Palpation of the uterus in a pregnant woman.

Lack of menstruation, nausea, loss of appetite and mood swings are just a few of the primary signs that may indicate pregnancy in the early stages.

After conception, a change in the color, size and shape of the uterus occurs, which can be noticed during a gynecological examination by the 6th week of pregnancy. How to feel the uterus during pregnancy? This can be done in a horizontal position, feeling the lower abdomen.

However, in the first trimester, only an experienced specialist can determine conception in this way.

How to calculate the approximate due date?

There are several ways to calculate when the long-awaited baby will be born.

• If menstruation came regularly before pregnancy, then the first day of the last “critical days” is taken as the starting point. To this date you need to add 9 regular calendar months and another week. This will give you (approximately) the day on which you can expect the baby to be born. You can do it differently: from the first day of your last period, count back 3 calendar months and then add a week.

• You can calculate the baby's due date based on the last ovulation. To do this, you need to take as a starting point the number on which your period should have started, but did not. From this number you need to count back 2 weeks and then add 273 days to this date.

• If a woman does not remember the date of her last menstruation, or she does not have them regularly, then you can use the day of the baby’s first movement as a starting point. To this day you need to add 20 weeks for primiparous women, 22 weeks for multiparous women.

• One of the most accurate methods that helps calculate the gestational age (and with it the due date) is ultrasound. It is especially convenient in the early stages. In the second and third trimesters, the child’s development may be delayed, and then the child’s size will look shorter.

Doctors use different methods to determine the expected date of birth and all the resulting calculations are recorded in the chart.

Features of the third trimester of pregnancy.

In this final period of pregnancy, the woman’s body and the baby itself are intensively “preparing” for childbirth. All organs of the child are already well developed, but their functional activity is not yet complete. In the third trimester, the child’s lungs intensively develop and a special substance is produced - surfactant, which is vital for normal breathing.

A fetus born even at the very beginning of the third trimester is successfully nursed in modern conditions. Most children born before 33 weeks of pregnancy require intensive care, breathing support with the help of special equipment, intravenous infusions of nutritional solutions and the use of medications. If the pregnancy ends with childbirth after 33 weeks, then there is a high probability that the child will be able to emerge without respiratory support and serious medications.

In the third trimester, significant changes occur in the female body. Often, an expectant mother has to be hospitalized in a hospital due to accumulated pregnancy problems (swelling, increased blood pressure, anemia, poor urine tests, too much weight gain, etc.).

How to notice the approach of labor? In the later stages of pregnancy, when childbirth will happen very soon, expectant mothers note a drooping abdomen, a feeling of some relief when breathing, a slight weight loss, and a decrease in appetite. Another symptom of approaching labor is the release of a mucous plug from the vagina. However, such discharge can occur both a few days before birth and on the day of birth itself.

Features of the second trimester of pregnancy.

In the second trimester, expectant mothers relax a little. Symptoms of toxicosis (if there was one) fade away, women begin to feel much better. The first tests and studies are behind us. The second trimester is no longer such a critical period with regard to spontaneous abortion, but this can still occur if the fetus is exposed to unfavorable factors.

The belly begins to increase in size due to the pregnant uterus. By the end of the second trimester, the fundus of the uterus reaches approximately the navel. Pregnancy is already becoming clearly visible to others. In the second trimester, the baby grows rapidly, and the functioning of all organs improves.

If during pregnancy in the early stages the baby was called an embryo, then in the second trimester it is already called a fetus. At 22 weeks of pregnancy, the fetus is considered viable. At this time it weighs approximately 500 grams. Of course, he will not be able to survive without high-tech help and very complex nursing. But all children born alive at 22 weeks or more have a chance to live and are necessarily nursed.

At what stage of pregnancy does the mother begin to feel the baby move? As a rule, when carrying her first child, a woman can clearly detect movements no earlier than 18-20 weeks of gestation. When carrying their second and subsequent children, some women feel movements at 16-18 weeks. Often, women simply confuse earlier movements with the peristalsis of their intestines.

The woman begins to gain weight with each subsequent visit to the gynecologist. Weight gain is caused not only by the fact that the baby is growing, but also by the growth of the uterus itself, the placenta, an increase in the volume of amniotic fluid, enlargement of the mammary glands, and an increase in the volume of circulating blood.

The weight of the expectant mother is recorded in the exchange card at each appointment. Also, at each appointment, the doctor measures the abdominal circumference with a tape and evaluates the resulting gains, measures the height of the uterine fundus, and evaluates the position of the baby in his womb. From about 20 weeks (less often from 18), the doctor begins to listen to the baby’s heart sounds with a stethoscope.

What other signs are there that a woman is pregnant?

Is it possible to somehow predict pregnancy in the early stages before visiting the hospital with a high degree of probability, that is, without performing an ultrasound? Yes, you can. A pregnancy test is very informative in this regard. It is recommended to take a pregnancy test no earlier than the first day of your missed period. It makes no sense to use a test to determine the presence of pregnancy before a missed period.

There are different pregnancy tests, but the essence of their work is the same: the test indicator reacts to the amount of human chorionic gonadotropin (hCG) in his urine. This hormone begins to be intensively produced in the body within a day after the fusion of mother’s and father’s cells. With each day of progressing pregnancy, its amount increases. About 2 weeks after conception, the pregnancy test becomes positive.

Pregnancy tests are rarely false positive in healthy, non-pregnant women. If the test shows a negative result, and the woman sees probable and doubtful signs that she is pregnant, then she needs to do a test over time in a few days. It is better to do this in the morning, when the urine is more concentrated. If a woman has an ectopic pregnancy, the test will also be positive.

You can more accurately determine the gestational age without resorting to ultrasound using a blood test for hCG levels. Its laboratory-confirmed quantity can tell you how much time has passed since conception. Determining hCG over time is very informative in terms of pregnancy progression.

What are the warning signs in the early stages?

Does your stomach hurt in early pregnancy? Normally, there should be no pain in the early stages of pregnancy. If a woman has a severe stomach ache in the early stages of pregnancy, there is a risk that the pregnancy may spontaneously terminate.

Should you panic if you experience bleeding during early pregnancy? Slight bleeding occurs when the embryo is implanted into the uterine wall. It happens that women mistake this discharge for menstruation (albeit scanty). If heavy bleeding appears during early pregnancy, this may indicate that a miscarriage has begun or has occurred.

The appearance of sharp pain in the abdomen, a drop in pressure, a sudden deterioration in the condition, or bleeding may indicate that the woman has an ectopic pregnancy. Such symptoms require urgent hospitalization and rapid diagnosis. An ectopic pregnancy threatens the patient's life due to bleeding.

What are the signs of the first trimester of pregnancy?

A woman does not immediately find out about her “interesting situation.” Even if the pregnancy is planned, it is impossible to say with certainty whether fertilization occurred or not.

Therefore, women begin to guess about their situation when certain signs appear in them. During pregnancy, signs of its presence are divided into suspected, probable and reliable.

How to reliably determine pregnancy?

• The birth of a new life in the early stages can only be confirmed with the help of ultrasound. When conducting a study with a sensor through the abdominal wall, it is possible to determine the fertilized egg in the uterus from 4-5 weeks of obstetrics.

• When conducting an examination with a vaginal sensor, the fertilized egg can be seen 1-1.5 weeks earlier. In addition to it, during an ultrasound, the yolk sac is visible.

An ultrasound helps to find out whether the fertilized egg has implanted in the uterus, or whether an ectopic pregnancy is developing, in which a successful outcome is impossible.

From about 5-6 weeks of gestation, the heartbeat of the embryo can be recorded during an ultrasound. After another 2 weeks, the movements of the embryo are clearly visible.

Based on what signs can you most likely assume pregnancy before and during a visit to the doctor?

• Delay of menstruation;

• The appearance of a cyanotic tint to the mucous membrane of the vagina and cervix;

• An increase in the size of the uterus, as well as a change in its shape and consistency.

• The last two signs can only be noted by a gynecologist when examining a patient in a chair.

There are also dubious signs of pregnancy in the early stages, by which one can only predict that the woman is in an “interesting situation,” but one cannot say for sure.

• Changes in appetite, nausea, vomiting (especially in the morning);

• The emergence of unusual food preferences;

• Sudden onset of intolerance to common odors;

• Drowsiness, mood swings;

• Enlargement of the mammary glands and some tension;

• Increased urination.

• Some patients report nagging pain in the early stages of pregnancy in the sacral area.

These symptoms are not at all informative if a woman is trying to determine the presence of pregnancy before her period is missed.

Features of the first trimester of pregnancy.

This is a very important period of pregnancy, during which the fusion of parental cells occurs, the fertilized egg attaches to the uterine wall, and the development of the embryo begins. All tissues and organs are formed and they begin to perform their functions. The placenta and umbilical cord develop, which play a vital role in providing the baby with oxygen and nutrients.

This period is especially dangerous with regard to the effects of various unfavorable factors and toxic substances on the embryo. They can negatively affect the baby, which can lead to a frozen pregnancy, miscarriage, or the formation of various pathologies.

The size of the uterus gradually increases in the first trimester. Only towards the end of the first trimester does the uterus begin to emerge from the womb. The size of the baby at this stage does not exceed 8 cm, and its weight is approximately 20 g. However, some women claim that their belly has increased in the early stages of pregnancy. Yes, this happens, but not due to an enlarged uterus, but due to increased gas formation and bloating. Such processes are caused by ongoing hormonal changes in the body and are absolutely normal.

As a rule, in the first trimester, a woman registers for pregnancy with a gynecologist, takes the necessary tests, and undergoes a series of examinations. If bearing a child is not part of the couple’s plans, then for up to 12 full weeks the resulting pregnancy can be terminated at will.

In the early stages of pregnancy, you should be very attentive to your health, get enough sleep, walk a lot, don’t be nervous, eat right, and give up bad habits.

What periods is pregnancy divided into?

In obstetrics, it is customary to divide pregnancy into three trimesters. Each of them has its own characteristics and characteristics.

• The first trimester lasts 13 weeks of obstetric period.

