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The first trimester of pregnancy: the size and weight of the fetus, the condition of the pregnant woman, the necessary tests. What is the danger of biochemical pregnancy

The 1st trimester of pregnancy is the initial, but very important stage of pregnancy, during which all organs and systems are formed in the unborn baby.
The first trimester is also quite difficult for mommy, since right now she will have to face most of the difficulties of the entire pregnant period.

1 trimester of pregnancy: how many weeks it ends

The early pregnancy or first trimester lasts 13 obstetric weeks. It is counted from the first day of the last menstruation, after which conception occurred. Many young mothers are perplexed why at the first examination by a gynecologist, just a week after the delay, they are given a period of 5-6 weeks, although in fact the baby in the tummy is no more than 3.5-4 weeks.

The answer to this riddle is simple - the first month of pregnancy in medical practice lasts 6, not 4 calendar weeks, since those 14 days from the start of the last menstruation when the egg was preparing for fertilization are taken into account. This is the period when your baby-to-be makes a serious "journey" through the fallopian tubes towards the uterus, which will become his home for the next nine months.

First trimester of pregnancy: what happens

The first trimester, like the next two three-month periods of bearing a child, has its own characteristics. During this period, important processes take place in the body of the pregnant woman and the embryo, which set the "course" for the entire course of pregnancy. Depending on the individual characteristics, the early stage of pregnancy is different for each woman.

Almost constant companions of all mothers in the first weeks are:

  1. impenetrable fatigue
  2. nausea
  3. headache and fainting
  4. drowsiness
  5. depression and irritability
  6. thrush
But feeling unwell can easily be experienced if you tune in correctly. To cope with toxicosis and surging hormones will help to revise the lifestyle. Try to rest more and walk in the fresh air, change your diet by replacing the sandwich menu with healthy food - this will help you quickly "adapt" to the appearance of a "tenant" in your stomach.

What happens to the child:
In the first three months, the embryo is actively developing. In the fifth week, serious processes are taking place in his body for the laying of important organs: the liver, kidneys and the digestive system. In the sixth week, the formation of the baby's heart is completed, which from this moment begins to contract. By the 12th week, the embryo is already completely similar to a man - its height is 5-6 cm, and its weight is 9-14 g.

Nutrition during pregnancy 1 trimester

Nutrition in the first trimester is a pressing issue for women in childbirth suffering from toxicosis, against the background of which there is an absolute aversion to everything related to food. What to eat early in order to provide the developing baby with all the necessary nutrients in full?

The diet and diet in the early period are best selected from your individual preferences, especially when toxicosis is raging and all foods in the eyes of a pregnant woman are divided into two categories - it is impossible to eat and acceptable. Fractional nutrition will help to deal with this problem - a little bit, but often.

What is useful to eat and drink: boiled meat and fish, vegetable soups, fruits and vegetables in any form, dairy products. You need to give up everything fried, spicy and sour, although it is better to leave pickled cucumber or sauerkraut on the menu - they cause appetite and help smooth out the symptoms of toxicosis.

A healthy first trimester menu should include:

  • Bran flakes, muesli and porridge;
  • Vegetable soups with light broth and stews;
  • Vegetable and fruit salads;
  • Steamed meat and fish cutlets, casseroles
  • Milk Puddings
For a snack, it is better to give up fast food and sandwiches, and stock up on biscuits and juice, which can be used to “seize” nausea in several runs between main meals.

Tests for pregnant women in the first trimester

The first trimester of pregnancy is the most eventful in terms of medical examination. It is during this period that women are prescribed many tests in order to draw up the correct plan for monitoring the course of pregnancy.

The list of mandatory tests and examinations includes:

  1. blood for HIV / AIDS, sexually transmitted infections, TORCH infections, hepatitis B and C, group and Rh factor, hemoglobin;
  2. general urine analysis;
  3. a smear on the microflora from the vagina;
  4. electrocardiogram of the heart.
Also, at an early stage, gynecologists issue a referral to a pregnant woman for undergoing medical examination by narrow specialists: a neuropathologist, ophthalmologist, otolaryngologist, dentist, surgeon and therapist.

Discharge during pregnancy in the first trimester

The first trimester is considered the most dangerous period of pregnancy, during which miscarriage can occur. The main symptom of the threat of interruption and miscarriage is bleeding.

Very often, in the first three months, expectant mothers have vaginal discharge of a different nature and shade. The norm is considered to be a mucous discharge of a whitish hue, aggravated by the hormone of pregnancy - progesterone.

You should urgently consult a doctor if you have:

  • Dark yellow, yellow, yellowish, or brown discharge. They may indicate the presence of a genital infection or fetal freezing.
  • White discharge of a curdled consistency. They are a sign of thrush, which can cause fetal abnormalities.
  • Spotting or spotting, which can be a sign of a miscarriage.

Sex in the first trimester of pregnancy

In the 1st trimester, when the future parents are not yet accustomed to their new status, the question of sex becomes acute in married couples - is it possible or not? Midwives in the first trimester very much even allow intimate relationships with mothers, if there is no threat of miscarriage.

But at this stage, the opponents of sex are often women who, against the background of a hormonal surge and constant malaise, have no desire to enter into an intimate relationship. This problem can be solved only on an individual basis. Psychologists recommend that caring daddies do not despair and wait a little - when the expectant mother "gets used" to pregnancy, she will certainly remember her husband, who needs her affection.

Sports during pregnancy first trimester

It is often difficult for expectant mothers leading an active lifestyle before pregnancy to give up sports. According to obstetricians, this is not worth doing, since today the concept of "shaking" the baby in the stomach is considered outdated, and gynecologists even advise women to go to the gym for an easy birth, but without fanaticism.

