First Trimester of Pregnancy | Birth and Baby
Are you experiencing the joys and challenges of the first trimester of pregnancy? Embark on the transformative journey of early pregnancy, exploring remarkable milestones and changes during this exciting period. Discover the joys and challenges of the first trimester as we embark on an extraordinary journey.
A Comprehensive Guide To Medical Imaging In The First Trimester Of Pregnancy
A comprehensive guide to medical imaging during the first trimester of pregnancy, covering various techniques and their applications. Gain essential insights for informed decision-making and optimal care.
Symptoms in Pregnancy
Early pregnancy comes with its challenges as most of us know who have had children. The pregnancy symptoms for some can last for weeks. There’s the nausea, the morning sickness, and vomiting. If that’s not enough we are constantly told to eat more to ensure the baby is being well fed.
However, as a consequence we get indigestion, heartburn, constipation, and then comes the weight gain. Of course with that comes the mood swings. ha! Every pregnant woman has different symptoms of pregnancy, but as soon as you hear that baby’s heartbeat… your due date can’t seem to come fast enough!
Detection of Pregnancy
There are three screening tests for the detection of early pregnancies in women. The first is having a blood test to detect the exact amount of hCG is in your blood. This will also determine what blood type is yours (such as A or B). It will also test for the Rh-factor, which it a protein that can be found on the surface of the red blood cells.
The second way to test for early pregnancy is via urine tests. These tests work by reacting to the amount of hCG in your urine. The third way would be via an ultrasound imaging examination. Ultrasound can detect pregnancies generally as early as 6 weeks gestation (6 weeks of pregnancy).
The embryo and baby’s heartbeat may be seen slightly earlier if the scan is done with the use of a trans vaginal transducer, but ideally, it is better to wait as long as possible.
Early Ultrasound for Pregnancy
Early ultrasounds are not common practice unless, the patient has had fertility support, is unsure of her last menstrual cycle dates, or is having some complications that may be alarming. An early ultrasound can identify many things; whether or not there is a viable pregnancy within the uterus, it can show endometrial thickening, a gestational sac, a yolk sac, a fetal pole, and a fetal heartbeat.
Oh… and one more thing, at this point, we will generally be able to tell you if you will be having a singleton or a litter of children. (Cause there is that!) If any of these structures are not well visualize, or not visualized at all, often the patient will be asked to return within a week or so. It can be a possibility that it was too early in conception to see any of these structures yet.
Nuchal Translucency Exam (Via Ultrasound)
There are also first trimester screening ultrasounds that are offered to pregnant mothers at the end of the first trimester, between the 11th and 14th week of pregnancy. This test is called a nuchal translucency exam. This exam is done to determine your baby’s risk of having Down syndrome (Trisomy 21), Edward’s Syndrome (Trisomy 18), Patau Syndrome (Trisomy 13), and some other chromosomal abnormalities. It can also detect some abdominal wall defects and skeletal defects. It is performed along side a blood test and can also detect major congenital heart problems in the baby.
The nuchal scan measures the translucent (clear) space at the back of the baby’s neck. The cut-off for this measurement to be considered within a normal range would be a thickness of no more than 3.5mm, front to back. Babies with abnormalities tend to accumulate more fluid at the back of their neck during the first trimester, causing this measurement to be increased.
Further Specific Criteria
Another specific criteria that is looked for under ultrasound during the first trimester screening exam is the presence of nasal bones. In the event that they are absent, it is believed that this could be indicative of an increased likelihood of chromosomal abnormalities. We do check for fetal development, physical activity, umbilical cord insertion, baby’s heartbeat, amniotic sac, sometimes the genitals, bladder, intestines, neural tube, and other major organs at this stage.
However, a full anatomical scan is performed in the second trimester when structures are more fully developed and easier to assess. Baby’s body measurements are compared to estimated fetal growth based on the mother’s last menstrual period.
The nuchal scan results are calculated by a combination of the nuchal measurement, your baby’s gestational age, the mother’s age, and a blood test result. This combination will work out a ratio of your chances of conceiving a baby with an abnormality. This test is about 70 to 80 percent accurate in detecting Down’s Syndrome on its own. Combined with the blood test, its accuracy increases to between 79 and 90 percent. In the event that you are given a concerning result, you would likely then be referred to a genetic councillor. From there, you may decide to undergo Chorionic Villus Sampling (CVS) or amniocenteses to receive a definitive diagnosis.