• The second trimester starts from the beginning of the 14th week of gestation until the end of 27 completed weeks.

• The third trimester begins at 27 completed weeks and ends with childbirth.

As a rule, when numbering trimesters, Roman numerals I, II, III are used.

How do doctors calculate the gestational age?

Many expectant mothers can tell down to the day when the child was conceived. But they don’t understand why the doctor writes in the exchange card the gestational age is much longer than the patient expects. Why? Are doctors really wrong? The fact is that the duration of the current pregnancy is counted not from the day of conception, but from the day when the expectant mother began her last period with a regular menstrual cycle.

Let's look at this with a simple example. The woman started her period on March 1st. On March 15 (mid-cycle) she became pregnant. What pregnancy date will the doctor estimate on April 20? The doctor will count from the first day of the last “critical days” and write the period 7 weeks 1 day. This will be an obstetric period. And the embryonic period is calculated from the date of conception. And in this case it is 5 weeks 1 day.

Therefore, there is no need to argue with the doctor and prove that you are right. You just need to know that in obstetrics it is customary to indicate the obstetric gestational age in documents.

That is, the difference between obstetric and embryonic periods is approximately two weeks, if 28 days pass between periods (from the first day to the first). It happens that a woman’s cycle lasts not 28 days, but 33-35 days. In this case, the doctor will take this point into account when determining the gestational age and when calculating the expected date of birth of the baby.

How long does pregnancy last?

In a physiological course, this process lasts ten obstetric months. Another name for obstetric months is lunar months. Such a month lasts 28 days. In everyday life it is customary to say that pregnancy lasts nine months. How is that right? When they say that pregnancy lasts nine months, they mean calendar months of 30-31 days. If we discard this “tail” of two or three days from each month, then just one more lunar month of 28 days will be added.

So that no one gets confused about months, it is much more convenient to consider the duration of the current pregnancy in weeks. A normal pregnancy lasts forty weeks. By the number of days, the result is 280. Of course, it does not always happen that a child is born exactly on the 280th day. If the baby was born at a full 37 weeks, then it is considered full-term. If the baby was born at 42 weeks or more, then it is considered post-term.

Thus, a full-term pregnancy lasts from 37 weeks 0 days to 41 weeks 6 days. A baby born between 22 weeks and 36 weeks 6 days is considered premature. If it turns out this way, the pregnancy is interrupted before 22 weeks, then the resulting fetus is considered a miscarriage.

Ultrasound to determine the gestational age.

In addition, an ultrasound diagnostic doctor can determine the gestational age.

If we are talking about short stages of pregnancy and the embryo has not yet been identified, but there is a fertilized egg in the cavity, then the calculation is carried out according to its average diameter, but this method is approximate. When the embryo is already clearly visible (and this is 7-8 weeks), the period is calculated based on the coccygeal-parietal size of the fetus, and this method is already more reliable.

At later stages, the doctor focuses on the size of the uterus, or more precisely on the height of the uterine fundus from the symphysis pubis. Everything is quite simple here: approximately every week the uterus grows by 1 cm (that is, if the period is 22 weeks, then the height of the fundus of the uterus from the womb will be approximately 22 cm).

How to calculate the expected due date?

To calculate the EDA (estimated date of birth), the Nägel formula is used:

To do this, you need to add 40 weeks to the first day of the last menstruation, or count 3 months from the first day of the last menstruation and add 7 days to the resulting number.

Everything is not as complicated as it seems, but it is better to trust your obstetrician-gynecologist.

How is gestational age calculated?

When you see the long-awaited two lines, which indicate a positive pregnancy test, the first thing you want to do is find out the gestational age.

In obstetrics, the gestational age is calculated not in months, but in weeks, and, in addition, the obstetric period is calculated not from conception, but from the first day of the last menstruation. That is, the first day of menstruation is considered the day of conception.

You will rightly note that this method of calculation is not accurate, because ovulation occurs on average 2 weeks after the start of menstruation. But this method is universal and applicable to almost any woman, subject to regular menstruation. The error is not significant and averages 10-14 days.

Alternative ways to determine the due date.

Determining the baby's date of birth can be done in alternative ways. There are several of them:

• Determination of the period can be entrusted to a qualified specialist - a gynecologist. In this case, he will not prescribe additional studies, but will conduct a routine examination. The size of the uterus is measured, which increases due to the baby in the womb. Please note that it is possible to calculate the period in this way only in the 1st trimester of pregnancy. In later stages, the uterus may increase in size differently in different patients, so examination may not provide an accurate understanding.

• Determining the date of birth based on ovulation. Ovulation is the most favorable time period for a woman, during which the probability of conception is highest. During this period, libido (sexual attraction to a partner) increases, and discharge from the cervix becomes thicker. Determining the date of ovulation consists of adding 280 days to this period (i.e. 9 months of pregnancy). If the time of ovulation is unknown, then you need to add the same 280 days to the middle of the last menstrual cycle.

• You can determine the term by the date of conception. But it must be borne in mind that conception may not occur at the moment of actual sexual contact with a partner. As a rule, this can happen on the third day after sex.

• One of the most effective methods with high accuracy is ultrasound. An ultrasound examination can reveal the due date, with an error of only a few days. The highest percentage of accuracy is if the examination is done during the period from 11 to 14 weeks of pregnancy. You should not rely heavily on this method in the early stages (5-6 weeks), when the fetus is still very small.

• A slightly archaic method involves the appearance of the first fetal movements. It was relevant earlier, when there were no hardware methods for determining the deadline. For women who are about to give birth for the first time, this occurs around the twentieth week, and for women who are not having their first pregnancy, this occurs at the 18th week. But even this method will be more accurate than any online calculator that can be found on the Internet.

Accordingly, when a woman feels the first significant tremors, twenty weeks should be counted from this date. If this is not the first time she gives birth, then you need to add 22 weeks. The same must be done in case of multiple pregnancy.

Many people feel the baby’s movements much earlier, but this is impossible from a purely physical point of view. If you experience similar sensations before 16 weeks, it may be due to intestinal colic or spasms.

Obstetric method for determining the date of birth.

By the date of your last menstruation, you can find out the duration of your pregnancy and the expected date of birth. All other calculations are carried out on this day. You need to subtract three calendar months from it and add seven days to the resulting amount. The number you get is the day of the probable date of birth.

For example, your last period was on March 13th. We subtract three months from this date – it turns out December 13th. We add seven days to this value, i.e. It turns out December 20th - this will be the probable day of your birth.

But there is one small nuance - all these calculations apply only to those women who have a stable menstrual cycle (28 days). Any hormonal disorders or stress affect the frequency of menstruation, the cycle shifts, and therefore it is more difficult to calculate the date of birth.

How to determine the due date?

Pregnancy is always an important and very responsible event in a woman’s life. When conception has already occurred, it is quite logical that the expectant mother wants to know the expected date of birth. This is a rather controversial issue with various interpretations. This concern of expectant mothers is understandable, because they have so much to do and prepare for childbirth. Therefore, many women turn to doctors with this question, but even they cannot predict with 100% certainty the exact time of the birth of the child. You can calculate the date of birth using different methods, which, to varying degrees of reliability, allow you to find out the approximate dates.

It should be taken into account that even if the calculation shows that the child should be born conditionally on December 1, it is not at all necessary that this will happen on this very day. The deviation can be in one direction or the other, i.e. the time of birth may be shifted two weeks later or earlier. In medical practice, the calculation of the EDA (estimated date of birth) is used.

When can you start having sex after childbirth?

The postpartum period lasts 6 weeks. This is a very important period for a woman, when the body gradually returns to its non-pregnant state. Therefore, during this period, it is best to abstain from sexual activity, especially if you had a cesarean section or episiotomy.

Pregnancy is not a disease, so the couple can enjoy an active and fulfilling sex life. In most cases, sex during pregnancy is safe.

Can sexual activity trigger labor?

In some situations, labor may begin after sexual relations, but this only happens if the woman’s body is completely ready for childbirth (in the last weeks of pregnancy - starting from 37-38 weeks).

This is due to the presence of prostaglandins in sperm - biologically active substances that stimulate uterine contractions. Therefore, if the due date has already arrived, sexual activity can contribute to the onset of labor.

Why does discharge appear from the mammary glands during sexual intercourse?

During pregnancy, the mammary gland prepares for feeding the baby in advance; from about the third month of pregnancy, the production of colostrum (a thick yellowish liquid) begins.

During sexual arousal, the hormone oxytocin is released. This is the same hormone that is released when you breastfeed your baby. The “love hormone,” which is responsible for sexual desire, also ensures milk production. Therefore, it is natural that a small amount of colostrum may be released during sexual intercourse.

Is it normal to not experience sexual desire during pregnancy?

Yes, it can be. Sexual desire in some women is biologically determined, so when the goal (pregnancy) is achieved, some women do not experience sexual desire.

Benefits of sex during pregnancy.

Sexual life during pregnancy helps the expectant mother feel attractive, desired, and feel an emotional connection with her partner. Therefore, having sex during pregnancy has obvious psychological benefits.

In some cases, you should abstain from sexual activity during pregnancy. These include:

• Cases of miscarriage during previous pregnancies (miscarriages, premature births).

• Threat of termination of this pregnancy (for example, increased uterine tone or short cervix).

• Unexplained vaginal bleeding.

• Painful sensations during sexual intercourse.

• Placenta previa (a condition in which the placenta lies low, covering the cervix).

• Multiple pregnancy (twins, triplets, etc.).

• If you have sexually transmitted infections, it is recommended to use a condom.

Check with your doctor because feeling well does not always mean there are no pregnancy complications.

Can sexual activity harm a child?

One of the most common reasons couples cut down on sex during pregnancy is fear that they will harm the baby. The baby is surrounded and softened by amniotic fluid, the muscular layer of the uterus, and the cervix, which also has a mucus plug.

Does your sex life change during pregnancy?

Certainly. And these changes are strictly individual. While some women may enjoy their sexuality during pregnancy, others may feel a complete lack of sexual desire throughout the entire 9 months. What matters is how the pregnancy progresses and whether there are any complications that impede a full sexual life. The psychological attitudes of partners regarding sex life during pregnancy also influence.