Of course, you should give up training with increased physical activity, active running and rocking the press. But cycling, swimming, yoga or gymnastics - these activities will even be useful for the expectant mother.

First trimester of pregnancy: do's and don'ts

The first trimester is a very important period in a baby's development. What can and cannot be done in the first three months so as not to harm the child?
Indeed, with the onset of pregnancy, women have to give up many habits. But this does not mean that you need to radically change your lifestyle. At the same time, you should nevertheless familiarize yourself with the categorical "taboos", as they promise a danger for the crumbs.

The categorical "no" of the first trimester:

  1. alcohol, cigarettes, coffee and soda;
  2. intense exposure to the sun;
  3. physical exercise;
  4. stress;
  5. toxic substances;
  6. medicines without a doctor's prescription.
The main "cans" of the first trimester are:
  1. calmness,
  2. good rest,
  3. walks on a fresh vacation,
  4. sleep and healthy eating.

Pregnancy 1 trimester: what you need to know

Are you becoming a mom for the first time and are confused when you see two stripes on the test, not knowing what to do first? The algorithm is simple: visit a gynecologist, register with an antenatal clinic, undergo the necessary examination and enjoy your interesting position.

At this stage, it is not necessary to give up work and travel, if they are planned. With good health and the absence of medical contraindications, plane flights are allowed, so you can safely go to hot countries - this will not harm either the baby or the mother.

It is important to remember that during pregnancy, especially in the first trimester, any colds and medication are dangerous. Even with a banal runny nose, you should immediately visit a gynecologist and get qualified recommendations, without self-medication using even those drugs that are sold without a prescription.

There are many factors that can have a negative impact on pregnancy in the first trimester. But do not despair - it is possible to avoid problems when carrying a child.

The rules of the first trimester: calmness and adherence to all the recommendations of the gynecologist, good rest and sleep, elimination of stress and overwork, healthy eating and a full drinking regimen.

And do not forget, bearing a child is not a disease that needs to be treated, but a wonderful condition given to a woman by nature. Enjoy it, and then the pregnancy will pass for you as one happy moment.

Reading time: 7 minutes

A woman in a position changes culinary preferences, lifestyle, attitude towards others. The expectant mother deliberately tries to limit herself from everything that can harm her child. This applies to diet, actions, bad habits. Knowing that it is impossible for pregnant women at an early stage is necessary not only for newly-made parents, but also for loved ones who also want to ensure a favorable course of pregnancy.

What is not allowed during pregnancy

There are many myths and facts about this period of a woman's life: some believe that she cannot cut her hair, paint her nails, actively move, etc. You should take a closer look at this. Due to the change in hormonal levels, it is better to refrain from curling and dyeing hair, as a result of which their condition may worsen. If you belong to the category of women who constantly dye their hair, opt for gentle options. The expectant mother is also prohibited from wearing synthetic underwear. During pregnancy, you must not:

  • take baths (hot);
  • visit the sauna and solarium;
  • take medications without consulting your doctor;
  • give vaccinations against rubella, tuberculosis, mumps;
  • conduct x-rays or fluorography;
  • clean the litter box (a cat is a carrier of a disease such as toxoplasmosis).

What pregnant women should not eat

A conscientious woman during pregnancy revises her diet with particular care, some even hang a list of prohibited dishes in the kitchen. During this period, food addictions or aversion to certain foods are formed. It may turn out that you are not attracted to healthy food, but more want to eat what is not allowed, therefore it is important to study the list of foods that are dangerous to the health of the developing organism.

Action on the body

Products

Fatty, fried, peppery, spicy

They affect the liver, kidneys and gallbladder, which are already displaced during pregnancy.

French fries, lard, steak, chili, Korean salads, adjika

They have a detrimental effect on the entire human body, for example, the carcinogenic additive E211 can contribute to the development of oncological diseases.

Chewing gum, candy, confectionery, chips, croutons, seasoning, sauce

Canned food

Influence the synthesis of proteins, which are the main building blocks of a developing organism

Canned fish

Some seafood

Tuna, mackerel, shark, crab, shrimp, swordfish.

Raw eggs

May cause salmonellosis infection

In the early stages

The development and health of the baby depends on how the first trimester of pregnancy goes, so the expectant mother should carefully approach the issue of her nutrition. It is advisable to give preference only to natural products prepared in compliance with all sanitary standards. At this time, there are no significant changes in the woman's condition, but you still need to limit or exclude the following products:

  • Sweets and flour products. They contribute to rapid weight gain, so in the early stages it is important to adjust your diet in order to feel good at the end of pregnancy and not suffer from edema. This category includes all kinds of confectionery and refined sugar, which do not contain vitamins, but are full of carbohydrates.
  • Foods that can cause allergies, which can result in a child's abnormal development or even a miscarriage. These include red vegetables, fruits, citrus fruits, honey.
  • Beans, beans, peas can cause increased gas formation, which will result in increased tone.
  • Chocolate, being a powerful stimulant, has a detrimental effect on the mental and nervous system of a little man. The measure is important here, a couple of pieces will not harm anyone, therefore it is allowed to allow yourself such a delicacy once a week.

What absolutely can not be eaten by pregnant women

The diet of the expectant mother should not harm the developing body. Some dishes can be limited during this important period of life, their single use will not lead to negative consequences. However, there are foods that need to be blacklisted for gestation and breastfeeding. Do not eat for pregnant women:

What is better not to drink

If a cup of morning coffee has become a daily ritual for you, you should give up this pleasure for the sake of the health of your unborn child. This drink has an adverse effect: it increases blood pressure, provokes the threat of miscarriage, causes insomnia, removes vitamins and minerals from the body. You also need to remove caffeinated products from your menu, you should not drink energy drinks and cola.

