In this series of articles we will cover all three trimesters of pregnancy beginning with 1st trimester.
Antenatal care
Antenatal care (ANC) is the care women get from health professionals during pregnancy. The goal of antenatal care is to ensure the health of both the mother and the fetus by monitoring fetal growth. Antenatal care refers to systemic supervision that includes an examination and advice for a woman during her pregnancy. The main aim of the ANC is to screen high-risk cases and prevent, detect, and treat complications early. It educates the mother about the physiology of pregnancy and improves her mental health during pregnancy.
The antenatal check-up helps identify any complications of pregnancy such as anemia,
pre-eclampsia, and hypertension, among others. Antenatal care allows for the
management of complications through referral to an appropriate facility for additional
treatments. The antenatal care process includes pregnancy early registration, history taking, conducting an antenatal examination, obtaining a laboratory investigation, and
providing health education.
The World Health Organization (WHO) suggests early initiation of antenatal care is a
key component of antenatal care. Prompt initiation of antenatal care can avoid
pregnancy-related problems and save the lives of mothers and babies. It helps in the
identification and mitigation of adverse pregnancy-related complications. Miscarriage is
now a common adverse pregnancy outcome in childbearing and is increasing global
reproductive health problems. A health survey finds that miscarriage is most common in
the first trimester and that an ANC visit in the first trimester reduces miscarriage risks,
emphasizing the importance of ANC visits in reducing miscarriage. Antenatal care must
be started as soon as a positive pregnancy is diagnosed.
1st Trimester
Pregnancy has three trimesters, totaling 9 months altogether (40 weeks or 280 days),
each of which is marked by specific, noticeable fetal developments. Each of the three
trimesters carries a set of risks. The first trimester refers to the initial 3 months of
pregnancy. Pregnancy age is determined by the woman's last period, while the
subsequent growth of the fetus is classified in terms of structural and organ growth and
function development.
The first trimester is counted from the first day of a woman's last period, although she is
not pregnant until ovulation, which typically happens mid-cycle. The first trimester is the
most crucial to the baby's development. During this period, fetus body structure and
organ systems are developing. Most miscarriages and birth defects occur during this
period.
Symptoms during 1st Trimester
For some women, the first trimester is characterised by nausea (with or without vomiting),
and most women tend to feel sick and lose their appetite. These symptoms show that the fetus may not be getting sufficient nutrition, and the mother may begin to display signs of vitamin or mineral deficiency. But remember that every pregnancy is different for each woman, and while some women have food cravings, others experience food aversions, and some have no change in appetite at all.
Some other changes in the first trimester include changes to your breasts as they become more tender, and heavier. In addition, your uterus will grow and put pressure on your bladder, so you will need to urinate more often.
If mothers suffer from increasingly severe symptoms during this period, they should consult with a doctor about possible methods of treatment.
Common symptoms during the first trimester:
Sore breasts
Nausea
Mood swings
Feeling tired
Increased urination
Acne or other skin changes
Mild shortness of breath
Heart-burns
Slight Bleeding
Other less obvious signs and symptoms of pregnancy that you might experience during the first trimester include moodiness, bloating, light spotting, cramping, constipation, food aversions, and nasal congestion.
Risks during 1st Trimester
The fetus is most vulnerable during the first trimester. During this time, all of the major
organs and body systems are forming and can be damaged if the fetus is exposed to drugs, infectious agents, radiation, certain medications, tobacco, or toxic substances.
The risk of having a miscarriage is high during the first trimester, and those risks can be
minimised by taking prenatal vitamins and avoiding smoking, alcohol, and drugs, including some prescription drugs. To reduce the chances of miscarriage, doctors also recommend dietary changes such as avoiding caffeine, deli meats, and shellfish. Additionally, the consumption of drugs, smoking, and alcohol can cause serious pregnancy complications and birth defects and should be stopped during pregnancy.
Vaginal bleeding is considered a dangerous condition during pregnancy that can affect
women during any trimester, and pose a risk to the lives of both mother and baby. If a
woman is suffering from one of these conditions, she should seek medical attention.
Other complications in the first trimester to be aware of include hyperemesis gravidarum,
which is excessive vomiting; spontaneous abortions or miscarriages; ectopic pregnancies;
and molar pregnancies.