Each trimester has its own characteristics that affect the sex life of the couple.

First trimester.

For many women, sexual desire decreases in the first trimester of pregnancy. Malaise, fatigue, drowsiness, nausea, vomiting, engorgement and tenderness of the mammary glands appear, which, of course, does not contribute to an active sexual life.

Second trimester.

In the second trimester, the malaise characteristic of early pregnancy disappears. The risk of miscarriage is significantly reduced (most pregnancy losses occur in the first trimester). Most women feel great and look good during this period. Some couples note that their sex life during this period becomes more active than ever.

Third trimester.

In the third trimester, there is a significant increase in body weight, heartburn, dyspepsia, and fatigue may appear. Therefore, a woman’s sexual activity decreases. In addition, the presence of an already quite tangible child confuses many couples and creates the presence of “someone else in the room,” which often stops many men.

Sex and pregnancy: what do doctors think?

During pregnancy, many couples are afraid to make love, so as not to provoke contractions and premature birth. Modern medicine considers this a misconception: during sex, the uterus and placenta experience vibration no more than during normal walking, and the process of childbirth will not start until both bodies - mother and baby - are ready for it.

In general, the position of doctors is this: you can and should have sex, provided that the pregnancy proceeds without complications.

There is an opinion that sex in the first trimester on the days of menstruation (corresponding to the cycle before pregnancy) can increase the risk of miscarriage. Statistics show the opposite: most cases of spontaneously terminated pregnancies occur due to congenital malformations, when the wise body of the mother itself makes a decision about the non-viability of the fetus.

In what cases is sex contraindicated during pregnancy?

There is a general list of indications for sexual rest. The nuances may vary, and the final decision on whether the expectant mother can have sex is made only by her attending physician - each pregnancy is so individual. Sex should be avoided if the following complications occur during pregnancy:

• threat of interruption (including hematoma or bleeding);

• amniotic fluid leaks;

• the placenta is located dangerously close to the cervix;

• too short or too early dilated cervix;

• infectious diseases in father or mother.

Sex and pregnancy: when is it possible, and when is it better to be careful?

It would seem that in the first trimester there should be no barriers to intimacy: the baby is no bigger than a bean, and the belly is still completely invisible - but no. This period is often accompanied by painful sensations: increased drowsiness, a constant feeling of fatigue, and in some pregnant women, trouble in the form of toxicosis, and often nausea. And that's not counting the mood swings! It is quite natural that in such conditions a woman’s desire decreases to almost zero. If you are past the negative symptoms, enjoy life, but still first consult with the gynecologist who is caring for your pregnancy. There are a number of unobvious factors that should be treated with great caution and you should refuse intimacy for a while if the doctor insists on it. Such restrictions, for example, include:

• low position of the placenta; increased uterine tone;

• pain and bleeding.

The second trimester is perhaps the most favorable time in the life of an expectant mother. The body has finally adjusted its “settings”, and health returns to normal: morning sickness recedes, shapes are rounded, skin glows with health, hair becomes thick. Under the influence of estrogen hormones, emotions become stronger: a woman wants more affection and love, she shows tenderness and desire for her loved one. During this period, the blood volume in the body increases noticeably - in order to provide both the expectant mother and the growing baby with all the necessary substances. Due to increased circulation, tactile sensitivity increases: hugs, massage and touching erogenous zones cause vivid and very pleasant sensations. The belly is already beginning to appear, but is not too big yet, which will allow you to maintain a variety of sex positions for the next three months.

The upcoming birth is a natural process, but often unpredictable, which can cause a fair amount of anxiety for the expectant mother in the third trimester. Carrying a belly becomes more and more difficult every day; the growing uterus puts pressure on the intestines and bladder. A woman may also worry about the weight she has gained, feel clumsy and ugly, which also does not contribute to the growth of libido. The man’s task at this time is to be especially delicate and attentive, to be more often interested in the condition and mood of his beloved, not to bother with requests for sex if she does not want it, and, if possible, to take control of various matters into his own hands without bothering his spouse. The months remaining before giving birth are her last chance to relax for pleasure and get a good night's sleep for a long time to come.

No attraction? This is fine?

Expectant parents are often faced with a lack of intimate desire at the beginning of pregnancy. It is important to remember that a man and a woman during this period are in different psychological states. A decrease in libido in a woman is typical for the first trimester and is explained not only by strong hormonal fluctuations, but also by a suddenly increased burden of responsibility - both for herself and for the unborn baby.

The emotional ups and downs that often affect a woman during pregnancy can cause a mixed reaction in the future dad: many men are lost and don’t know how to behave when their loved one pulls away, is capricious or cries for no apparent reason, they are afraid of hurting her or making her uncomfortable during pregnancy. proximity. It is worth remembering that the future father, no less than the mother, deserves attention and respect for his experiences. This period is also not easy for him: the man thinks about how to maintain well-being, protect and provide everything necessary for the new life entrusted to his family, while the expectant mother is busy carrying the baby.

Fortunately, in most cases, by the second trimester - when the expectant parents finally get used to their new status - the desire returns, and mutual understanding in the couple improves. The key to success in this matter is to trust each other and not be shy to discuss with your closest person everything that worries and concerns you.

Sex is an important part of family life, and pregnancy is no exception.

During pregnancy, a woman experiences many internal changes - from physical to emotional. The most important thing that a partner can give her during this period is support and love. During these nine months, future parents will not only have to understand that their family will soon grow, but also be able to preserve the passion that brought them together. Closeness with a beloved man helps maintain a favorable hormonal level in a woman’s body and family harmony in a couple. Sex during pregnancy is possible, but precautions must be taken. Let's take a closer look at what happens to a woman's and man's desire during pregnancy, how to have sex without risking the health of mother and baby, and what doctors think about this topic.

When should pregnant women not have sex?

In addition, your OB/GYN will likely advise you to avoid sex:

• if you have already had any heavy bleeding during this pregnancy;

• if the placenta is at a low level, which can be determined by ultrasound examination;

• if you have previously had miscarriages or premature births;

• if there are signs of a threat of miscarriage;

• in case of multiple pregnancy:

• for isthmic-cervical insufficiency;

• if there are signs of inflammatory diseases.

In this case, there is a risk of complications, and therefore it is better to take a forced break from sex for a favorable pregnancy outcome for the period that the doctor recommends to you.

Often couples are looking for an answer to the question of which position is more appropriate to have sex during pregnancy. As for the first and second trimesters, there are no restrictions, it all depends on the preference of the couple. But in the later stages, it is recommended to refrain from sex in a position when the woman is on her back, since the enlarged uterus begins to put pressure on the blood vessels, leading to hypoxia, as well as in a position when the woman is on top, since it requires more physical activity from her load and less comfortable due to a large belly. Poses on the side or the man from behind are better; for additional comfort, you can place a pillow under the chest.

At the same time, a woman needs to listen to her feelings and desires, and if something bothers her, she should consult her doctor for advice.

Intimate life during pregnancy.

Here comes the long-awaited pregnancy, a loving couple is expecting a child, and a natural delicate question immediately arises - is it possible to continue to have sex and will this not harm the normal course of pregnancy and the condition of the fetus? There is often an opinion that sex can harm the child or cause premature termination of pregnancy, but this, according to experts, is nothing more than a misconception.

The answer is clear - yes, you can and should have sex if the pregnancy is progressing normally and there is no threat of its termination.

Sex is a naturally important part of our lives, which affects a woman’s overall health, both physical and psychological. During sex, a feeling of pleasure arises due to an increase in endorphin in the body - the hormone of happiness, and during orgasm the hormone oxytocin is released, which leads to rhythmic muscle contraction and a feeling of pleasure. This is a normal physiological process, both outside and during pregnancy, which gives a woman a great mood, relieves stress, and makes it possible to obtain the beneficial substances found in a man’s sperm - hormones, prostaglandins, enzymes that have a positive effect on a woman’s metabolism generally.

It is believed that due to the release of oxytocin and small contractions, the uterus is better prepared for the process of future childbirth, as if “training”, and normally this does not lead to excessive uterine tone and premature pathological contractions.

Sex in late pregnancy helps the birth canal prepare for childbirth, it becomes more elastic, and sperm, due to its composition, has a positive effect on softening the cervix before childbirth.

In addition, when having sex during pregnancy, you do not need to use protection, which allows the couple to relax more and enjoy each other. Agree, this is an important psychological component.

Obstetrician-gynecologists believe that during a normal pregnancy, the patient should not be given recommendations to abstain from sexual activity, since sexual intercourse during a normal pregnancy does not increase the risk of complications. Sex and orgasm do not increase the risk of premature birth or spontaneous miscarriage, regardless of gestational age.

It is important to know and remember that sexual intercourse, as a natural part of our lives, is not prohibited during pregnancy only if the woman is in normal health. Of course, there are some restrictions, and in case of pain, discomfort, bleeding, as well as itching, burning in the vagina and leucorrhoea, you must stop sexual intercourse and consult a doctor, since these are manifestations of serious complications of pregnancy that require treatment.

Preparation for the hCG test.

Before taking tests for pregnant women for the amount of hCG, the following preparation is required:

• Fasting for 7–8 hours before the procedure;

• Limit intake of any liquid several hours before the examination.

It is also necessary to warn your doctor about taking medications.

Statistics show that the highest concentration of hCG in the blood is observed in the first half of the day, so the doctor usually prescribes such a test in the morning.

If the recommendations are not followed, the study may show an unreliable result, so additional procedures will have to be performed.

Reasons for increasing hCG levels.

In the results of blood tests, the level of hCG may be seriously higher than normal for the following reasons:

• Presence of toxicosis;

• Formation of more than one fetus;

• The appearance of hydatidiform mole;

• Presence of genetic problems;

• Complication due to diabetes mellitus.

The level of human chorionic gonadotropin can be increased not only due to pregnancy, but also due to certain abnormalities:

• Extremely high levels of hCG due to taking hormonal drugs;

• The presence of malignant neoplasms in various organs (kidneys, gastrointestinal tract, uterus, lungs, etc.);

• Preservation of unstable hormonal levels as a result of an abortion.