It is permissible for black tea lovers to sometimes consume this drink, which should be weak. The reason for this is the same caffeine that penetrates the placenta and can harm the baby. Carbonated water must be discarded due to the content of chemicals and dyes.

Any drinks containing alcohol put a strain on the kidneys, which already work in an increased mode during pregnancy. Even if you decide to indulge yourself with a glass of beer, it can negatively affect the intellectual abilities and the formation of the unborn baby, especially in the first trimester. Therefore, drinking alcohol is prohibited. It is also better not to drink kvass at this time. These tips for early pregnancy can help you avoid many unpleasant moments.

What can not be done by pregnant women

During this special period of life, new habits, rules appear and the perception of the surrounding world changes. Sometimes a woman thinks that she is capable of turning the world upside down, and sometimes she does not even have the strength to brush her teeth. It is important to treat this with condescension and observe a set of measures that will ensure your safety. According to these rules, it is prohibited:

  • To carry out general cleaning with household chemicals. In extreme cases, you need to protect yourself as much as possible by wearing gloves and airing the room.
  • Sit in a motionless position at the computer or work you love. When doing embroidery or any other creative process, do not forget to do active physical 15 minutes.
  • Walk in high heels (more than 4 cm). If you do not want varicose veins or flat feet to develop, you cannot.
  • Sit cross-legged. In this position, the veins in the popliteal fossa are pinched, and blood circulation in the pelvic organs slows down. The result can be fetal hypoxia.
  • Smoke. This leads to a poor blood supply to the placenta due to its vasoconstrictor action. There is a possibility that the baby will be born prematurely or with low birth weight.
  • Forget about parties and discos. The smell of cigarette smoke, alcohol and loud music are not conducive to a healthy pregnancy.
  • Put off extreme sports. Adrenaline negatively affects the mental activity of the baby, so you should avoid stress, anxiety and be less nervous. The mom-to-be should provide herself with a calm and positive environment.

In the early stages

It is not recommended to sleep on your stomach during the first trimester. In this position, pressure is exerted on the uterus, which can damage the embryo. It is possible to be in this position on rare occasions, but at no time should it become a habit. However, when the tummy has already noticeably increased, it is advisable to heed the recommendations of doctors and exclude rest on the back. Blood circulation may be impaired due to the fact that the grown belly will put stress on the deep veins.

In the first trimester, the girl's hormonal background changes, the result of which is a change in mood and emotional outbursts. During this period, for some, intimate relationships are a necessity, while for others they are undesirable. According to doctors, a pregnant woman is allowed to have sex, moreover, it also has a positive result, since endorphin is produced. A nice bonus is the training of the pelvic muscles.

However, there are contraindications in cases where the tone of the uterus is increased, there is a risk of miscarriage or the presence of an infection in a partner. It is better to refuse intimate relationships so that there is no termination of pregnancy. In other cases, the expectant mother is allowed to have sex throughout the entire period of pregnancy, the main thing is to avoid deep penetration, pressure on the abdomen and too long an act.

What movements should not be done during pregnancy

While waiting for a baby, a woman should exclude work that involves lifting heavy objects (more than 3 kg). The permissible weight, in exceptional cases, is 5 kg. It is also contraindicated for pregnant women in the early stages to rearrange furniture in the apartment, to make sharp and impulsive movements. This can lead to premature birth. Do not do repairs and hard physical work. Let someone else paint the walls, knock out carpets, or wash windows.

Video

Pathological conditions in obstetric practice that have arisen in connection with gestation and disrupt its natural course. At the initial stages, they may not be accompanied by clinical symptoms, later they are manifested by pain in the lower abdomen, vaginal discharge, impaired fetal movement, headaches, edema. For diagnostics, ultrasound of the uterus and fetus, MRI pelviometry, laboratory tests, invasive prenatal methods, CTG and other techniques are used. Depending on the condition of the woman and the unborn child, treatment may be aimed at maintaining or terminating the pregnancy.

General information

According to experts in the field of obstetrics and gynecology, only about 30-50% of pregnancies are physiological, and this percentage is constantly decreasing. The most common complications of the gestational period, apart from early toxicosis, are miscarriages, which end up to 15-20% of pregnancies, and premature birth (6-10%). At the same time, 30-80% of deeply premature babies suffer from disabling diseases. About 8% of pregnant women develop oligohydramnios, 3-8% have preeclampsia and eclampsia, and 2-14% have gestational diabetes mellitus. Every fiftieth pregnancy is ectopic, and in every two hundred there is a placenta previa. Other types of complications in pregnant women are less common.

Causes of pregnancy complications

The complicated course of the gestational period can be triggered by many factors from the mother or the fetus. The most common causes of pregnancy complications are:

