with the measurement of fetal TVP at 11 to 14 weeks.
Allows you to identify about 70% of all defects (varies from 40% to 100% for different researchers) during screening of pregnant women.
Recent studies support the notion that indications for amniocentesis are more likely to be based on first trimester testing data than based on the age of the pregnant woman (younger or older than 35).

Should all women be tested for cystic fibrosis (cystic fibrosis)?
Testing for cystic fibrosis (CF) is available at genetic counseling, but since 2001 it has been excluded from the American College of Obstetrics and Gynecology (ACOG) from the list of mandatory screenings in the US.
The ongoing testing does not reveal a large number of mutations in the responsible gene.
Like most genes, this test has its limitations, as not even all mutations of this gene are known today.
Because of this, the introduction of this test into the complex of examinations for pregnant women is delayed.
However, ACOG has introduced several new guidelines since the spring of 2001 for the detection of Cystic Fibrosis.
In cooperation with the Cystic Fibrosis Foundation, a patient may optionally be tested for CF if the risk of carrying such a gene is high. For example: about 1 in 29 white people (about 3% of the white population) are carriers of the altered gene. African Americans have a 1 in 65 risk, Hispanics have a 1 in 46 risk, and Asians have a 1 in 90 risk (less than 1%). Cystic fibrosis will only show up in a child if both parents are carriers of the gene.
In the rare cases where both parents have the gene, the fetus has a 25% risk of cystic fibrosis.
The new ACOG recommendations include (1) providing information to parents in the form of pamphlets, (2) couples at risk (Europeans and Ashkenazi Jews) will be offered CF testing, (3) assistance with evaluation and further management or termination of pregnancy interested couples.
Director of the National Human Genome Project, Francis Collins, MD, PhD, noted in his speech that the study of the human genome will be of great practical importance in obstetrics and gynecology.

What is "phenylketonuria"?
Classical phenylketonuria is a rare metabolic disorder, usually due to a deficiency in a liver enzyme known as phenylalanine hydroxylase.
Deficiency of this enzyme leads to an increase in the level of phenylalanic acid in the blood and other tissues. If untreated, the disease leads to mental retardation, microcephaly, growth retardation, seizures, eczema, behavioral disturbances, and other symptoms.
Approximately 1 in 15,000 babies in the US is born with phenylketonuria. Since there is an effective treatment, screening for PKU is done in all states.
If PKU is diagnosed immediately after birth and metabolic disorders are immediately corrected, then such infants will be no different from other children and a normal quality of life can be expected from them.
Approximately 3,000 women in the United States have PKU. If these women follow a diet without (or very low in) phenylalanine during pregnancy, they and their children will be healthy.

What are the safe ways to treat nausea and vomiting of pregnancy in early pregnancy?
Nausea and vomiting are common in pregnant women, especially in the first trimester. Severe nausea and vomiting is often referred to as hyperemesis gravidarum, which is a diagnosis of exclusion.
As in non-pregnant women, causes of nausea and vomiting include gastrointestinal problems (infection, gastritis, cholecystitis, peptic ulcer, hepatitis, pancreatitis), urinary tract infection, ENT diseases (labyrinthitis, vestibular disorders), medications (digoxin, morphine), metabolic disorders (hypercalcemia, hyperparathyroidism) and psychological problems.
Nausea and vomiting are difficult to treat as they occur during the first trimester of pregnancy, when fetal tissue is developing and minimal pharmacological intervention is recommended.
The best treatment is the right dietary strategy.
Some patients know which foods they tolerate well, other patients can eat dry biscuits, lemonade and ginger products.
Vitamin B6 also reduces nausea and vomiting and can be administered orally, intramuscularly, intravenously.