In rare cases, in the presence of serious hormonal imbalances, elevated levels of hCG may also be found in men.

Reasons for deviations from the norm of the hCG hormone.

Normally, after pregnancy, the level of human chorionic gonadotropin should gradually increase. If it decreases, the doctor may suggest the presence of problems such as:

• In the early stages:

    • Fetal death;

    • Possibility of spontaneous abortion;

    • Absence of an embryo in the fertilized egg;

• At a later date:

    • Placental abruption.

In some cases, low hCG levels may be associated with incorrectly calculated gestational age. Therefore, to determine the exact cause of low hormone levels, early pregnancy tests are usually performed, as well as several types of other tests.

Changes in hCG during pregnancy.

After the physical onset of conception, the level of hCG in the female body begins to rise, and every two to three days its concentration almost doubles. It reaches its highest level at 8–11 weeks, and then it begins to gradually decrease.

The first test can be taken on the 6th day of the expected delay, but the result will be more accurate on the 11th–12th day. Therefore, doctors recommend undergoing blood tests two to three times (every two days each).

Monitoring the level of hCG allows you to monitor the dynamics of pregnancy development, the appearance of pathologies, and more:

• During an ectopic pregnancy, the hormone level practically does not increase:

• If the development of the embryo has stopped, then the level of hCG drops from the moment of its death.

Usually the analysis result is compared with a special table. In the first or second weeks, the concentration of hCG can range from 25 to 700 units, at its peak it can reach 18,000–240,000 units, and at the end of pregnancy – 2,179–60,000 units.

After establishing the fact of conception, the doctor refers the patient to other blood tests:

• General;

• Biochemical;

• For clotting;

• For hepatitis and HIV;

• For the presence of TORCH infections;

• For genetic pathologies;

• Rh factor and blood group (if they have not been determined previously);

• The content of hormones produced by the thyroid gland;

• For antiphospholipid syndrome;

• For the presence of STDs.

Reasons for taking a blood test for pregnancy.

A blood test can show the presence of pregnancy as early as the sixth day after successful conception. Whereas a standard pregnancy test in some cases can give incorrect results. Therefore, tests during pregnancy are prescribed to determine conditions such as:

• Establishing the actual fact of conception;

• Assessment of hormonal levels for disruptions;

• Tracking pathological types of pregnancy:

    • Frozen – in this case, at a certain stage the embryo stops its development;

    • Ectopic - in this situation, the zygote is not attached to the wall of the uterus, but in the fallopian tube.

A blood test also shows the presence of infections, other types of dysfunction of the body and diseases such as:

• Cytomegalovirus;

• Diphtheria;

• Tetanus;

• Herpes;

• Chlamydia;

• Hepatitis;

• Ureaplasmosis;

• HIV;

• Mycoplasmosis;

• Syphilis;

• Leptospirosis;

• Chlamydia.

Any of these diseases poses a danger not only to the woman’s body, but also to her unborn child. Therefore, if there are abnormalities in the blood test results, the doctor refers the patient for additional examination.

Possible discrepancies between the hCG analysis and the pregnancy test.

Sometimes an hCG test will give a positive result, while a pregnancy test will give a negative result. It should be borne in mind that a blood test for human chorionic gonadotropin is highly sensitive and detects pregnancy in the earliest stages, so you should trust this method.

If the pregnancy test is positive, but the blood test result is negative, then the problem is most likely with the quality of the test strips. That is why, to determine hCG at home, it is recommended to purchase several tests at once - both expensive and cheap.

Norms of hCG concentration.

In healthy women who are not pregnant, the hCG level is 0-5 mU/ml.

During pregnancy, the norms of human chorionic gonadotropin depend on the period.

1. In the second week - 25-300 mU/ml.

2. In the third week - 1500-3000 mU/ml.

3. In the fourth week - 10,000-30,000 mU/ml.

4. In the fifth week - up to 100,000 mU/ml.

5. In the sixth to eleventh week - up to 225,000 mU/ml.

6. At the sixteenth week - 10,000-58,000 mU/ml.

7. By the twentieth week - 1600-49000 mU/ml.

Indicators for pregnancy resulting from IVF do not differ from hCG values during normal pregnancy.

If a pregnant woman has elevated hCG levels, this indicates:

• multiple pregnancy;

• post-term pregnancy;

• chromosomal abnormalities of the fetus (Down, Patau, Edwards syndromes);

• early toxicosis, gestosis;

• diabetes.

A significant decrease in the levels of this hormone may be associated with delayed fetal development, ectopic or frozen pregnancy, threatened miscarriage, placental insufficiency, and late intrauterine fetal death.

HCG test results are provided with an accuracy of one milliunit.

If hCG levels deviate from the norm, additional studies are carried out to determine the exact cause of this phenomenon. This is an ultrasound of the pelvic organs and a biochemical blood test.

Is it possible to measure hCG at home?

Rapid pregnancy tests (test strips) determine the level of hCG in the urine. These strips contain specific antibodies to this hormone. If the level of human chorionic gonadotropin in the urine exceeds the sensitivity of the test, the strip is colored. This means that there is a pregnancy.

It is possible to determine the level of hCG in urine with high probability starting from the fifth day of delay.

The rapid test demonstrates the fact of an increase in human chorionic gonadotropin, but does not measure its level. Only a laboratory blood test can determine its concentration.

It should be taken into account that pharmacy test strips can give a false positive result. For example, if a woman is taking medications containing hormones, the test may respond to this with the appearance of a second strip.

How to get tested for hCG?

Blood is donated for hCG determination on an empty stomach. Venous blood is used for analysis. The last meal before collecting biomaterial should be taken no later than 8-10 hours. This is necessary in order to exclude chylosis (physical turbidity of blood serum in a test tube due to the presence of large amounts of fat). Chylosis significantly reduces the reliability of the analysis.

It is advisable to keep dinner as light as possible. During the day before donating blood, you should avoid eating fatty, salty, spicy and smoked foods.

It should be taken into account that the reliability of the analysis is affected by taking medications containing hormones. For example, if a woman stimulates ovulation with such drugs, traces of their active components remain in the blood for a long time and may give false positive results.

If pregnancy is suspected, doctors recommend donating blood for hCG 4-6 days after a missed period or 14-20 days after ovulation.

A blood test for this hormone is carried out using the method of enzyme immunoassay of blood serum.

Human chorionic gonadotropin is the most accurate pregnancy marker of all.

Indications for hCG analysis.

Women are prescribed a test for hCG concentration when:

• suspected pregnancy;

• prolonged delay of menstruation, which can be associated not only with pregnancy, but also with impaired ovarian function, stress, and infections;

• diagnosing the condition of the fetus at different stages of pregnancy;

• assessing the condition of the placenta during pregnancy;

• diagnosis of fetal malformations;

• suspected malignant tumors of the fetal reproductive system.

Also, the level of hCG is determined after artificial termination of pregnancy.

In men, a test for human chorionic gonadotropin is performed if testicular tumors are suspected.

Types of tests for human chorionic gonadotropin.

Human chorionic gonadotropin is a protein that contains two particles, alpha and beta. The first of them, in structure and functions, resembles some pituitary hormones, which regulate the synthesis of hormones by the ovaries and thyroid gland. The beta particle has a unique structure.

HCG produces chorionic villus cells after the egg attaches to the wall of the uterus, a few days after fertilization. Some of these cells are required for the normal development of the fetus, and another part is required for attachment to the uterus. HCG also suppresses the aggressive reaction of the pregnant woman’s immune system directed against the cells of the fetus, participates in the sexual determination of the fetus, and activates the gonads and adrenal glands of the developing fetus.

When studying this hormone, two types of tests are taken:

1. For total hCG. The study is intended for early diagnosis of pregnancy, when standard test strips cannot yet detect pregnancy because the pregnancy is too early. If pregnancy develops normally, in the first weeks hCG doubles every 2 days and reaches its maximum concentration at 10-11 weeks. After this, hormone levels gradually decrease. If the pregnancy is multiple, the level of human chorionic gonadotropin increases in proportion to the number of fetuses.

2. For free b-hCG. This analysis is carried out to diagnose neoplasms (hydatidiform mole, testicular oncology, choriocarcinoma). The test is also performed during screening of the first and second trimesters to assess the risk of Down and Edwards syndromes in the fetus. Analysis for free b-hCG is carried out at 8-13 and 15-20 weeks of pregnancy.

Errors in determining pregnancy using hCG.

When testing blood, erroneous results are possible (about 2%), but most often additional examinations are necessary to confirm the diagnosis.

False positive.

The woman has elevated hCG in the blood, but there is no developing fetus on ultrasound. This happens in cases where, before the analysis, drugs were used to stimulate ovulation, or hormonal drugs were prescribed.

Usually the doctor recommends repeating the hCG determination after 3-5 days. If there are still high indicators, but they do not correspond to the expected period, then you need to look for a tumor.

False negative.

The analysis did not detect an existing pregnancy. This is possible in a very short period of time - no more than 8 days have passed since ovulation. The second reason is a violation of the attachment of the fertilized egg; if it is located outside the uterus, then hCG does not grow in the required quantity. The same situation occurs when fetal development stops and there is a threat of miscarriage.

A blood test for hCG helps determine the presence of pregnancy. It is more informative than test strips. Hormone determination is also required if neoplasms are suspected, to monitor a developing pregnancy.

We recommend reading the article about how much hormone testing is done. From it you will learn about how many tests are done in gynecology and how long to wait for the results of hormone tests in the clinic.

This is especially important if the previous ones had complications or there is a risk of chromosomal diseases of the fetus. For the result to be reliable, preparation is required. In case of deviations from the norm, additional examination is necessary, since the rise and fall of the hormone is not the main diagnostic sign. There is a possibility of false results when detecting pregnancy.

Results of express analysis for hCG.

In order to correctly assess the detected hormone level, it is necessary for a doctor to decipher its values. There may be normal, increased, or decreased results.

Norm.