  • Extragenital somatic pathology... With cardiovascular diseases (hypertension, heart defects, arrhythmias) and urological diseases (glomerulonephritis, pyelonephritis), the risk of late gestosis increases. Gestation can also lead to the decompensation of almost any chronic disease.
  • Endocrinopathies... With violations of the hypothalamic-pituitary regulation and endocrine function of the ovaries, the process of implantation of a fertilized egg suffers, the contractile activity of the myometrium changes. Diabetes mellitus provokes microcirculatory disorders both in the woman's body and in the fetoplacental system.
  • Inflammatory gynecological diseases... With salpingitis, adnexitis, endometritis, the likelihood of an ectopic tubal and cervical pregnancy increases. Chronic cervicitis can provoke isthmic-cervical insufficiency. With inflammation, intrauterine infection of the fetus is possible.
  • Abnormalities in the development of the uterus... In women with an intrauterine septum, a two-horned, saddle-shaped or infantile uterus, spontaneous abortion, premature birth, placental insufficiency, placental abruption and fetal hypoxia are more often diagnosed.
  • Abnormal pregnancy and past childbirth... Postponed miscarriages and early births increase the likelihood of recurrent miscarriage. Cicatricial deformity of the neck after its rupture is the main cause of isthmic-cervical insufficiency. After a rupture of the uterus during childbirth, it is likely to rupture in the late stages of the next pregnancy, especially multiple pregnancies.
  • Multiple pregnancy... In the presence of two or more fetuses in the uterus, chronic extragenital pathology is more often exacerbated, late toxicosis is observed, polyhydramnios occurs, amniotic fluid leakage, and the threat of premature termination of pregnancy.
  • Infectious diseases... Viral and bacterial infections can provoke miscarriage, premature birth, aggravate the course of gestosis, chronic somatic and endocrine diseases, and cause complications in the form of inflammation of the membranes. Some pathogens can infect the fetus in utero.
  • Immunological factors... Habitual miscarriage is more often observed when the blood of the mother and the fetus is incompatible according to the AB0 system or the Rh factor, and the patient has an antiphospholipid syndrome.
  • Fetal genetic abnormalities... The most common reason for the termination of pregnancy with an early miscarriage is incompatible with life in the development of the fetus.
  • Iatrogenic complications... Performing amnioscopy, amniocentesis, cordocentesis, and chorionic biopsy and cervical stitches increases the risk of high amniotic bladder rupture, infection, and early termination of pregnancy.

Additional provoking factors, in which complications of pregnancy are more often observed, are addictions (nicotine, alcoholic, narcotic), an asocial lifestyle. The risk group also includes pregnant women under 18 and over 35 years old, patients with inappropriate nutrition and obesity, women who lead an inactive lifestyle, experience excessive physical and psychological stress.

Classification

The clinical classification of pregnancy complications takes into account who has developed pathological changes and at what level - in the mother, fetus, in the mother-fetus system or in embryonic structures. The main complications in a woman are:

  • Conditions and diseases associated with pregnancy... The patient may experience early toxicosis, late gestosis, anemia, gestational diabetes and thyrotoxicosis, varicose veins. Functional changes in the pyelocaliceal system contribute to the rapid development of inflammatory urological diseases.
  • Complications of existing diseases... The loads on the body of a pregnant woman provoke decompensation of chronic endocrine and somatic pathology - thyrotoxicosis, hypothyroidism, diabetes mellitus, cardiomyopathy, hypertension, gastrointestinal diseases. Dysfunction of organs and systems sometimes reaches the degree of failure (cardiovascular, renal, hepatic).
  • The threat of termination and miscarriage... Gestation can end prematurely with an early or late spontaneous abortion (up to 22 weeks inclusive) or early delivery (from 23 to 37 full weeks).
  • Ectopic pregnancy... When the ovum is attached outside the uterine cavity, an ectopic pregnancy is observed. Currently, this condition in 100% of cases ends with fetal death and the occurrence of severe complications in a woman (internal bleeding, hypovolemic shock, acute pain syndrome).

In some cases, the main pathological changes occur in the fetus. This group of complications consists of:

  • Genetic abnormalities... Malformations caused by genetic defects cause miscarriages, and when carrying a pregnancy - severe neurological, mental and somatic disorders in the child.
  • Intrauterine infection... Infection can be caused by bacteria, mycoplasmas, chlamydia, fungi, viruses. Its complications are impaired fetal maturation, early termination of pregnancy, multiple malformations, fetal death, pathological course of childbirth.
  • Fetal hypoxia... This condition is noted with insufficient oxygen supply, can cause ischemia and necrosis in various organs. The result of prolonged hypoxia is a congenital pathology of the newborn or antenatal fetal death.
  • Hypotrophy... With a pronounced delay in fetal development from the gestational period, it is possible that generic hypoxia, problems with spontaneous breathing, meconium aspiration, followed by the development of pneumonia, thermoregulation disorders, hyperbilirubinemia, and brain damage may occur.
  • Incorrect position and presentation... With breech and oblique presentation, there is a high likelihood of complications in childbirth, with transverse, independent childbirth becomes impossible.
  • Frozen pregnancy... Intrauterine death of a child with its preservation in the uterine cavity leads to the development of severe inflammatory complications - purulent endometritis, peritonitis, sepsis, which pose a threat to the health and life of a woman.

In case of complications from embryonic structures that provide nutrition and protection of the fetus, the unborn child most often suffers, who may develop inflammatory diseases, hypoxia, malnutrition, leading to congenital pathology or antenatal death. In addition, such complications provoke premature and pathological childbirth. Taking into account the level of lesions, they are distinguished:

  • Pathology of the placenta... Cysts and tumors may develop in the placental tissue, and infectious and inflammatory processes (deciduitis, willitis, intervillositis) may develop. Possible placental disc abnormalities, abnormalities in the attachment of the placenta to the uterine wall - tight attachment, accretion, ingrowth and germination. Serious complications include low placement, presentation, and premature placental abruption.
  • Umbilical cord pathology... When the inflammatory process spreads to the tissue of the umbilical cord, funiculitis occurs. The main anomalies in the development of the umbilical cord are its shortening, lengthening, meningeal attachment, the formation of false and true nodes, cysts, hematomas, teratomas, hemangiomas.
  • Membrane pathology... The most common complications from the fetal sac are low and polyhydramnios, premature rupture and leakage of water, the formation of amniotic strands, chorioamnionitis.

A separate group of complications is represented by disorders in the system of interaction between the mother and the fetus. The main ones are:

  • Rhesus conflict... The condition is accompanied by the destruction of fetal red blood cells and the development of various complications, from hemolytic jaundice to the death of a child.
  • Placental insufficiency... Violation of the morphological structure and functional capabilities of the placenta, caused by various reasons, leads to hypoxia, malnutrition, and in especially severe cases - fetal death.

