What to Do in Your First Trimester?
What is the first trimester?
The first trimester is the very beginning of the pregnancy period. The period is of 12 weeks duration starting from conception till 12 weeks. This duration is calculated from the last menstrual period presuming that the ovulation occurs on the 14th day of the cycle.
What actually is happening in my womb in the first trimester?
During this period, the pregnancy foundation is being laid down, and therefore, this phase is crucial. Two important components, such as the formation of the baby’s bodily parts and organs and placental formation to create nutrition passages between the mother and the baby are underway. (Placenta is a newly formed organ inside the womb along with the baby that supplies easy to be utilized nutrients from the mother).
Pre-pregnancy care is important: By the time the pregnancy is diagnosed it is already clocked to 5 to 6 weeks. By this time the neural tube of the baby is already formed. The neural tube is the foundation of the brain and the spinal cord and therefore it is important that before planning pregnancies the mother takes pre-pregnancy guidance from a doctor, corrects nutritional deficiencies, achieves ideal weight, and is assessed for any illnesses.
What are the things that are needed to be prioritized by a pregnant woman during the first trimester (1-12 weeks)?
Establishment of the duration of the pregnancy and health of the mother which can be done clinically by the doctor and confirmed with surety by laboratory tests and sonography examination.
Blood tests as under:
Complete blood count for anaemia: Haemoglobin level/ blood cells/ other indices
· Screening for thyroid disorders, diabetes and renal abnormality
· Urine testing for infections, proteinuria, glucose and casts
· Blood group and Rh typing confirmation
· Screening for transferrable diseases such as hepatitis B , HIV AIDS , syphillis (may be repeated after 6 months)
· Screening for genital infections
Sonography tests:
· Confirmation Scan (up to 7 weeks): To confirm the pregnancy is in the womb and presence of heart beat and number of babies
· Dating Scan (8-10 weeks): Especially when the mother has irregular cycles or the confirmation scan is not corresponding
· NT Scan (11 to 13 weeks): Nuchal translucency is a special test which helps to screen the baby for abnormalities such as Down syndrome or other developmental abnormalities.
· Some additional special tests may be necessary as under:
Special tests:
Screening for rubella, toxoplasmosis, thyroid antibodies, thyroid function tests
Double marker test ( done along with NT with biomarkers in the mothers blood to predict adverse outcomes such as baby growth restriction ,pregnancy related raised blood pressure (preeclampsia ), premature placental separation
Indirect Coomb’s test in Rh negative mother
Evaluations of diabetes and anaemia
Screening for thalassemia or sickle cell disease which are disorders which are transmitted genetically to the baby.
Additional tests may be requested for additional evaluation and this can be case specific and will be individualised by your clinician such as blood tests and Doppler studies
What are the medicines that are needed to be taken and are they necessary?
Prenatal supplements:
Folic acid help prevents developmental abnormalities in the baby and the placenta Pyridoxine and dicyclomine help in preventing pregnancy nausea and vomiting nutritional supplements are given.
In addition, some medications may be additionally prescribed in special situations. Vaccinations especially for flu can be taken.
Can I do exercises or are there any restrictions for physical activity?
You can continue doing exercises that you were doing before conception, but it is better to avoid strenuous and tiring exercise. Daily walks at least for 40 minutes are a good practice. One should avoid strenuous work and lifting of heavyweights and hectic travels.
What foods should be consumed?
Home-made healthy and fresh food rich in nutrients, clean and balanced in macronutrients such as proteins and carbohydrates should be taken. Pregnancy can cause mild constipation, and taking food rich in fiber is a good practice. Also, folic acid, folates are abundantly found in fresh fruits and vegetables.
Is it ok to feel tired and puki (nauseated)? How can I overcome this?
Yes, the pregnancy is demanding on the mother’s body, and nutritional and energy needs are increased. This can cause tiredness and a feeling of nausea. Eating small meals ad healthy titbits especially dry ones throughout the day at short intervals, drinking adequate water, and medications can help overcome these symptoms.
Back ache seems to be common?
Yes, the pregnancy is demanding on the mother’s body, and nutritional and energy needs are increased. This can cause tiredness and a feeling of nausea. Eating small meals ad healthy titbits especially dry ones throughout the day at short intervals, drinking adequate water, and medications can help overcome these symptoms.
Any important hygiene practices I need to follow?
Bathing daily or twice in the very hot weather, wearing clean comfortable cotton clothes, frequent hand washing, brushing twice, keeping private parts clean, and avoiding crowded places are important hygiene practices.
Are there any restrictions?
Unhealthy foods, stale food, fasting, hectic work and travel, medications over the counter without doctor’s permission, crowded places, infected or sick family members.
Your responsibility as a patient: To completely share the details about your health, about past illnesses, surgeries, and medications consumed for some illnesses such as tuberculosis, epilepsy (fits), raised blood pressure diabetes, or other medications in detail.
It’s a good practice to properly date these details and share them with your clinician for better guidance.
Take all the medicines on time. Pay attention to the clinical instructions and follow them diligently.
Inform about any allergic conditions especially to any medicines.
Any warning signs?
Crampy pain in the tummy, giddiness, blackouts, excessive vomiting, dehydration, high-grade fever, urinary symptoms, bleeding from the vagina need doctor's consultation and check-up.
Dr Girija Wagh
MD FICOG FICS Dip Endoscopy, Specialist in Maternal and Fetal Care Medicine, Infertility and Gynecology