How Much Alcohol Is Safe During Pregnancy?
Any amount of alcohol is considered dangerous. There are cases of Fetal Alcohol Syndrome (FAS) with very little alcohol consumption.
Pregnant women, even drinking small amounts of alcohol, can affect the development of the fetus.
Heavy alcohol consumption (3.5 drinks per day) is a proven risk factor for the development of Fetal Alcohol Syndrome and poor pregnancy outcomes.
FAS can be prevented but cannot be cured in an already affected fetus.
Consequences of FAS for the fetus - mental retardation, intrauterine growth retardation of the fetus in all parameters (length, weight, head circumference).
Further consequences include abnormal brain development and/or behavioral disturbances. The craniofacial features of FAS include a flattened sulcus of the upper lip, small and oddly shaped eyes, a small skull, an upturned nose, and a small or irregularly shaped upper jaw.
Pathology of the heart is very rare, as well as pathology of the limbs (deformity of the feet and bones). Today in the United States, FAS is diagnosed by doctors in 1 case per 750 newborns.
While there is debate about the safe amount of alcohol to drink during pregnancy (low doses of 1.2 drinks per day, the average dose of 2.2 drinks per day), research results have emerged showing that even drinking in small doses can affect the development of the fetus.
In children exposed to medium doses of alcohol in utero, growth retardation, mental retardation, and behavioral disorders were found to be the same as with the use of large doses of alcohol, but less pronounced than with FAS. Drinking alcohol at 7 months of pregnancy increases the risk of preterm birth at both medium and low doses.
Moderate alcohol consumption can also have significant consequences for the development of the fetal nervous system.
Studies have emerged that examine the impact of alcohol consumption during pregnancy on school performance and the ability to communicate with peers.
Studies have shown that alcohol affects the fetus more if the mother has consumed a large dose of alcohol once than if she drank 1-2 doses for several days.
Whether alcohol will affect the fetus depends on several factors such as gestational age, frequency of use, genetic characteristics.

Should a pregnant woman avoid eating any foods to prevent listeriosis?
Listeriosis is caused by the bacterium Listeria monocytogenes and causes gastrointestinal upset such as nausea, vomiting, and diarrhea. Listeriosis can cause fetal damage or miscarriage. The American College of Obstetrics and Gynecology recommends avoiding unpasteurized milk and soft cheeses (cottage cheese, cheese), raw or undercooked meats, fish, shellfish, and bird eggs.
Also, pregnant women should thoroughly wash fresh vegetables and fruits before eating.
Additional recommendations from the Food and Drug Administration include the following:
Do not eat hot dogs and other snacks containing meat that has not been heated over a fire or boiled in boiling water;
Avoid soft cheeses. Hard cheeses are safe.
Do not eat frozen pates and meat pastes raw (Listeria easily tolerates freezing). Canned analogues are safe.
Do not eat frozen seafood raw. Canned analogues are safe.

What other foods should a pregnant woman avoid?
Do not eat raw vegetables, unpasteurized juices, liver, meat, poultry and eggs that have not undergone sufficient heat treatment. These products may contain poison from Salmonella or Escherichia coli (including the dangerous variety E coli 0157). Proper handling kills bacteria. The temperature regime should be controlled by a thermometer. Beef should be cooked at a temperature of at least 70o C, steaks at 65o C, whole poultry at a temperature of 80o C. Eggs should have a hard yolk when cooked. Hollandaise sauce contains raw eggs and is not safe for pregnant women. Liver can contain a very high amount of vitamin A, so you should not consume it in large quantities to avoid overdose.