When classifying complications, it is equally important to take into account the time of their occurrence. There are early complications, often leading to termination of pregnancy, and late ones, affecting the development of the fetus and the course of labor.

Symptoms of pregnancy complications

Despite the relationship between certain pathological conditions and gestational age, there are a number of common signs that indicate a complicated course of pregnancy. The first is abdominal pain. They are usually localized in the lower abdominal cavity, and can radiate to the groin and lower back. Less commonly, pain begins in the epigastrium and then goes to the lower abdomen. Pain syndrome occurs with an ectopic pregnancy, a threat of miscarriage and premature birth, a threatening rupture of the uterus (in pregnant women with a scar on the uterus). In such cases, weakness, dizziness, and sometimes loss of consciousness are observed. Pain in inflammatory diseases is often associated with fever.

A complication of pregnancy is indicated by vaginal discharge. A miscarriage, premature birth, abruption or placenta previa are accompanied by bloody discharge. Purulent and mucopurulent leucorrhoea are observed in inflammatory processes. The watery nature of the discharge is characteristic of premature effusion or leakage of amniotic fluid.

Almost any change in a woman's general well-being can be a sign of possible complications. In the first trimester of pregnant women, nausea, vomiting and other signs of early toxicosis are worried. With late gestosis, dizziness, pain in the occipital region, the appearance of "flies" before the eyes, swelling in the legs, nausea, vomiting occur. A sudden rise in temperature can be observed with the development of inflammatory complications or with an infectious disease. A pregnant woman may notice the appearance or intensification of symptoms characteristic of extragenital pathology - dry mouth, frequent heartbeats, shortness of breath, heartburn, varicose vessels, etc.

Fetal complications of pregnancy are often identified by changes in the frequency of movements. If movements are not felt for more than 4 hours, there is no reaction to habitual stimuli (stroking the abdomen, music, food), you should urgently consult an obstetrician-gynecologist. Hypoxia is characterized by active stirring and a hiccuping sensation of the fetus.

Diagnostics

If you suspect a complication of pregnancy in the process of collecting anamnesis, provoking factors are identified, an examination is prescribed to determine the type and degree of violations. Recommended for diagnosis:

  • External obstetric examination... The size and shape of the uterus, the tone of its muscles, areas of pain are determined.
  • Inspection in mirrors... Allows you to detect discharge, assess the condition of the vaginal mucosa and cervix.
  • Microscopy and bacterial culture of a vaginal smear... Shown for assessing the state of vaginal secretions, identifying pathogens of infectious diseases.
  • Ultrasound of the pelvic organs... Aimed at determining the size of the uterus, the state of its wall and scar (if any), assessing the size and condition of the fetus, placenta, umbilical cord, amniotic fluid volume.
  • MRI pelviometry... Effectively detects anomalies in the development of the fetus and embryonic membranes, suspected by ultrasound.
  • Invasive prenatal diagnosis... With the help of amnioscopy, amniocentesis, chorionic biopsy, cordocentesis, placentocentesis and fetoscopy, congenital chromosomal abnormalities are excluded, the condition of the membranes, the amount and color of amniotic fluid are assessed.
  • Non-invasive rapid tests... The determination of specific markers allows, in doubtful cases, to diagnose an ectopic pregnancy, to establish the leakage of amniotic fluid, to confirm the premature onset of labor.
  • Laboratory monitoring of pregnancy... Determination of the level of hormones - hCG, free beta-hCG and estriol, PAPP-A, placental lactogen and alpha-fetoprotein - is indicative for violations of the placenta, the presence of fetal pathologies and complications of the gestation process.
  • TORCH-complex... In the course of a serological study, infectious diseases that affect the fetus in utero are diagnosed - toxoplasmosis, rubella,

During the first six days after conception, the embryo "travels", moving along the fallopian tube. Then it enters the uterine cavity and attaches to the mucous membrane of its walls (so-called implantation occurs). The first six days of life, the embryo lives autonomously, like a chicken in an egg, feeds on its own reserves and has nothing to do with its mother, its heart will begin to work in 23 days. After implantation occurs, a connection occurs between the child and the woman through the umbilical cord and the branched chorion, which is formed at the site of attachment of the ovum to the uterine mucosa. By the 16th week of pregnancy, the branched chorion becomes the placenta.

At the 5th week, the corpus luteum of the ovary, which produces the hormone progesterone to support pregnancy, reaches its peak, and a real hormonal explosion occurs in the woman's body. Because of this, the expectant mother is often whiny, irritable, gets tired quickly, and swelling may appear on her face.

In addition, by the 5-6th week, nausea and vomiting often intensify, the breasts become more sensitive and even painful, the skin around the nipples darkens. The uterus, which until the beginning of the 9-month wait was the size of a tangerine, is actively growing, pressing on the bladder, forcing the expectant mother to run to the toilet more often, and on the rectum, which can cause constipation, and more secretion is released from the vagina.

Gynecologist in the 1st trimester

In the 1st trimester of pregnancy, you will meet with an obstetrician-gynecologist from the antenatal clinic, who will assess the condition of your body, send you for additional examinations and consultations, and advise on how to cope with anxiety. In addition, the doctor will give advice on lifestyle, behavior and nutrition.

The first weeks of pregnancy

What health problems can occur during the first weeks of pregnancy?

Fainting

What to do? Lay the expectant mother so that her head is below the level of the heart, give her a drink of sweet strong tea, open the windows in the room. To avoid fainting, your doctor will advise you to walk more (especially before bedtime), avoid stuffy rooms and smoking companies.

Nausea, vomiting, weight loss

What to do? See a doctor, have a urine test for acetone, in the morning, without getting out of bed, eat something "small" (for example, cookies), eat often and in small portions during the day.