Chorionic Villus Sampling/ Amniocentesis
In Chorionic Villus Sampling (CVS), a needle is inserted through your skin into your uterine wall under the guidance of an ultrasound imager. The needle is then guided to the placenta, and a syringe is attached to be used to retrieve a small sample of the cells from the chorionic villi. For an amniocentesis, a similar procedure is performed, however, this time, a small sample of the amniotic fluid that surrounds the fetus is obtained. These tests are very accurate, but like any, come with a minute chance of faulty results and some risks. Those would be all be discussed with you by your physician before any test would be carried out.
Miscarriage
If the patient is experiencing other physical symptoms, such as vaginal bleeding, pelvic and abdominal cramping, and has had a confirmed hCG blood test result, often the ultrasound findings may be indicative of a miscarriage. A physical exam would be carried out to begin with. A Miscarriage is the spontaneous loss of a pregnancy before the 20th week.
Approximately 10 to 20 percent of known pregnancies end in miscarriages. A lot of people might miscarry before even knowing they were pregnant to begin with. Unfortunately, this unpleasant experience is a very common occurrence. Most miscarriages are one-time occurrences, and women often go on to have healthy future pregnancies.
Ectopic Pregnancy
We would also use ultrasound if we were questioning an ectopic pregnancy. This occurs when implantation of a fertilized egg occurs outside of the uterus and precedes to grow. The most common area for this to occur would be in the fallopian tubes. This is where the egg is transported from the ovaries to the uterus. For the most part, the patient would exhibit a lot of abdominal pain down low and generally to one side. On a pelvic exam, they would be bleeding and have a lot of discomfort when using the washroom. This would be considered an emergent situation and would need to be addressed immediately.
An ectopic pregnancy has no chance of survival. They must be removed as soon as they are detected in the mother. If left untreated, they can result in a life-threatening hemorrhage. Tissues outside of the uterus cannot provide the necessary blood supply and/or support to the fetus. The fetal structure typically ruptures between 6 to 16 weeks of gestation, making survival impossible.
A medication called methotrexate would be given to the patient to immediately stop the pregnancy growth. This is then carefully monitored to ensure that surgery is not additionally required. If need be, surgery is used to removed the pregnancy of the affected fallopian tube as well. Surgery is performed laparoscopically. The fallopian tube is usually left in the patient to heal on its own. The mother’s blood pressure would be consistently monitored throughout this entire process, and do to the amount of blood loss during the ectopic pregnancy, she would be required to be screened for anemia.
Births
Approximately 140 million babies are born into our world every year. That’s equivalent to four births every second of every day. It is estimated that 97 out of 100 babies in the U.S. are born without any major birth defects. Some of these defects do not require treatment, while others can easily be treated. Smoking, drinking, the use of certain drugs, obesity, and uncontrolled diabetes are some factors that can contribute to birth defects in babies.
I hope this provides an overview of key points to consider when exploring early pregnancies. There are a multitude of screening options available to parents with regards to pregnancy. I intend to blog on the second trimester, and third trimester ultrasound examinations in their own separate postings. (Hopefully with the addition of some interesting case studies).
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Frequently Asked Questions
Are there any dangers during pregnancy that can happen at this stage?
It is important to be aware of the potential risks and dangers during pregnancy, particularly as you reach the later stages. Some common risks include preterm labor, gestational diabetes, preeclampsia, placental abruption, and infections. Additionally, remain vigilant for signs of preterm labor or sudden changes in your health or the baby’s health. Regularly consult with your healthcare provider during pregnancy to ensure ongoing monitoring of potential risks. Additionally, it is a good idea to eat a balanced diet, take prenatal vitamins, get regular exercise, and avoid smoking, alcohol, and drugs to help promote a healthy pregnancy and reduce the risk of complications. rewrite in better style and in an active voice
Why is first trimester pregnancy so critical?
The first trimester of pregnancy is one of the most critical times for both mother and baby. During this period, the baby’s organs and systems are forming, making it essential that the mother receives proper nutrition and care. During the first trimester, it is important for the mother to get regular prenatal care and to take any necessary steps to ensure a healthy pregnancy. This can include taking prenatal vitamins, eating a balanced diet, avoiding alcohol, drugs, and cigarettes, getting adequate rest, and exercising regularly. Taking these steps can help reduce the risk of complications such as miscarriage or preterm labor. Be alert to symptoms that may indicate problems and seek medical attention if necessary.
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