Is it safe to eat fish during pregnancy?
The American College of Obstetrics and Gynecology (ACOG), in conjunction with the Food and Drug Association (FDA), has issued a warning about the unsafe use of fish by pregnant, breastfeeding, and planning women in the near future. It is not the fish itself that is dangerous, but eating it in large quantities, as this increases the release of natural methylmercury (mercury), the level of which has been increased in water in recent years due to industrial emissions. Mercury is very toxic to the fetus and the breastfed newborn. All fish contain traces of mercury, and the larger and older the fish, the more mercury it contains and the more dangerous it is for pregnant and lactating women to consume.
The Food and Drug Association (FDA) in its March 2004 leaflet warns pregnant and breastfeeding women against eating shark meat, swordfish and the like, while 12 ounces (about 350 grams) per week of smaller and finer fish can be safely consumed. cooked fish. The least mercury is found in shrimp, canned light tuna, and salmon. But albino tuna (white tuna) contains more mercury than light tuna, so you can eat 6 ounces, that is, 170 grams, per week, that is, eat one serving per week. The Poison Prevention Agency (EPA) recommends that pregnant and lactating women, as well as children, consume no more than 1 serving per week and freshwater fish caught in the river, for the same reason. The safe amount is 8 ounces (230 grams) per week for adults (weight of fish before cooking).

Can pregnant women dye their hair?
The chemical agents in the paint can be absorbed through the skin and enter the body of a woman, so before the obstetrician - gynecologists considered it unsafe for the fetus. Today it has been found out that a very small amount of dye is absorbed by the skin, so hair coloring is no longer considered dangerous.

Is it possible to use medicines during pregnancy?
Each medication has its own list of contraindications. If in doubt, it is best to discuss contraindications with your doctor. Nevertheless, there is some regularity.
The Food and Drug Association (FDA) suggests sorting drugs into categories, indicating it in the instructions for the medication:
Category A. These medicines have been used for many years, have been tested for safety in pregnant women, and there is evidence of safety in pregnant women. Remember that a drug may be excluded from this safe category if taken at a higher dosage. This also applies to folic acid, vitamin B6, thyroid preparations.
Category B. This includes drugs that have been used in pregnant women for a long time, no malformations caused by them have been noted, but do not yet have evidence of safety for the fetus. Includes antibiotics, acetaminophen (Tylenol), aspartame (artificial sweetener), famotidine (Pepcid), prednisone (cortisone), insulin, and ibuprofen through the third trimester. Do not take ibuprofen before the third trimester of pregnancy.
Category C. This includes medicines that have not yet been tested. They are prescribed to pregnant women if the possible benefit outweighs the possible risk of damage to the fetus. These include prochlorperazine (Compazine), fluconosole (Diflucan), ciprofloxacin, and some antidepressants.
Category D. Drugs at risk for fetal use. These include alcohol, lithium (used in the treatment of manic depressive illness), phenytoin (Dilantin), and most cancer chemotherapy drugs. When planning a pregnancy, it is better to replace these drugs with safe ones.
Category X.These are drugs with a proven damaging effect on the fetus and should not be taken during pregnancy. A drug for skin acne (Akutan), for the treatment of psoriasis (Tegison or Soriatan), a sedative drug Thalidomide, and a drug that was used earlier (until 1971 in the USA and until 1983 in Europe) to prevent miscarriages - Diethylstilbestrol.

A complete list is available to your doctor, consult him on the safety of medicines.

The first trimester of pregnancy is one of the most important periods for the future baby and mother. During this period of time, the development of the fetus occurs rapidly. The first weeks of pregnancy are of great importance, during which the internal organs of the baby, the immune system, are laid.

The first trimester is how many weeks?

For the convenience of assessing the condition of the fetus and the expectant mother, obstetricians conditionally subdivide the entire gestation period into trimesters. In total, pregnancy lasts 3 trimesters, in each of which important changes occur. The most responsible are the 1st and 3rd - the beginning and end of the entire period of bearing a baby. According to the observations of specialists, most of the pathologies and complications of gestation occur at this time.

The future mother should be attentive to the state of her body. Knowing the number of the current week of gestation, pregnant women cannot always answer the question of what trimester it is. The first trimester of pregnancy is how many weeks? A similar question can be heard from the lips of a woman bearing her first child. In obstetrics, the first trimester is called the weeks from 1st to.

First trimester in weeks

Having learned how long the first trimester lasts for weeks, women are often interested in the main events of this period. One of the first to be noted is the formation and development of the placenta. This unique organ is the link between the mother's body and the fetus. It directly delivers oxygen and nutrients to the baby. The hormonal background in the female body changes, which causes a change in the appearance of the pregnant woman.