Bleeding

What to do? Lie down, calm down and dial "03". It often happens that bleeding appears on the days of the expected menstruation. This usually happens in women who, even before pregnancy, had problems with the menstrual cycle (ovulation did not occur in the middle of the cycle, but shortly before "menstruation"). In any case, the obstetrician-gynecologist must find out why the bleeding appeared and prescribe treatment.

If the reason lies in hormonal deficiency, you will need to undergo a special examination, and then the doctor will prescribe mini-doses of hormones that are necessary to maintain the pregnancy. If this is due to the incorrect location of the branched chorion, which can be found out with an ultrasound examination, you will be advised to bed rest and a sedative.

Lower abdominal pain

What to do? Lie down, calm down, take a comfortable position, you can insert a candle with papaverine into the rectum. If pain persists or recurs frequently, see your doctor.

Early pregnancy

In order for the child to be comfortable and to receive the required amount of nutrients and oxygen (all this comes to him through the blood), try to lead a correct lifestyle. Remember that you need to sleep at least 8-10 hours at night, spend more time outdoors, for example, take a walk with your husband before going to bed. If you feel nauseous in the morning due to low blood sugar, try eating a cookie or apple before getting out of bed. Eat what you want, often and in small portions. Drink herbal tea (peppermint, ginger) to help relieve nausea. Do not eat spicy and oily foods, avoid strong odors, smoky and stuffy rooms. At the beginning of pregnancy, do not limit yourself in the choice of food: you can eat almost anything you want, just not very much.

Try to include more dairy products, meat, juices, fruits and vegetables in your diet. Don't forget about foods that contain fiber and help your intestines work. For the health of your baby, give up smoking and alcohol. It is known that alcohol can harm a child and cause him to have alcohol syndrome, which will later become the cause of his mental retardation. Smoking leads to termination of pregnancy, in addition, the baby can be born with a low birth weight.

Infections, working with chemicals or with a large amount of computers in early pregnancy can cause the baby to stop developing. This is due to the fact that in the first eight weeks, all organs and systems of a small organism are laid, and any harmful effect can cause a heart defect, a violation in the development of the central nervous system.

Signs of pregnancy are usually subdivided into doubtful (presumptive), probable and reliable.
Doubtful signs of pregnancy based on subjective data (feelings of the woman herself). These signs are characteristic of pregnancy, however, in different women they may be expressed to a greater or lesser extent, or may be completely absent. Also, these signs can be symptoms of another condition or disease, that is, they are not specific (characteristic only for pregnancy). Doubtful signs of pregnancy include:

  • vomiting or nausea (especially in the morning);
  • change in appetite or food preferences, perversion of appetite (desire to eat inedible substances - clay, lime, chalk, earth);
  • intolerance to certain odors (tobacco smoke, perfume, alcohol);
  • dysfunction of the nervous system (drowsiness, frequent mood swings, dizziness, malaise, irritability);
  • increased urination;
  • enlargement and engorgement (hardening) of the mammary glands, their increased sensitivity;
  • discoloration of the skin on the face, in the nipple area, along the midline of the abdomen (a vertical line dividing the abdomen into two equal halves);
  • the appearance of scars (stripes) of pregnancy ("stretch marks") on the mammary glands, thighs, abdominal skin.
Likely signs of pregnancy are more specific (characteristic of pregnancy), are detected during an objective examination (examination of the patient by a doctor). The presence of probable signs in the absence of pregnancy indicates serious violations in the woman's reproductive system (diseases). Likely signs of pregnancy are:
  • cessation of menstruation;
  • discharge of milk or colostrum (a thick, yellowish liquid) from the mammary glands;
  • swelling, cyanosis of the mucous membrane of the external genital organs, vagina and cervix;
  • symptoms detected during a gynecological examination: an increase and softening of the uterus, its asymmetry, mobility, a change in consistency with mechanical irritation (touch);
  • a positive home or laboratory test for an increase in the level of hCG (human chorionic gonadotropin). At home, an increase in the level of this hormone is determined using various tests to determine pregnancy, in laboratory conditions, hCG is determined in the blood or urine.
Signs of pregnancy there is evidence of the presence of an embryo (fetus) in the uterus. These are:
  • probing through the abdominal wall of small (arms, legs) and large (head, back, pelvis) parts of the fetus, its movements;
  • listening to the fetal heartbeat;
  • sensation of fetal movement by the mother;
  • detection of the ovum, embryo (embryo) or fetus with ultrasound (ultrasound) of the uterus;
  • detection of parts of the fetal skeleton on an X-ray or tomogram (when performing an X-ray examination of a pregnant woman, in addition to her bones, the bones of the fetus are displayed in the abdomen).

Incubation period

As a rule, doubtful (sensations that appear in women that are characteristic of pregnancy, but are not guaranteed to confirm its presence, since they can also occur outside of pregnancy) signs of pregnancy begin to appear at 3-4 weeks of pregnancy. The first day of a missed period usually corresponds to 4-5 weeks of pregnancy, however, sometimes menstruation can occur even with the onset of pregnancy, while a significant decrease in the volume of menstrual flow is usually observed. In rare cases, menstrual function does not stop throughout pregnancy, but this is not the norm, but indicates a hormonal imbalance (violation).

An increase in the level of hCG (chorionic gonadotropin - "pregnancy hormone") is observed from the moment of implantation of the fetus, that is, its attachment to the uterine wall (8-12 days after conception), and therefore modern highly sensitive tests to determine pregnancy can determine the change in the level of hCG already from the first day of delay in menstruation.

Reliable signs of pregnancy, with the exception of ultrasound signs, are determined in the second trimester of pregnancy. Ultrasound detection of pregnancy is possible from the 5th obstetric week with a transabdominal study (the sensor is applied to the abdomen), and with a transvaginal study (the sensor is inserted into the vagina), pregnancy can be detected as early as 4-5 weeks.

