1st Trimester

1st Trimester

Morning Sickness

Nausea and vomiting are common and may be unpleasantly persistent during the first three months of pregnancy. This is due to the high levels of hormones in the bloodstream, which are necessary to maintain an early pregnancy. In most every instance it disappears around the fourth month. Morning sickness can occur at any time of the day, morning, noon or night- or even all day long. Not all women experience morning sickness. Some women have a few queasy moments, others feel nauseated and some vomit several times a day.

Suggestions for controlling morning sickness:

  • Eat a diet high in protein and complex carbohydrates. This combination helps fight nausea.
  • Drink plenty of fluids, especially if you are losing them through vomiting.
  • Avoid the sight, smell and taste of foods that make you queasy.
  • Eat often and before you become hungry.
  • Keep crackers, pretzels or small cookies by your bedside and eat one before you arise in the morning or if you wake up during the night.
  • Ginger Ale or Sprite can help settle the nausea.
  • Cold fluids or warm soups are sometimes tolerated better than solid food when symptoms are severe.

If vomiting becomes so severe that you are unable to retain anything, call our office for further instructions. There are prescription medications that are safe to take if necessary.

Pap Smear

The pap smear is a test to evaluate the cells of the uterine cervix. It can alert us to precancerous conditions of the cervix. It is perfectly safe to perform the pap smear during pregnancy.

Cervical Cultures

Sometimes the appearance of the vaginal discharge suggests a vaginal or cervical infection. There are several different types of infections and it is important to determine the exact cause of the infection so that it may be promptly treated. Most infections, like yeast, are harmless to the fetus, but several can either increase the risk of preterm delivery or infect the baby at birth. When evaluating an abnormal cervical discharge I frequently recommend testing for gonorrhea and Chlamydia. Because these sexually transmitted infections can be asymptomatic it is much safer to test and put the matter to rest than to overlook the possibility of their presence.

Complete Blood Count (CBC)

On your CBC I look to see if you are anemic, or low in blood iron. I can also tell if your platelets (cells that help stop bleeding) are present in normal amounts. The white blood cell count (number of cells that fight infection) is also determined and used as a general health screen.

ABO and Rh

This is the blood type. You may have type A, AS, B, or O blood. The other test is Rh, and you may be either Rh positive (you have the Rh type,) or Rh negative (you don’t have the Rh type.) For our purposes the Rh is the more important test during pregnancy. I need to know if you are Rh negative so that we may do further testing during pregnancy to assure a healthy fetus. Being Rh negative does not make your pregnancy “high risk” as long as certain precautions are taken. I have a nice pamphlet that fully explains these precautions if your test shows you are indeed Rh negative.

Indirect Coombs Test (Antibody Screen)

This test is related to blood group testing. It tells me if you have made antibodies to any of the blood groups. Antibodies to certain blood groups can potentially cause harm to your fetus, but this can be ameliorated if we are aware of their presence.

Rubella Screen

Tests to see if you are immune to rubella, or “German Measles.” If we determine you are not immune, you should try to avoid close exposure to sick children, particularly children with fever and a rash.

Hepatitis B Surface Antigen

This test tells us if you are a carrier of hepatitis B. If you are a carrier you could infect your fetus, your sexual partner, and you should not be a blood donor. Babies born to mothers who carry hepatitis B are vaccinated at birth to reduce the chance of infection. Some mothers have been vaccinated against hepatitis B, and this test remains valid even if the vaccine has been administered.

HIV Screen

This is the test for the HIV (AIDS) virus. This test is recommended for every pregnant woman, both at the initial prenatal visit and again at childbirth. Because there are medications that can markedly reduce the chance of the baby contracting the HIV virus; this test is highly recommended. The test is confidential, meaning that results will be reported only to you.

Other Tests

Sometimes other tests are ordered based on your past medical history, family medical history and your physical examination. These include testing for diabetes, thyroid disorders, and other conditions. Typically cholesterol screening is not recommended in pregnancy, as it is both normal and desirable for the level to be elevated at this time.

P.S. Slightly terrified of needles?

Let us know and we’ll try to make things easier! We would like to document an intrauterine pregnancy early in the first trimester. Ideally ultrasound done at 6-7 weeks will confirm an intrauterine pregnancy and rule out an ectopic pregnancy, which is a treatable condition. This is a pregnancy in the fallopian tube, which can be a medical emergency. It is usually accompanied by severe pain and bleeding. If you have a history of ectopic pregnancy, please notify us once you have a positive pregnancy test. Once a pregnancy is documented with a fetal heart rate the risk of miscarriage drops from 20% to 5% it is also important to know that 50% of women may spot or bleed in the first trimester, and 1/2 of those women will proceed with a normal pregnancy.

Possible Signs of a Miscarriage

  • When pain is severe or continues unabated for more than one day, even if it is not accompanied by staining or bleeding.
  • When bleeding is as heavy as a menstrual period or light staining continues for more than three days.
When to Get Emergency Medical Attention
  • When you have a history of a miscarriage and experience either bleeding or cramping or both.
  • When bleeding is heavy enough to soak several pads in an hour or when pain is so severe you can’t bear it.
  • When you pass clots or grayish or pink material-which may mean a miscarriage has already begun.
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