For women outside pregnancy and men, hCG is not higher than 5 mIU/ml. It is considered normal if it is not detected at all. If conception occurs, then hCG levels increase, and by the 10th week they begin to decrease.

If a woman takes a test to determine pregnancy, then if data is received in the range from 5 to 25 units, the result is considered doubtful. So she needs to repeat it in two days.

Promoted.

Outside of pregnancy, men have high test results when:

• development of a tumor from the tissue of the embryonic membrane;

• neoplasms of the gonads, uterus, internal organs;

• spontaneous miscarriage, abortion (up to 5 days);

• use of drugs with hCG (there are also dietary supplements with this hormone).

During the period of bearing a child, exceeding the indicators indicates the likelihood of:

• there is more than one fetus in the uterus (the hormone increases in proportion to their number);

• incorrect assessment of the period of conception;

• use of progesterone for preservation;

• toxicosis (early or late);

• diabetes mellitus in women;

• fetal developmental anomalies, genetic disorders (for example, Down syndrome, Edwards syndrome).

Demoted.

It only matters during pregnancy. Dysfunction of the placenta leads to insufficient formation of hCG.

This condition is extremely dangerous, its causes include:

• fixation of the fertilized egg outside the uterine cavity;

• cessation of development or death of the fetus;

• the likelihood of spontaneous miscarriage (hormone levels drop by more than half);

• insufficient blood flow through the placenta;

• post-term pregnancy.

How long does a blood test for hCG take in the laboratory?

The standard time required for analysis is one business day. When the laboratory is very busy, the issuance of results is delayed for several days.

Some diagnostic centers provide a service for express blood testing for hCG. In this case, it is possible to find out the result within a few hours.

If the laboratory does not conduct the research itself, but sends the taken material to another institution, then the blood test takes longer. At the client’s request, you can receive a printout: in hand, via e-mail, in your account on the official website.

It is important to know exactly what standards and units are accepted for measurements, therefore, as a rule, they are indicated along with individual indicators.

How to take a hormone test - on an empty stomach or not?

With all types of hormonal studies, the results of the analysis are influenced by stress, increased temperature due to infection, changes in diet, compliance with the rules of preparation - for example, whether blood was donated on an empty stomach or not. Therefore, for reliable results, it is important to take into account the recommendations:

• Last meal – 8-10 hours before.

• Schedule a visit to the laboratory in the morning.

• The day before diagnosis there should be no physical or emotional overload, or consumption of alcoholic beverages.

• Do not undergo examination during exacerbation of diseases or viral infections with fever.

• If a woman is prescribed medications to stimulate ovulation or infertility therapy, then she should consult a doctor to determine whether they can be administered before the test or whether they need to be discontinued.

• All physical procedures, massage, ultrasound and x-rays can only be performed after donating blood.

• Immediately before diagnosis, it is important to be at rest for at least 20 minutes; smoking is prohibited an hour before.

If an examination is scheduled after an abortion, at least 24 hours must pass. If hCG was introduced to treat infertility, then the minimum period for its determination in the blood is 3-5 days. Gynecologists usually refer for analysis no earlier than 7 days after the end of therapy.

Will a blood test show pregnancy in the early stages?

Detection of the hormone in the blood is ahead of the results of pharmacy tests. Most of them are designed for hCG content in urine of 20-25 units per 1 ml. This usually corresponds to the first week of a missed period. The timing of pregnancy detection in the laboratory is possible 5-8 days from conception. However, blood tests are much less likely to show incorrect results.

If you need to accurately establish conception and whether the fertilized egg is attached normally, then 2 studies are needed with an interval of three days. It is important to take them in the same laboratory.

Types of tests for hCG.

There are two research options - general and beta-hCG. Each of them has its own indications for determination.

General.

It is taken to detect pregnancy in the early stages, when it has not yet reached the level to appear in the urine. This means that the test strip will not show it yet. The hormone grows progressively - per day its concentration increases by 100%. This increase continues until the placenta is formed - by the end of 3 months. Then the need for it decreases, and it gradually decreases. In the 2nd trimester, all pregnant women need a test to check the development of the baby in the uterus.

Free beta.

The hormone consists of two chains of amino acids. The first repeats in structure some of the lutropin, follitropin and thyrotropin of the pituitary gland. They are found in the blood of all people. The second part is that only hCG has a beta chain. Its detection is a sign of disease, but also requires additional examination. This means that a diagnosis is not made based on elevated beta-hCG. The need for research arises when:

• tumors of the reproductive system;

• neoplasms of internal organs;

• the risk of Down syndrome in the fetus;

• suspicion of other chromosomal abnormalities.

Pregnant women over 35 years of age or those with a family history of genetic diseases, those exposed to radiation or toxic substances, or severe viral infections must be tested.

Indications for a blood test for hCG to diagnose pregnancy.

A woman can go to the laboratory on her own for a pregnancy test. It will show its onset from 5-7 days after probable conception. A referral is issued by a gynecologist when:

• Absence of menstruation - amenorrhea caused by stress, ovarian dysfunction, infection, intoxication. The study is necessary to exclude pregnancy before starting treatment.

• Suspicion of twins or more fetuses.

• Possibility of ectopic attachment of the fertilized egg.

• Tumor caused by chorionic particles (hydatidiform mole, chorionic carcinoma).

• Observation of the development of the placenta and fetus from 12 to 18 weeks.

• If there is a threat of miscarriage, a frozen or stopped pregnancy (pain, blood from the vagina, changes on ultrasound, cardiotocography).

• After an abortion, to check its complete completion.

• Detection of abnormalities in the structure of fetal organs (together with alpha-fetoprotein, estriol), congenital genetic defects.

The oncologist recommends testing hCG if there is a suspicion of tumors with hormonal activity. They may be in the kidneys, digestive system, lungs, uterus or ovaries. Testicular neoplasms in men are also capable of producing this hormone.

Monitoring indicators over time (as pregnancy progresses) is prescribed to patients from risk groups and in the absence of symptoms:

• there was previously a frozen fetus, ectopic attachment of the embryo;

• the child was born with developmental anomalies;

• recurrent miscarriages;

• multiple births;

• prior to pregnancy, infertility treatment was carried out;

• diseases of the thyroid gland, adrenal glands, and ovaries were identified.

The value of the hormone in a blood test for hCG.

In a healthy woman, human chorionic gonadotropin appears after the fertilized egg is fixed in the uterine cavity. This means that conception has occurred and pregnancy begins to develop. The first days (5-7) after fertilization, the egg moves through the tubes of the uterus; there is no chorion (the membrane of the embryo) yet, which means its hormone is absent. HCG is produced as the fetus grows and is responsible for the following processes:

• Suppresses menstruation.

• Helps produce hormones (estrogens, progesterone) that are needed to rebuild a woman’s body.

• Affects the adrenal cortex, and it begins to intensively produce cortisol, which inhibits the immune system. This is important so that the mother’s body does not reject a fetus that is foreign to it.

• Stimulates the growth and development of the placenta, improves its blood supply.

• Provides the formation of male hormones in the fetus, activates its adrenal glands and gonads.

Outside of pregnancy, childbirth and abortion in women and in the body of men, hCG should not be present or trace amounts are detected due to the similarity of its molecules with some pituitary hormones. If its value exceeds the permissible norm, then this is a sign of a tumor process of the testicles and ovaries and requires additional examination of the patient.

One of the reasons for the physiological (outside of illness) detection of hCG is the introduction of its drugs to stimulate puberty, in programs for the treatment of infertility. Bodybuilders use hCG during courses of steroids (anabolic steroids) to prevent impotence and impaired sperm production.

When should you call an ambulance with your period during pregnancy?

Any bleeding during pregnancy should be reported to your doctor as soon as possible. However, there are a few red flags that indicate that getting your period during pregnancy can be a serious problem that requires immediate hospitalization.

Remember these warning signs:

• severe pain or intense cramps in the lower abdomen;

• heavy bleeding, and it does not matter whether it is accompanied by pain or not;

• vaginal discharge, which contains not only fluid, but also dense fragments (tissue);

• dizziness or fainting;

• temperature 38 °C or higher;

• chills.

If spotting during pregnancy is accompanied by any of these symptoms, even just one, call 911 immediately!

Does menstruation occur during late pregnancy? Premature placental abruption.

Normally, the placenta detaches from the wall of the uterus and leaves the woman’s body after the baby is born. Sometimes premature placental abruption is possible at the beginning of labor or even during pregnancy. Usually this process is accompanied by bleeding - from minor to heavy.

Premature placental abruption is very dangerous for the fetus, because it is with its help that the baby eats and breathes. Therefore, during routine examinations of pregnant women, doctors pay close attention to risk factors that can lead to this syndrome. If suspicious signs are detected, the doctor prescribes therapy or hospitalization.

In addition to the above reasons, bleeding during pregnancy can be associated with a number of diseases. In particular, they are caused by cervical polyps, myomatous nodes located in the placenta, cervical cancer and other causes.

It is impossible to determine what exactly happened based only on external signs. In most cases, even an experienced specialist will not be able to identify the cause without additional laboratory and instrumental studies. Remember this, as a rule, without exceptions: any “period” during pregnancy is a reason to immediately contact your doctor!

Does menstruation occur during late pregnancy? Placenta previa.

False menstruation can result from improper attachment of the placenta. Bleeding usually occurs with the onset of labor, but can also occur later in pregnancy. They begin unexpectedly and are often abundant.

Such obstetric hemorrhages are dangerous due to the large loss of blood by the woman, which can result in the development of iron deficiency anemia and intrauterine fetal hypoxia. When this syndrome appears, hospitalization is necessary for dynamic observation and correction of clinical and laboratory parameters.

Does menstruation occur during late pregnancy?

There cannot be periods during pregnancy, but obstetric bleeding does occur in the second half of pregnancy. They bother expectant mothers less often, but can seriously threaten both the woman’s condition and the life of the baby.

The most common of them are associated with pathologies of the placenta.

Why do “periods” appear during the first half of pregnancy? The Vanishing Twin.

