The First Trimester of Pregnancy: An Overview
Based on your age or family history, you may also need to do the following:
- Schedule an ultrasound, if you’re over 35 or larger than you should be for your gestational dates. (You could be carrying twins or more!)
- Arrange for a perinatal consultation for risk factors if you’re over 35, have a troubling family history of genetic disorders, or have had a previous complicated pregnancy.
- Schedule an amniocentesis if you’re over 35 or at risk for Down syndrome or other possible birth defects.
- Request previous birth records, including C-section notes and prenatal charts (to check for prenatal hypertension, gestational diabetes, first trimester bleeding, placental abnormalities, anemia, etc.). The C-section notes help determine if it’s safe to have a vaginal delivery this time around.
First-trimester visits are usually monthly, unless there are concerns. Most obstetricians like to get at least two ultrasounds to confirm your due date within a few days.
Monthly visits continue until about 20 weeks, well after the first trimester. Visits are more frequent only if there are special medical and obstetrical concerns, such as first trimester bleeding (which may mean a possible miscarriage), uncontrolled nausea and vomiting, and pelvic pain (which could be an ectopic pregnancy).
Most Common Causes of Bleeding in the First Trimester
First-trimester bleeding is any bleeding in the first 12 weeks and is never considered normal—that’s the bad news. The good news is that it’s usually caused by something fairly harmless. If you have any bleeding, don’t ignore it. It is one of the most common reasons a woman goes to her obstetrician.
One fairly harmless cause of bleeding is cervicitis, an inflammation due to infection, often caused by a common yeast infection. A simple prescription or over-the-counter cream can quickly take care of it.
Cervicitis is a condition in which the delicate cells at the mouth of the womb, the cervix, bleed for one of three reasons:
- The mechanical action of intercourse
- An alteration in the acidity in the vagina (pH)
- The effects of infections on the cells in the cervix
With the hormonal changes of pregnancy, the fragile cells inside the cervix peek out a bit onto the exterior and are exposed to the vagina. The vagina is a harsher environment for these cells. Usually nestled more deeply away from sexual activity, they now can be easily damaged, which can cause bleeding. Of course, this cervical bleeding is merely what you’d consider spotting. There is usually only bleeding with sex when you have a condition like cervicitis.
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