Forms

Uterine pregnancy can be singleton (there is one embryo in the uterus (up to 10 obstetric weeks of pregnancy) or a fetus) and multiple (more than one embryo (fetus) in the uterus).
In multiple pregnancies, twins can be identical (they occur when a fertilized egg is completely divided in two and have the same genetic data) or fraternal (implantation (attachment to the wall of the uterus) of two or more different fertilized eggs occurs).

Pregnancy is conventionally divided into two periods:

  • embryonic (embryonic) - up to the 10th obstetric week. During this period, fertilization, cell division, the movement of a fertilized egg from the fallopian tube into the uterine cavity, implantation (attachment of the embryo to the wall of the uterus), the development of germ layers (bookmarks - building material for future organs) and the formation of organs and systems take place.
  • fetal (fetal) - from the 11th obstetric week to childbirth. During this period, there is an increase in the size of the fetus, the development and improvement of its organs and systems.
Also, pregnancy is usually divided into trimesters (1, 2, 3), respectively, three months each (up to 12 weeks, 13 - 28 weeks, 29 - 40 weeks).

Causes

Pregnancy results from the fertilization of an egg by a sperm, which occurs in the upper third of the fallopian tube.
Further, the fertilized egg moves along the fallopian tube and enters the uterine cavity, where it attaches to the wall of the uterus (this happens on the 20th - 22nd day of the cycle). From this moment, changes in the woman's hormonal background begin to occur: the corpus luteum (temporary formation) in the woman's ovary, formed during ovulation (the release of the egg from the ovary), begins to produce the hormone progesterone, and the resulting chorion (the organ responsible for the attachment of the embryo to the wall of the uterus) produces hCG - human chorionic gonadotropin. The woman's body adjusts to carrying pregnancy, and signs of pregnancy begin to appear gradually.
If, for some reason, implantation (attachment of the embryo to the wall of the uterus) did not occur, then the mechanisms of pregnancy do not start, the ovum dies without food and goes out during menstruation.

The most favorable period for conception is the middle of the cycle (2 - 3 weeks of the menstrual cycle), when ovulation occurs (the release of the egg from the ovary). However, due to the fact that male and female germ cells have a certain lifespan (the lifespan of an egg cell - 24 hours, sperm - 2-5 days), as well as due to disruptions in the menstrual cycle, pregnancy can occur at the beginning or at the end of the menstrual cycle but less likely.

Diagnostics

A doctor can diagnose pregnancy based on:

  • analysis of woman's complaints - delayed menstruation, nausea, vomiting, general malaise, weakness, drowsiness, engorgement and soreness of the mammary glands, etc.;
  • analysis of menstrual function (date of the last menstruation, average duration of the menstrual cycle, date of the expected next menstruation, possible conception, etc.);
  • home test results to determine pregnancy. These tests are based on the determination of hCG (human chorionic gonadotropin), which is excreted in the urine after implantation (attachment to the wall of the uterus) of the ovum. These tests, subject to the technique of their conduct, are quite accurate and can determine an increase in the level of hCG from the first day of missed menstruation (especially in morning urine, which is the most concentrated);
  • gynecological examination data (the gynecologist can detect an enlargement of the uterus and other gynecological signs of pregnancy);
  • data of ultrasound (ultrasound) of the pelvic organs. An ultrasound scan earlier than 10-11 weeks is usually prescribed if the doctor has doubts about the localization (location) of pregnancy (uterine or ectopic) or if a frozen pregnancy is suspected (a condition in which the embryo or fetus in the uterus stops developing and dies );
  • indicators of the level of hCG (human chorionic gonadotropin) in the blood.
Also, the doctor prescribes a number of tests for the pregnant woman (blood, urine, tests for some infections - toxoplasmosis, cytomegalovirus, chlamydial, mycoplasma infections, herpes simplex virus type 1.2, etc.) and specialist consultations (,) to identify concomitant diseases that can complicate the course of pregnancy.

Complications and consequences

Complications of pregnancy can be:

  • - a complication, which, as a rule, manifests itself in the first half of pregnancy and can manifest itself as dyspeptic disorders (nausea, vomiting), salivation, impaired liver function (hepatosis);
  • - complication of pregnancy, characterized by dysfunction of vital organs and systems, which usually occurs after the 20th week of pregnancy. Gestosis can be mild, moderate and severe. Preeclampsia is manifested by an increase in blood pressure, edema, excretion of protein in the urine (proteinuria);
  • and . Preeclampsia is a condition of the body of a pregnant woman that occurs against the background of the development of severe gestosis, which is characterized by increased blood pressure, dizziness, flashing flies in front of the eyes, clouding of consciousness. If you do not take any measures to help the pregnant woman and lower blood pressure, then preeclampsia can turn into eclampsia - a serious condition that threatens the life of the mother and child. An attack of eclampsia manifests itself in the form of a convulsive seizure with loss of consciousness, which lasts from several tens of seconds to several minutes. After the attack, the woman is unconscious or coma. The development of eclampsia can lead to the death of the mother and the fetus and therefore may require urgent operative delivery (caesarean section), regardless of the gestational age;
  • - spontaneous termination of pregnancy up to 37 weeks. Termination of pregnancy before the 20th week is called a miscarriage, from 20 to 37 weeks - premature birth. If a woman has three or more miscarriages, then in this case they speak of a habitual miscarriage;
  • the threat of termination of pregnancy (threatening) - an increase in the tone (tension) of the uterus, the appearance of pulling, cramping pains in the lower abdomen in a pregnant woman. Bloody or profuse clear vaginal discharge (bleeding, premature rupture of amniotic fluid) may also appear. All these symptoms require immediate hospitalization of the woman;
  • threat - the appearance of signs of incipient labor (increased tone of the uterus, pain in the lower abdomen, contractions, discharge of amniotic fluid) in the period from 28 to 37 weeks of pregnancy;
  • premature pregnancy () - the birth of a child between 20 and 37 weeks;
  • - the birth of a child for a period of 42 weeks or more;
  • - termination of the development of the embryo (up to 10 weeks of pregnancy) or the fetus and its death;
  • intrauterine fetal death (after 28 weeks of pregnancy);
  • - incompatibility of the blood of the mother and the fetus for the Rh factor (Rh-conflict) or blood group, as a result of which the mother's body begins to produce antibodies (protective substances) that attack (damage) the erythrocytes (red blood cells that carry oxygen) of the fetus, as a result what hemolytic disease of newborns can develop;
  • gestational diabetes - a disorder in the endocrine system of a woman, similar to (increased blood sugar) that occurs during pregnancy in some women and usually resolves after childbirth;
  • - dysfunction of the placenta (an organ that provides the supply of nutrients and oxygen from the mother to the fetus), decreased blood flow through the placenta and impaired nutrition and oxygen supply to the fetus);
  • - attachment and further development of a fertilized egg not in the uterine cavity, but in the fallopian tube (tubal pregnancy) or in the abdominal cavity (abdominal pregnancy).