One of the unusual cases is the phenomenon of the vanishing twin. This situation sometimes occurs during multiple pregnancies. The mother's body rejects one or more embryos, arranging a selective miscarriage of all fetuses except one chosen one, and they leave her body along with obstetric hemorrhages.

Vanishing twin syndrome can only occur if a woman has a multiple pregnancy. It is rarely observed during natural conception; most often this phenomenon occurs during artificial insemination with the implantation of several embryos.

Why do “periods” appear during the first half of pregnancy? Menstrual bleeding.

Is it possible to be pregnant while on your period? Oddly enough, some obstetric bleeding is actually associated with the functioning of the mechanisms responsible for the menstrual cycle. Rarely, during pregnancy, so-called menstruation may occur, that is, cyclic discharge that differs from normal menstruation in the minimum volume of blood, but sometimes coincides with the usual cycle according to the calendar.

This phenomenon is not considered normal. While carrying a baby, the hormonal levels must be adjusted in such a way as to completely eliminate the situation in which pregnancy and menstruation occur at the same time. Periodic spotting often indicates insufficient progesterone production. Tell your doctor about this so that he can analyze the situation and, if necessary, prescribe additional hormonal support for pregnancy.

Why do “periods” appear during the first half of pregnancy? Risk of miscarriage.

Spontaneous abortion usually occurs in the first trimester. Sometimes it happens in very early stages, and the woman does not even know that she was pregnant. Due to the delay, she may think that conception has occurred, but soon bleeding occurs, which can be confused with menstruation.

The threat of miscarriage may appear later, when pregnancy has already been confirmed. Bleeding in the first trimester is always a reason to immediately consult a doctor. In many cases, spontaneous abortion is a reaction of the pregnant woman’s body to dangerous chromosomal abnormalities and other fetal malformations that are incompatible with life6. However, there are also situations when the threat of miscarriage occurs due to hormonal imbalances or other reasons that modern medicine can eliminate and ensure the birth of a healthy baby.

The answer to the question of why menstruation occurs during pregnancy after several weeks without menstruation may be associated precisely with the threat of miscarriage. In such a situation, you should definitely consult a doctor and do it as quickly as possible.

Why do “periods” appear during the first half of pregnancy? Ectopic pregnancy.

If the bleeding is accompanied by intense sharp or constant nagging pain in the lower abdomen, this is an alarm bell! Often this condition is a sign of an ectopic pregnancy and requires immediate medical attention. Dangerous symptoms may not appear immediately and begin to bother the woman as early as the second month - up to the 8th week.

Under no circumstances should you try to endure the pain or wait out the discharge. Ectopic implantation is deadly for the mother. In most cases, it requires immediate hospitalization and surgical removal of the fetus.

You can suspect an ectopic pregnancy based on the following symptoms:

• pain in the lower abdomen, usually on one side;

• vaginal bleeding or watery brownish discharge;

• shoulder pain;

• discomfort when urinating or defecating.

If your period comes on time or is slightly late and is accompanied by at least one of these symptoms, be sure to contact your doctor to find out what's going on.

Why do “periods” appear during the first half of pregnancy? Contact bleeding.

Under the influence of hormones, the cervix during pregnancy is abundantly supplied with blood and becomes more vulnerable and sensitive. In some women, this can lead to minor spotting at the slightest external influence. For example, this can happen after a smear test by a gynecologist, the use of vaginal tablets/suppositories, or sexual intercourse.

Contact bleeding is a physiological phenomenon during pregnancy. However, even if you suspect the appearance of discharge for one of the above reasons, it is better to additionally consult a doctor. It is possible to reliably assess the condition of the cervix and exclude serious pathology only during an examination in a gynecological chair.

Why do “periods” appear during the first half of pregnancy? Implantation bleeding.

After fertilization, the egg moves towards the uterus and after about 6–10 days attaches to its wall. This natural process causes slight damage to the endometrium and may be accompanied by minor bleeding.

These false periods occur already during pregnancy, but often the woman does not yet know that a new life has arisen inside her. This is where the common myths arise that “it turns out I was already pregnant, but I was still getting my period.” Implantation bleeding is characterized by a small amount of discharge and lasts 1-2 days, so it can be confused with regular menstruation, which for some reason came a little earlier than expected and passes surprisingly easily.

There's no need to worry. Rather, this is a reason for joy: with a high probability, these unexpected “periods” during pregnancy are a sign that you will become a mother.

Can I have periods during pregnancy?

Menstruation is a monthly bleeding from the genital tract in women, which is the rejected tissue of the inner lining of the uterus - the endometrium. Menstruation occurs when the egg is not fertilized. But if the embryo is formed, it attaches to the endometrium, and its expected monthly detachment does not occur. Therefore, any blood-containing vaginal discharge during pregnancy is called “obstetric bleeding”1. Some of them are harmless, others are very dangerous. These are not periods. This means that every expectant mother must learn that under no circumstances should bloody discharge from the genital tract be ignored during pregnancy. Many of them are a sign of pathologies that significantly increase the risk of miscarriage and premature birth1. Therefore, report any bleeding to your doctor immediately!

Popular questions and answers about the first month of pregnancy.

In the first month of pregnancy, most women have a variety of questions. Among other things, many worry that, not knowing about the “interesting” situation, their actions could harm the child’s health.

How to cope with toxicosis?

The term “toxicosis” is considered obsolete in the medical community. Now they say “drooling, vomiting.” But the essence does not change: in the early stages, progesterone (the corpus luteum of pregnancy) is produced in the ovaries, which causes vomiting. The simplest remedy against it is alkaline drinking. This can be either mineral water or a solution of baking soda (1 teaspoon per glass of boiled water) 2-3 times a day. When the placenta forms and progesterone begins to be produced in it, this nausea will pass. This usually occurs by 16 weeks even without treatment.

Is it dangerous to drink alcohol in the first month of pregnancy if you don’t know about your situation?

It's okay if this happened out of ignorance. The main thing is to stop drinking alcohol when you already know you are pregnant. In Europe, pregnant women are allowed some dry wine. And our doctors of the old school even treated toxicosis with champagne - a teaspoon 5-6 times a day.

Is it possible to have sex in the first month of pregnancy?

Can. These are positive emotions and relaxation for a woman. But everything is individual. If there is a threat of miscarriage or serious illness in a pregnant woman, it is necessary to limit sex life for some time. If there are no contraindications, sex should be with a condom and without fanaticism.

How much weight can you gain in the first month of pregnancy?

Weight gain should be no more than 200 g per week. During the entire pregnancy - 10-12 kg and no more. Therefore, you need to control your diet.

What medications can and cannot be taken in the first month of pregnancy?

Among the drugs for the treatment of arterial hypertension, enalapril is undesirable; among anti-inflammatory drugs, sulfadimezines are undesirable. For diabetes mellitus, tablet medications are not recommended to lower blood sugar levels - they contribute to disruption of uterine placental blood flow. Among antibiotics, doxycycline and fluoroquinolone drugs are undesirable.

Laxatives are not recommended: they enhance intestinal motility and increase uterine tone. Tranquilizers and sedatives are also undesirable.

Vitamin complexes, some antibiotics (penicillin, macrolides, cephalosporins), aspirin, and indomethacin are approved for use. Herbal sedatives are not prohibited.

What can and cannot be done by an expectant mother?

A pregnant woman can live a normal life. But it is necessary to review and change what can affect the health of the child and the woman herself and complicate the course of pregnancy. This applies to both nutrition and lifestyle.

Healthy food.

Pregnant women are recommended to eat vegetables and fruits, mainly growing in the region of their residence. Citrus fruits are undesirable - they can cause allergic reactions and create the basis for diathesis in the unborn child.

Healthy: herbal teas (if you are not allergic to herbs), vegetable soups and salads, buckwheat porridge. Consumption of sweets should be reduced. Chocolate, coffee, hot spices are not recommended.

Getting rid of bad habits.

It wouldn’t hurt to repeat: the expectant mother should give up alcohol and cigarettes. The potential harm is great and the risks are beyond doubt.

We treat teeth and chronic diseases.

Contrary to popular stereotypes, dental treatment during pregnancy is possible and necessary.

Dental disease is a potential source of infection that can have a negative impact on your child. They definitely need to be eliminated.

For the same reason, it is necessary to treat chronic sore throats and tonsillitis. If there are diseases not related to gynecology (liver, heart, stomach, etc.), ideally they should be dealt with before conception, and during pregnancy, if necessary, be observed by specialists.

We will postpone cosmetic procedures.

During pregnancy, it is not even recommended to dye your hair, because chemical components penetrate the woman’s body and can have a negative effect. It is advisable to use less cosmetics and limit cosmetic procedures using active chemicals and hardware technologies. Massage of the lower back and anterior abdominal wall is undesirable during pregnancy.

You can sunbathe.

Exposure to reasonable amounts of sun is good. The body receives vitamin D, which is necessary to prevent rickets and protect bone tissue. Just don’t overuse sunbathing!

We dosage physical exercises.

You can play sports in the first month of pregnancy if there is no threat of miscarriage or other problems. But the exercises should not strain the anterior abdominal wall.

Special gymnastics are highly recommended to strengthen the pelvic floor muscles and for better stretching of the perineum. It is better to swim in the sea than in swimming pools, where reagents that are undesirable for the health of a pregnant woman may be used to purify the water. The safest, but at the same time useful activity is walking. This is also good for the muscles of the pelvic floor and perineum. You can just walk around the house on your toes, sit on an exercise ball.

Examinations in the first month of pregnancy.

When a pregnant woman first contacts her, the doctor gets acquainted with her medical history, then proceeds to an objective examination: pays attention to the woman’s physique and weight, the condition of her skin, visible mucous membranes, measures temperature, height and weight, blood pressure, assesses the condition of the mammary glands and nipples , the presence of colostrum separated from them.

Other methods are also used to confirm pregnancy.

Gynecological examination using speculum.

This is the simplest and at the same time mandatory method. Even in early pregnancy, it allows you to see characteristic changes in the mucous membrane of the vagina and cervix.

Pregnancy test.