Child development in the 1st trimester of pregnancy

The first trimester of pregnancy begins from the moment of fertilization. However, in practice, women often cannot give the estimated date of the last sexual contact. Given this, doctors are forced to start counting from the first day of the last menstruation. In this way, the obstetric period is established.

The first trimester is the period of fetal development. It consists of 12 weeks, each of which is characterized by its own changes. Let's single out the main processes that occur with the unborn baby at this time:

  1. 1- obstetric week- does not happen yet, the body is just beginning to prepare for a possible pregnancy, the egg is maturing.
  2. 2nd week- ovulation occurs - the release of a mature egg into the abdominal cavity for further fertilization.
  3. 3rd obstetric week- corresponds to the first week from conception. At this time, fertilization and migration of the fetal egg into the uterine cavity occurs.
  4. 4th week- the cells of the embryo are actively dividing, which ensures its growth. The fetal membranes become visible, each of which gives rise to its own organ system:
  • endoderm - digestive tract, liver, thyroid gland, pancreas, respiratory system;
  • mesoderm - bone skeleton, muscle and connective tissue, excretory and circulatory systems, genitals;
  • ectoderm - yolk sac, chorion, amniotic membrane.
  1. 5 weeks- the laying of the musculoskeletal system, kidneys, liver, intestines. The chorion develops, from which the placenta will form.
  2. - the front part of the skull is formed: the rudiments of the nose, eyes appear, the chin, cheeks, auricles acquire clarity.
  3. - the muscular system and limbs are improving, the baby begins to carry out the first movements. The liver synthesizes blood cells.
  4. 8–10 weeks- the formed placenta begins to function, which is involved in the synthesis of hormones.
  5. 11–12 weeks- the formation of organ systems is completed, the child reacts to external stimuli. The external genitalia become visible, the first assumptions can be made about the sex of the baby.

First trimester of pregnancy - sensations

The early stages of pregnancy are rich in new sensations that a woman had not experienced before. One of the frequent manifestations that accompany the first trimester is nausea. It appears by the end of the second month of gestation and is associated with a change in the hormonal background in the female body. In general, the change in the sensations experienced by a woman during the first trimester of pregnancy can be described as follows:

  • 3rd–5th week- there is a slight malaise, increased fatigue, drowsiness;
  • 6th–7th week- the condition is normalizing, the woman feels great;
  • 8th–10th week- the time of the appearance of the first: headaches, nausea, vomiting, sensitivity to odors, changes in taste preferences - the main manifestations of this disorder;
  • 11–12 weeks- manifestations of toxicosis intensify, the woman gradually gets used to her new position. The chest becomes edematous, increases in size.

First trimester of pregnancy - discharge

Throughout the first trimester, vaginal discharge has a thick consistency. Due to this, their volume may decrease. This is due to hormonal changes in the female body. The reason for this is progesterone. Under the action of this hormone, a kind of plug is formed in the cervix, as obstetricians call it.

In its consistency, it resembles a clot of mucus, which completely covers the entrance to the uterine cavity. In this way, the reproductive system protects the fetus from possible exposure to pathogenic microorganisms penetrating the outside of the vagina. The exit of the mucous plug occurs on the eve of childbirth or during the first stage of delivery.

The first trimester of pregnancy - what is possible, what is not?

Every expectant mother should be aware of the dangers that accompany the first trimester of pregnancy, what you need to know in order to avoid possible complications. With the onset of gestation, a woman is forced not only to change her usual lifestyle, but also to make adjustments to her diet. There are a number of restrictions for pregnant women, the neglect of which is fraught with a violation of the process of intrauterine development of the fetus.

First trimester of pregnancy - what can you do?

