The first trimester is a high-risk time for a fetus, there are many early pregnancy complications. There are many obstacles to overcome, and miracles to happen. It can be one of the most emotional times in a woman's life, for so many reasons. Unfortunately miscarriages are extremely common, as many as 1 in 3 pregnancies from conception will miscarry. For this reason be cautious, there is a long road ahead! Here are some of the common questions I receive regarding early pregnancy complications, signs of a miscarriage, and miscarriage symptoms and other complications in the first trimester.
When can I take a pregnancy test?
A pregnancy test should begin to test positive around the time of your missed period, which is about two weeks after conception. If you continue to have symptoms of a pregnancy, and no period, try again in a couple of weeks to be sure. Don't drink, smoke or do other harmful things while you are waiting, just in case. Also, start taking prenatal vitamins, their benefit has been proven when women actually start taking them before pregnancy, so the sooner the better.
What are the initial signs of pregnancy?
Most woman notice breast tenderness, fullness and nausea first. These symptoms can start within just a few weeks of pregnancy. You may also notice some vague pelvic "crampiness". Though this can be confused with a miscarriage symptoms, it is actually quite normal. Fatique, constipation, bloating are also common. Spotting is extremely common, as some of the lining didn't get the memo that you are pregnancy and may try to have a period! If it is minor, dark and intermittent, this is a good indicator that it is not the first signs of miscarriage.
What is the risk of miscarriage?
If you look at all conceived eggs, the risk of the pregnancy being interrupted in the first trimester is almost one out of three. I think it is important for women to realize it is indeed this high, so they are cautious. It is very common, and women shouldn't blame themselves. If you think about what an absolute miracle it is that an egg and sperm come together to make a little person, you can imagine lots of things can go wrong along that path. Miscarriages are nature's way of making sure most babies are healthy. In addition, the older a woman is when she conceives, the higher the chance the fetus has a major chromosome problem, and the higher the risk for miscarriage. Miscarriages can be emotionally devastating, and there are many good resources out there for woman grieving an early pregnancy loss, see my links for a few of these sites.
What are the complications of the first trimester?
1. Blighted ovum---this occurs when conception occurs, but a fetus never develops. Usually a woman will have significant bleeding, a typical miscarriage symptom, and within a few weeks of a positive pregnancy test, and the ultrasound will show no development of a fetus. Some woman will miscarry naturally, some will undergo evacuation of the uterus.
2. Spontaneous abortion---sometimes the fetus develops to a certain point, but then just stops developing. Usually this occurs before there is a fetal heart beat. Once you see the heartbeat, the chance of miscarrying the pregnancy falls to less that 5%. The most common miscarriage symptom is bleeding, and the pain should be general and not well-localized.
3. Ectopic pregnancy---this is a dangerous medical condition when the pregnancy does not implant normally in the uterus, but in the Fallopian Tube, cervix, or elsewhere. Usually these occur in the Fallopian Tube, hence the nickname "tubal pregnancy". When this occurs, the tube cannot expand normally and will rupture. With rupture comes significant internal bleeding, shock and about 100 women in the United States every year still die from ruptured ectopics.
Unlike the typical signs of a miscarriage, ectopics present with pain, with variable amounts of bleeding. If you begin to have sharp, stabbing pain that is located to one side in the early parts of pregnancy, often associated with some vaginal bleeding but this can be minor, then you should present to your doctor right away. It is normal to have a vague crampiness that is not well-localized, but you shouldn't be able to point to the pain and say "it really hurts right here!". If you can that is a sign of an ectopic, not signs of a miscarriage.
4. Molar pregnancy---these are fairly uncommon, cancerous pregnancies. They occur when conception goes terribly wrong and the conceptus has very abnormal chromosomes. A large, tumorous placenta develops that can become cancerous and even metastatic. Luckily the treatment for molar pregnancies that do become cancerous is very effective.
So enjoy the first feelings of being pregnancy, but be cautious. There is a long journey ahead, and that journey commonly has some stumbling blocks. Seek medical care early to have the best chances of having a healthy pregnancy. Take prenatal vitamins as soon as you start thinking about getting pregnant, and make sure they have at least 0.4 mg folic acid to prevent birth defects. If you have medical conditions, make sure you see a doctor and discuss the potential implications for you and baby to optimize your pregnancy outcome. If you feel you are having miscarriage symptoms, or signs of a miscarriage, seek medical treatment to take the best care of yourself.
|