The pregnancy confirmation method is suitable if the pregnancy is very short and there are doubts about conception. Modern tests are highly informative, and even after several days of delay they show that there is a pregnancy.

Analyzes.

In the early stages, it is important not to miss an ectopic pregnancy, when implantation occurs not in the uterine cavity, but in the tube or cervix. The signs are similar: at first it may not differ from a normal pregnancy. Therefore, a blood test to determine hCG, the hormone human chorionic gonadotropin, plays an important role here. In case of an ectopic pregnancy, its level is lower than it should be at this stage.

All tests necessary for a woman in each individual case are prescribed by a doctor: a smear for STIs and others.

Ultrasound.

Even in the early stages, ultrasound diagnostics is an informative and safe examination method. An ultrasound clearly shows the embryo, which has implanted in the uterine cavity. Ultrasound research methods are used to diagnose pregnancy and its timing. And also in case of complications of pregnancy and fetal development.

Child development in the first month of pregnancy.

The embryonic period of development lasts from the moment of fertilization until 8-9 weeks of pregnancy, when the embryo acquires characteristic human features.

1 week of pregnancy.

During this period, follicles mature in the ovaries, one of which will contain that fateful egg.

There is no embryo yet, but serious preparatory work is underway for its appearance: the uterine cavity is cleared of the endometrium, which was not useful in the last cycle, vesicles-follicles with developing eggs inside are maturing in the ovaries.

2nd week of pregnancy.

Still no child. But the process of its emergence is rapidly progressing. The most active follicle ruptures and releases an egg ready for fertilization. And when the fastest and most tenacious sperm reaches this mature egg, it breaks through its shell, the nuclei of male and female cells merge and a new life is conceived.

3rd week of pregnancy.

During this period, a germinal disc with a primary streak is formed - from many cells that are constantly dividing and developing. The size of a fertilized egg in the 3rd week of pregnancy is about 0.13 mm.

4th week of pregnancy.

By the beginning of the 4th week, the fertilized egg enters the uterine cavity, attaches to its wall and continues to develop. The germinal disc takes on a cylindrical shape, and the head and tail of the embryo are formed. By the end of the 28th day, a bend of the body appears, the length in the back reaches 4-5 mm.

Symptoms, signs and sensations during pregnancy.

To determine the duration of pregnancy, doctors take into account presumptive and probable signs.

Possible ones include:

• changes in appetite, taste, smell,

• nausea and vomiting, drooling,

• weakness, malaise,

• irritability and tearfulness,

• dizziness and headaches,

• insomnia,

• deposition of subcutaneous fat layer,

• stretch marks on the stomach,

• skin pigmentation (on the face, along the white line of the abdomen, in the area of the nipples and external genitalia).

Such signs can be observed not only in pregnant women. But for a doctor they have diagnostic value, because some of them occur before objective signs of pregnancy.

Possible signs objectively confirm pregnancy: in women of childbearing age, menstruation suddenly stops, the mammary glands, uterus, and vaginal mucosa change. Let's look at them in a little more detail.

Changes in the chest.

The mammary glands enlarge. When pressed, a clear liquid is released from the nipples - colostrum.

Changes in internal organs.

At 1 month of pregnancy, the uterus enlarges to the size of a chicken egg. The cervix becomes drier. The mucous membrane of the vagina and cervix acquires a bluish tint and becomes more loose.

Pain.

During this period, the stomach may hurt as the uterus prepares to receive a fertilized egg, which moves towards it to gain a foothold in the cavity. On the anterior wall of the uterus there are round uterine ligaments, they begin to stretch, the uterus enlarges, and therefore the woman feels pain in the lower abdomen. This is not a threat of termination of pregnancy, but a variant of the norm.

Do you have periods in the first month of pregnancy?

Normally, a pregnant woman should not have menstruation. Some people experience spotting for several months or even throughout their pregnancy. This is a menstrual-like reaction, but not menstruation.

What does the stomach look like?

In the first month of pregnancy, a woman relies more on sensations: external manifestations are not yet bright enough or are completely absent. For example, in the early stages the belly does not increase. It begins to grow by 12-14 weeks, when the uterus rises to the level of the womb.

Key facts about the first month of pregnancy.

Menstruation.

Stops. There may be slight spotting, which indicates that the embryo is implanting in the uterine mucosa.

Woman's behavior.

Irritability or tearfulness may appear. Many women pay attention to changes in taste preferences, and a different perception of smells appears.

External signs.

Little noticeable. Some women may experience pigmentation and the first stretch marks on their abdomen by the end of 1 month of pregnancy.

Pain.

A pregnant woman may feel pain in the lower abdomen as the fertilized egg approaches the uterus.

Child development stage.

Embryo.

Determination of gestational age.

The formula is simple: the pregnancy period is counted from the first day of the last menstruation. For example, on May 5 a woman started her period, and on June 20 she comes to the doctor due to a two-week delay. The doctor conducts an examination, after which he confirms the pregnancy. This is indicated by an enlarged uterus, changes in the mucous membrane of the vagina and cervix. Also, at the first appointment with the gynecologist, you can determine the period. As a rule, this is 4-5 weeks.

Prognosis and possible consequences of spotting during pregnancy.

When the physiological causes of spotting during pregnancy are diagnosed, the woman needs to calm down, enjoy the process, and live a full life.

Options for action in case of pathological development of pregnancy will depend on the complexity of the case. Identified hormonal imbalances are corrected with special medications. The threat of miscarriage in some cases can be controlled with medications at home or in a hospital. With the right actions of the doctor, there is every chance of carrying the fetus to term.

Ectopic, frozen pregnancy and hydatidiform mole are extremely dangerous for the health and even life of a woman. It is extremely important to undergo surgery in a timely manner. After such pathologies, the body must be given time to recover. Gynecologists recommend becoming pregnant again no earlier than 6-12 months after treatment procedures. Women, as a rule, undergo medication and, if necessary, psychological treatment.

Diagnosis and medical care for discharge during pregnancy.

It is sometimes difficult for young, inexperienced women to recognize how dangerous discharge during pregnancy is. Any doubts should be resolved at an appointment with a gynecologist, who will prescribe a pelvic ultrasound and relevant tests to find out the cause.

Physiological conditions resolve on their own and do not require therapy. The results of ultrasound and tests in this case will be normal. Women, as a rule, do not experience additional pain symptoms or general deterioration in well-being.

Pathological conditions are insidious in that until a critical moment they can be asymptomatic with minor spotting. At the same time, it is very important to seek help in time.

An ectopic, frozen pregnancy and hydatidiform mole cannot result in the birth of a child. In such cases, the anomaly must be urgently removed.

Pathological causes of bleeding during pregnancy.

Pathological causes of bleeding during pregnancy pose a serious threat to the health and life of the mother and fetus. In all cases, consultation with a gynecologist is required, and in some cases, urgent surgical intervention.

Pathological causes include:

• hormonal disorders;

• threat of pregnancy failure;

• miscarriage;

• ectopic pregnancy;

• frozen pregnancy;

• hydatidiform mole.

Hormonal disorders are a common problem in gynecology. A lack of progesterone or an excess of androgens (male hormones) can cause spotting in early pregnancy. If you consult a doctor in a timely manner, this pathology can be treated. Self-prescribing medications is strictly prohibited.

Insufficient production of progesterone entails the threat of termination of pregnancy or miscarriage. With such pathologies, the discharge can be either spotty or copious. Sudden heavy bleeding in the early stages will no longer allow saving the fetus. From 5 to 20% of pregnancy terminations occur in the early stages. Doctors call the causes of the pathology genetic abnormalities.

With ectopic, frozen pregnancy and hydatidiform mole, spotting brownish discharge is characteristic. Less often – scarlet, bright blood. Sometimes the pathology is accompanied by acute pain in the lower abdomen, lower back, and increased body temperature.

Physiological causes of bleeding during pregnancy.

Physiological causes of bleeding during pregnancy do not pose a threat to the health and life of the mother and fetus. Therefore, no treatment is required. As a rule, a woman notices such discharge in the first month, less often in the second and third. They differ from regular periods in volume, intensity, and duration.

Bleeding in the early stages may occur for the following reasons:

• as a result of implantation of a fertilized egg;

• if conception occurred towards the end of the cycle;

• with false menstruation, or pseudo menstruation;

• when two eggs mature at the same time.

When the zygote attaches to the wall of the uterus, small blood vessels are damaged and a few drops of blood may be released. This is called implantation bleeding. But such discharge is very scanty and lasts no more than 1-2 days. Additional symptoms may include mild pain in the lower abdomen and general malaise. For most women, the process of egg implantation goes unnoticed.

When conception occurs towards the end of the cycle, the body does not have time to adapt to maintaining the pregnancy. In this case, bloody discharge similar to menstruation is possible. The situation is typical for the first month. Next month, as a rule, this does not happen.

The situation with false menstruation is more mysterious. This happens in very rare cases. During pregnancy, a woman has full menstruation for up to 3-4 months. Medicine is unable to explain such unique moments.

The simultaneous maturation of two eggs is also quite rare. In this case, one cell is fertilized, and the other comes out along with the blood. Such “menstruation” is typical for the first month; in the next month, there is usually no discharge.

Is it possible to have periods during pregnancy?

From a physiological point of view, the concepts of pregnancy and menstruation are incompatible. We know from school that the inner surface of the uterus is lined with three layers. The most mobile is the endometrium, which grows at the beginning of the cycle. The function of the endometrium is to create a favorable background for the implantation of a fertilized egg.

If conception does not happen, the female cell dies and comes out along with the blood. This process in the female body is cyclical and occurs monthly until fertilization occurs. Thus, for young healthy women of reproductive age who have regular sexual intercourse, delayed menstruation is a reliable sign of pregnancy.

When a fertilized egg implants into the endometrium, all the body’s forces are directed to maintaining the pregnancy. Menstruation stops. Therefore, once conception has taken place, menstruation in its direct sense is always a deviation from the norm. It would be more correct to talk about bleeding.

It should be noted that bloody discharge in the second and third trimester always means pathology. It could be:

• beginning miscarriage;

• premature birth;

• placental abruption;

• death of the fetus in the womb, etc.