In order for the first trimester of pregnancy to pass without “accidents”, the expectant mother must lead a healthy lifestyle and follow a number of rules. Doctors recommend that pregnant women take walks in the fresh air more often in the early stages. This will help strengthen the immune system, saturate the body with oxygen. It is important to pay special attention to rest. Frequent nausea, vomiting, headache affect the well-being of a woman who cannot sleep for a long time. It must be remembered that sleep has a positive effect on the nervous system, allowing you to quickly restore strength.


First trimester - what not?

Almost the entire 1st trimester, the body of a pregnant woman gradually gets used to her new position. Given this, the expectant mother should be attentive to her well-being. Giving up bad habits is one of the first conditions for a successfully developing pregnancy process. We must also not forget that during the first trimester, the immunity of a pregnant woman is weakened, so the risk of infection increases many times over. A cold in the 1st trimester can lead to a disruption in the process of fetal formation.

Excessive physical activity, sports training are contraindicated throughout the entire gestation period. However, this does not mean that it is necessary to completely eliminate physical activity. Habitual running, classes in the gym can be replaced by walking. In this case, you must be careful about the choice of clothing. The belly in the first trimester of pregnancy is almost invisible, but you should not wear clothes with a belt or tight jeans. They will disrupt the blood flow in the pelvis.

First trimester - nutrition

For the entire first trimester of pregnancy, nutritionists advise to completely exclude fatty and hard-to-digest foods from the menu. In this case, the basis should be protein foods. If familiar foods provoke attacks of nausea, you can replace them with cottage cheese, chicken eggs, cereals. The changed hormonal background often causes constipation, so the menu, 1st trimester, must necessarily contain foods high in fiber:

  • vegetables;
  • fruit;
  • bran bread;
  • berries.

Meals should be frequent and fractional. A pregnant woman can safely consume her favorite foods and dishes. However, some need to be limited:

  • alcohol;
  • coffee;
  • pickles;
  • smoked meats;
  • acute;
  • fast food.

Vitamins for pregnant women - 1 trimester

There are a large number of vitamins for expectant mothers on the pharmaceutical market. The complex of minerals and vitamins is selected taking into account the gestational age, so before using the drug, you should consult your doctor. It must be remembered that the best vitamins for pregnant women, 1 trimester, are those that do not cause side effects and are well tolerated by the expectant mother. Among the most popular:

  • Vitrum;
  • Elevit;
  • Alphabet;
  • Complivit Trimestrum 1 trimester.

First trimester - tests and doctors

Almost all pregnancy, the first trimester in particular, is accompanied by examinations and tests. These measures allow timely identification of possible deviations, which, in the absence of attention from doctors, can develop into complications and pathologies. The first trimester of pregnancy is the time when a woman becomes registered. In this case, the pregnant woman undergoes the following specialists:

  • therapist;
  • ophthalmologist;
  • otolaryngologist;
  • dentist;
  • endocrinologist;
  • neuropathologist;
  • surgeon.

Among the mandatory analyzes of the first trimester:

  • general and biochemical blood test;
  • analysis for blood group and Rh factor;
  • examination for sexual infections;
  • blood for hepatitis B and C;
  • setting sugar levels.

Ultrasound screening of the 1st trimester

Doctors rarely prescribe ultrasound in the early stages. 1 trimester - the period when the fetus is just being formed, not all organs and systems are functioning yet. Given this feature, the study is carried out at the end of the first trimester. Ultrasound is part of screening - a comprehensive examination, which is aimed at diagnosing pathologies and anomalies in the development of the fetus. It is carried out from the 11th to the 13th week of gestation. The main parameters evaluated by ultrasound, their normal values ​​are shown in the table below.

Biochemical screening of the 1st trimester

The first trimester of pregnancy is a period during which there is a high risk of intrauterine anomalies, developmental pathologies. To diagnose them at an early stage, the concentration of hCG and PAPP-A is set. Chorionic gonadotropin reflects the development of pregnancy, and plasma protein A indicates possible genetic diseases. The norm indicators of these two substances are displayed in the table.