What Happens During The First Trimester Of Pregnancy

What You Need to Know

  • At your first prenatal visit, you will undergo a physical exam as well as certain tests and screenings to assess the health of you and your unborn baby.
  • First trimester symptoms vary from woman to woman, with some experiencing all known symptoms and others only a few. Duration of symptoms can vary as well.
  • After eight weeks, the embryo is referred to as a fetus.
  • Although the fetus is only 1 to 1.5 inches long at this point, all major organs and systems have been formed.
  • During the first trimester, the fetus is most susceptible to damage from substances, like alcohol, drugs and certain medicines, and illnesses, like rubella (German measles).
  • Your first prenatal visit is the most thorough. To evaluate the health of both you and your unborn child, a thorough medical history is taken, a physical examination is conducted, and various tests and procedures are run. Your first prenatal visit may include:

  • Personal medical history. This may include taking record of any of the following:
    • both past and present medical conditions, such as diabetes, hypertension, anemia, and/or allergies
    • Current medicines (prescription, over-the-counter and nutritional supplements)
    • Previous surgeries
  • Maternal and paternal family medical history, including illnesses, intellectual or developmental disabilities, and genetic disorders, like sickle cell disease or Tay-Sachs disease
  • Personal gynecological and obstetrical history, including past pregnancies (stillbirths, miscarriages, deliveries, terminations) and menstrual history (length and duration of menstrual periods)
  • Education, including a discussion regarding the importance of proper nutrition and expected weight gain in pregnancy; regular exercise; the avoidance of alcohol, drugs and tobacco during pregnancy; and a discussion of any concerns about domestic violence
  • Pelvic exam. This exam may be done for one or all of the following reasons:
    • To note the size and position of the uterus
    • To determine the age of the fetus
    • To check the pelvic bone size and structure
    • to conduct a Pap test, also known as a Pap smear, in order to detect the presence of abnormal cells
  • Lab tests, including the following:
    • Urine tests. These are done to screen for bacteria, glucose and protein.
    • Blood tests. These are done to determine your blood type. In the first trimester of pregnancy, the Rh factor is tested on all pregnant women. When the mother’s blood is Rh-negative, the father’s blood is Rh-positive, and the fetus’ blood is Rh-positive, this is known as Rh incompatibility. Anemia in the fetus could result from the mother’s production of antibodies against the Rh-positive fetus. To stop the development of Rh antibodies during pregnancy, compatibility issues are monitored and the proper medical care is available. Additionally, other blood antibodies that could cause issues during pregnancy are screened for during the initial visit.
  • Blood screening tests. These are done to find diseases that could have an effect on the pregnancy. One example is rubella, an infectious disease that is also called German measles.
  • Genetic tests. These are done to find inherited diseases, like sickle cell disease and Tay-Sachs disease.
  • Other screening tests. These are performed to find infectious diseases, like sexually transmitted diseases and urinary tract infections.
  • The initial prenatal appointment provides you with the chance to ask any questions or voice any concerns you may have regarding your pregnancy.

    Johns Hopkins Hospital Designated as Baby-Friendly

    The Johns Hopkins Hospital has received the Baby-Friendly Hospital Initiative designation, a global initiative started by the World Health Organization and the United Nations Children’s Fund. These facilities are recognized for providing the best level of care for mother-baby bonding and infant feeding.

    What tests will I have in the first trimester of pregnancy?

    Prenatal exams, screenings, and other tests keep both you and the fetus healthy. Care during pregnancy is commonly referred to as prenatal care. Prenatal care appointments are crucial because they allow your healthcare provider to answer any questions you may have, perform checkups and screenings, and talk to you about what to expect during pregnancy and delivery.

    During your first trimester, you’ll have between two and three prenatal appointments. This may differ based on your doctor or if you are experiencing a high-risk pregnancy. You can anticipate talking about your own medical history, your family’s medical history, and your gynecological and obstetrical history (including previous pregnancies and births). This examination is very thorough to ensure your health and the health of the developing fetus.

    Your doctor will determine your due date at your first prenatal appointment. You can also expect them to perform the following:

  • A physical exam, including checking your weight and blood pressure.
  • A pelvic exam.
  • A Pap test (if you’re due for one).
  • Tests to check for certain sexually transmitted infections (STIs).
  • Check your pee for bacteria, protein and glucose (sugar).
  • Order blood tests to check hormone levels, Rh factor, iron levels and certain diseases.
  • Check the fetal heart rate.
  • At your initial appointment, some healthcare professionals use transvaginal ultrasound to confirm pregnancy and assess the size and heart rate of the fetus. This ultrasound also shows if you’re expecting multiples. Your doctor inserts a wand into your vagina during a transvaginal ultrasound. The majority of pregnant women are encouraged to have at least one ultrasound in the first trimester, though the exact timing varies depending on your provider. In your first trimester, additional ultrasounds might be recommended if you’re expecting multiples.

    Your provider may suggest other screening tests during pregnancy. Screening exams determine whether you or the fetus are at risk for specific diseases. Your screening results may indicate that you need diagnostic tests. Diagnostic tests confirm or rule out health problems. Your doctor might advise a screening during the first trimester to look for chromosomal disorders like Down syndrome, which carry a higher risk. Talk to your provider about the screenings they recommend.

    Pregnancy: The First Trimester

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