Prevention of pregnancy

In order for a child to be born healthy, and to prevent the development of complications during pregnancy, a woman must adhere to the following recommendations:

  • planning pregnancy. A planned pregnancy creates the best conditions for the conception and development of the baby. A couple planning a pregnancy should consult with (), be examined for genital infections and, if necessary, treat them. It is also advisable to undergo medical genetic counseling, especially in the presence of hereditary diseases in relatives. When planning a pregnancy, a couple needs to eat right, give up smoking and alcohol, take a course of vitamins;
  • examination for TORCH infection. For a woman planning a pregnancy, it is advisable to undergo an examination for (a latent infectious disease that can be dangerous to the fetus, especially if it is infected before 12 weeks of pregnancy), the presence of antibodies to the virus (if a woman has not had rubella before pregnancy, she must get vaccinated), research on and. These infectious diseases (,) are combined into a single concept of TORCH infections - infections that are most dangerous for a woman if they become infected during pregnancy, especially in the first trimester;
  • observance of the principles of rational nutrition by a pregnant woman. During pregnancy, a woman's need for nutrients, vitamins and minerals increases. The nutrition of a pregnant woman should be balanced, varied and provide a woman and a child with all the necessary substances. There are two key points to keep in mind:
    • everything that the mother ate passes through the bloodstream in the placenta to the baby;
    • if the child needs something, and the food does not supply enough of this substance, he can "borrow" the deficient substance from the mother's body (for example, calcium). Of course, a pregnant woman should exclude alcohol, toxic (poisonous) and psychostimulating substances from the diet, it is advisable to limit substances containing caffeine (coffee, tea, cola) to a complete rejection;
    • all medicines, herbs, "folk remedies" can be used only after consultation;
  • regular observation of a woman, timely examination and analysis, strict implementation of all recommendations. If the condition of the pregnant woman worsens, the appearance of alarming symptoms - an unscheduled visit to the doctor;
  • observance of the rules of personal hygiene by a pregnant woman, exclusion of exposure to poisonous and strong-smelling substances. It is advisable for a pregnant woman to refuse hair coloring and perm. Cosmetics for pregnant women must be hypoallergenic (do not cause allergic reactions);
  • wearing comfortable clothes and shoes. Clothes for pregnant women should preferably be made from natural fabrics, not squeezing the stomach, comfortable and functional. Shoes should be chosen comfortable, lightweight, always stable and non-slip. During pregnancy, a woman needs to give up shoes with a heel or platform, as it increases the load on the spine;
  • maintaining the physical shape of the pregnant woman. Pregnancy, if it proceeds without complications, is not a disease, and therefore does not serve as a contraindication for moderate physical activity, homework. It is only necessary to exclude weight lifting, excessive stress on the abdominal muscles and situations that create a risk of injury to a woman. In late pregnancy, the physical activity of women decreases slightly. To prepare the body for childbirth and maintain muscle tone of a pregnant woman from an early stage, it is recommended to perform gymnastics for pregnant women, which may be recommended by a doctor or a specialist in preparing pregnant women for childbirth. Daily walks in the fresh air are also recommended;
  • psychological preparation for childbirth and support. A woman during pregnancy is very vulnerable, susceptible to stress and negative emotions, needs support and protection. It is necessary to exclude stressful situations, to postpone for an indefinite time the solution of all conflicts and problems. It is important to get positive emotions, rejoice in your condition, drive away from yourself disturbing thoughts inherent in pregnant women, especially if the pregnancy is the first. In a difficult family situation or inability to cope with anxiety on your own, you should seek help from or.

Additionally

Pregnancy planning

Planning for pregnancy is the key to its successful course. If, for any reason, the occurrence of pregnancy is currently undesirable, there are various methods of preventing unwanted pregnancy (contraception). These include:

  • biological method:
    • interruption of intercourse;
    • calendar method (exclusion of intercourse or protection during ovulation);
  • barrier method:
    • chemical (spermicidal suppositories, gels and tablets);
    • mechanical (condoms, vaginal rings, caps and diaphragms);
  • hormonal contraception:
    • combined oral contraceptives (COCs);
    • gestagens (mini-drank);
    • hormonal patches, rings, subcutaneous implants, hormonal intrauterine device;
    • hormone injections;
    • emergency (postcoital) contraception;
    • intrauterine contraceptives (spirals).