Genetic disorders found in the family will affect the growth of the fetus, meaning it may be-placed at risk if the mother has a history of any of the following types of pregnancies:
An infant fatality, either during or after the birth,
A premature birth
A history of pre-eclampsia, chronic hypertension, overt diabetes mellitus, and
autoimmune diseases
Food and nutrition intake
A well-balanced diet provides the necessary nutrients for baby growth and development.
The health of the mother is equally imperative. Weight monitoring of the baby and
mother will be a significant aspect of your care.
By the end of the first trimester, the baby will weigh one ounce and have arms and legs,
and fingernails, toenails, and reproductive organs will also start to form. So food intake
and nutrition are more essential during this stage.
Folic acid is a major vitamin that helps prevent neural tube defects. Women need to take
at least 400 mcg of folic acid daily, starting at least one month prior to conception and
throughout the duration of the pregnancy is important. Folic acid can be obtained from a
variety of foods, that includes beans, lentils, fortified cereals, and dark leafy greens, but
you should still take a prenatal vitamin to make sure you're getting adequate amounts.
Alcohol and smoking tobacco during pregnancy increases the risk of premature delivery
and birth defects.
Treatments
During the first trimester, a woman's body and a baby’s body are changing rapidly. All
nutrients are important, following nutrients are essential for the baby's growth and
development during pregnancy:
Folic acid.
Iron.
Calcium.
Vitamin D.
DHA.
Iodine.
Omega-3 fatty acids
Vitamin B12
Choline
It is normal to gain 3 to 5 pounds during the first trimester. Its due to increased blood and
fluid volume. During the first trimester, nutrients are required to support a healthy
pregnancy and fetus growth.
Treatments
First Trimester Screening includes a combination of ultrasound markers (nuchal
translucency, nasal bone, and tricuspid regurgitation) along with blood biochemical
markers that give a screening report about the risk of chromosomal anomalies and other
growth abnormalities during the pregnancy. These tests indicate the risk of the
development of hypertensive disorders like pre-eclampsia and placental disorders.
Screening tests, diagnostic procedures and prophylactic treatments, and special tests and procedures are advised for the mother to identify the risks
An ultrasound scan is done to observe the development growth of the fetus and to
determine the expected date of delivery. Multiple pregnancies can be identified during the scan to avoid pregnancy difficulties.
There is no clear reason to cause nausea and vomiting during pregnancy, and treatment
focuses on reducing the severity of symptoms. The approach for preventing symptoms
and reducing the severity by changing the diet.
Blood tests help to determine the hemoglobin, blood cell count, blood typing, thyroid
screening, infections, diabetes, and screening for Rh antibodies.
Health measure includes:
Take prenatal vitamins.
Exercise regularly.
Diet food that includes high in fruits, vegetables, low-fat forms of protein, and fiber.
Drink lots of water.
Eat more calories (about 300 calories more than normal).
Importance of check-ups
Antenatal care is the care of pregnant women until the child is born and is aimed at
detecting any existing problems that may develop, which can affect the mother or her
unborn baby. Antenatal care appointments are important because in pregnancy care
provider discusses what you can expect during pregnancy, delivery and performs
checkups and screenings, and answers any questions you have.
Every pregnant woman needs to have antenatal check-ups. The number of visits is
determined by the woman's condition and requirements. During the ANC, the mother
will offer appointments with a midwife or a doctor that is specialized in pregnancy,
an obstetrician. Obstetrics and gynecology doctors are equipped with the knowledge
and experience in caring for prenatal mothers and delivering babies.
The doctor will advise getting the antenatal profile test, usually during the first
trimester. It helps to detect any infectious diseases in the mother that can affect the
baby or conditions like thyroid disease, diabetes, etc. that may need management to
avoid complications during pregnancy.
Antenatal tests can help identify risks to the developing baby and thus aid in its development.
To inform and prepare parents for the birth of an affected infant
To allow treatment or delivery in utero (before birth) at a specialized center for immediate postnatal care (after birth)
To allow the termination of an affected fetus (abortion)
Choose your best Gynaecologist and Obstructionist as soon as a pregnancy is suspected and begin your ANC.