At any stage of pregnancy, minor bleeding can provoke an aggressive examination in the chair, a nervous breakdown, or violent sexual intercourse. Fortunately, they pass quickly, but you still need to be careful.

The complex of reasons that cause bleeding during diagnosed pregnancy can be physiological or pathological.

Causes and consequences of menstruation during pregnancy.

First of all, it should be noted that bleeding during pregnancy is not normal. Any woman has a question: “Is menstruation during pregnancy always dangerous?” In most cases, bleeding can have serious consequences, but there are also practically safe situations. In order to determine the level of danger, the gynecologist first of all needs to establish the cause of the bleeding. The reasons for this phenomenon are quite varied:

• The process of implantation of a fertilized egg may be accompanied by damage to blood vessels, and accordingly there may be spotting, which is absolutely safe. This process occurs in the first weeks of pregnancy.

• During the 3-5 weeks of pregnancy, one of the most common causes of bleeding is that the fertilized egg does not have time to implant into the mucous membrane of the uterine organ before the onset of menstruation. During this period, hormonal processes associated with fertilization have not yet passed, and accordingly, menstruation begins according to the cycle. This situation is quite rare, but quite possible.

• Hormonal changes in a woman’s body. After conceiving a child, the female body begins to produce progesterone, which prevents the uterus from contracting and maintains pregnancy. Insufficient levels in the body can lead to bleeding, which usually begins in accordance with the menstrual cycle. In this case, there is a danger of miscarriage, because along with blood and tissue, the uterus can reject the fetus. In most cases, if you consult a doctor in a timely manner, miscarriage is prevented by taking hormonal medications that replace progesterone. Similar processes occur when there is an excess of male hormones – androgens – in a woman’s body (hyperandrogenism). In this case, hormonal therapy is also used.

• The presence of pathologies in the female body or fetal development disorders. In the first months of pregnancy, bleeding may indicate detachment of the fetus and the threat of miscarriage. The detachment process can be caused by various reasons (neoplasms on the walls of the uterus, endometriosis, unsuccessful attachment of the fetus, etc.). A woman’s body can cope with this situation by producing progesterone, but if the bleeding is heavy and painful, you should immediately consult a doctor. Most often, specialists prescribe certain medications and bed rest.

• Another pathology is ectopic pregnancy. In this case, bleeding also appears. Unfortunately, it is not possible to save the child, since fertilization occurs in the fallopian tube and not in the uterus. Over time, the embryo grows and does not have enough space, as a result of which the tube may rupture, which is a threat to the woman’s life. Fetal pathology can also develop as a result of intrauterine infectious diseases. In such cases, it is very rare to save a pregnancy. It is imperative to examine the rejected embryo in order to prevent similar situations in the future.

• A fairly rare, but quite possible cause of bleeding can be a multiple pregnancy, when one of the embryos develops normally, and the other is rejected by the uterus.

Thus, during pregnancy, any bleeding is a pathology. If a pregnant woman notices even a slight spotting bleeding, she must react to this and contact medical specialists. Only a gynecologist will be able to determine the cause of bleeding, select appropriate treatment for it, and help prevent miscarriage. Any delays are fraught with the development of complications that can have a negative impact on the entire body as a whole and on the woman’s reproductive system in particular.

Menstruation in the early stages of pregnancy.

The risk of bleeding in the early stages of pregnancy is exacerbated by the fact that the woman may not know that she is pregnant. Especially if bleeding appears on the days when menstruation was supposed to begin. In this case, the woman will most likely mistake the bleeding for normal menstruation, which will endanger the life of the child and her health. If you have the slightest doubt, be sure to consult a gynecologist, because diagnosing pregnancy in the early stages can be one of the decisive factors that will save the life of your baby.

Menstruation during pregnancy: when should you sound the alarm?

Pregnancy is one of the most crucial periods in the life of any woman. During this time, the expectant mother should especially carefully monitor her health and changes in her body, because not only her life and health, but also the future baby’s, depends on this. One of the warning signs that can threaten the health and life of the mother and child is menstruation during pregnancy.

Initially, it should be said that spotting during pregnancy cannot be considered menstruation in the full sense of this concept. After all, you don’t need to be a biologist or a doctor to understand that menstruation and pregnancy are incompatible processes. Menstruation is the process of the uterus rejecting the remains of an unfertilized egg and particles of tissue with which it is covered. During pregnancy (fertilization of the egg), you should talk about bleeding, which can warn a woman of possible danger.

Visualization of the fertilized egg.

Using the results obtained from examining patients who were treated with in vitro fertilization (IVF), it was found that the fertilized egg is usually visualized between the 4th and 5th weeks after the last menstrual period. Experience shows that it can be detected after 4 weeks and 2 days, counting from the first day of the last menstruation. In most cases, with transvaginal echography, the yolk sac is visualized when the size of the fertilized egg reaches approximately 1 cm, and the yolk sac together with the embryo - when its size is about 1.5 cm.

Based on preliminary data, it was revealed that during the period of detection of the ovum during transvaginal echography, the level of beta-hCG ranges from 500 to 800 mIU/ml according to the criteria of the Second International Standard, and according to the new criteria it ranges from 1,500 to 2,400 mIU/ml, which significantly lower than those found when compared with the results described for transabdominal echocardiography (1,800-3,000 mIU/ml).

During this period, the fertilized egg itself increases in diameter by approximately 1-2 mm daily and is determined within the thickened endometrium. To record the dynamics of the size of the fertilized egg, a repeat study can be performed after 3-5 days. In the middle of the 5th week from the last menstruation (3.5 weeks of gestational age), the embryo, whose dimensions range from 2 to 5 mm, is located near the wall of the yolk sac, which is visualized as a round cystic structure with anechoic contents with a diameter of 2 to 4 mm. An increase in the yolk sac (over 6 mm), as well as its decrease, may indicate the death of the embryo. The embryo with the yolk sac are located eccentrically in the cavity of the fertilized egg, forming an image of the so-called “double bubble”.

By the end of the first half of the embryonic period, the chorion surrounding the fertilized egg is visualized as a ring of hyperechoic tissue. At 4 weeks from the last menstrual period, the size of the ovum is only 3 to 5 mm in diameter, increasing to approximately 1 cm by the 5th week of pregnancy.

In the early stages of development, the embryo may be difficult to visualize during transvaginal examination. Despite the fact that many of its structures have already been formed, they have not yet been identified using echography. During these periods, the neural tube closes in the middle part, but remains open in the region of the head and caudal ends. Gill arches are formed, as well as somites, which look like rounded elevations on the surface of the embryo. Until the end of this period, 42-44 pairs of somites are formed, from which skeletal bones and muscles will subsequently develop.

Mid-embryonic period of development.

The so-called “mid-embryonic period of development” occurs from 4 to 6 weeks from the beginning of the last menstruation. The anatomy of the embryo in this early period of development is usually still inaccessible for research due to the insufficient resolution of most diagnostic instruments currently used.

Differences in the timing of ovulation (up to 12 days) and implantation (up to 3 days) may influence the findings obtained during transvaginal examination at these early stages of pregnancy. With transvaginal echography, one of the first signs of intrauterine pregnancy is an anechoic round inclusion with a diameter of only a few millimeters, located in the uterine cavity against the background of a thickened hyperechoic endometrium. A gestational sac can be detected no earlier than 4 weeks and 3 days, but is most often detected by transvaginal examination after 5 weeks. 

At 5 weeks of pregnancy, inside the fetal egg, surrounded on the periphery by a layer of hyperechoic chorion, two cavities are determined, located one inside the other, which represent the developing primary yolk sac and the cavity of the extraembryonic coelom (exocoelom). This picture is revealed only within 2-3 days. An embryo that is not visualized by echography at this stage is designated as three-layered, since upon microscopic examination three distinct cell layers (endoderm, mesenchyme and ectoderm) can be distinguished. 

Since transvaginal echography is a relatively new clinical method, the need to accumulate additional clinical data remains relevant to establish reliable criteria for the relationship between the size of the ovum and visualization of the yolk sac and embryo.

Normal development of pregnancy in the early stages.

When discussing the normal development of early pregnancy from an echographic point of view, it is useful to divide the first trimester into three periods: 4 to 6 weeks, 7 to 8 weeks, and 9 to 11 weeks. During the embryonic period, all major organs are formed. In the fetal period they grow and complete their functional development.

Such a distinction is somewhat arbitrary and is based on terminology accepted in embryology. These terms, particularly gestational age, differ from those used clinically.

Embryologists usually count gestational age from the moment of conception, while in clinical practice it is customary to use menstrual age, which is counted from the first day of the last menstrual period, since, as a rule, its date is known.

Although the time interval between the first day of the last menstrual period and the moment of conception is usually two weeks, it can vary up to 8 days. All data presented here is described based on the calculation of gestational age based on the date of the last menstrual period.

Indicators determined by ultrasound.

Deviation of indicators in a smaller direction is a sign of intrauterine growth retardation; changes in a larger direction are a sign of a large fetus, which will complicate natural childbirth. In such cases, doctors prefer caesarean section.

An increased size of the fetal head is a sign of hydrocephalus - an increase in the amount of fluid in the brain. To make such a diagnosis, the ventricles must also be enlarged. Sometimes the pathology is accompanied by other developmental disorders, so additional thorough research is necessary.

If the nuchal translucency indicators are too high, the woman should consult a geneticist and undergo additional examinations as prescribed by a specialist:

• blood test for alpha fetoprotein, human chorionic gonadotropin;

• amniocentesis – study of amniotic fluid;

• placentocentesis – study of placental cells;

• cordocentesis - study of blood taken from the fetal umbilical cord.

A child's normal heartbeat is rhythmic, occurring at regular intervals, clear and distinct. Irregular heartbeats may indicate a congenital heart defect or fetal hypoxia, and a dull sound may indicate intrauterine oxygen deficiency.

If the heart rate exceeds the norm, a diagnosis of tachycardia is possible; if it decreases to 120 or less, a diagnosis of bradycardia is possible. A heart rate that goes beyond normal limits often occurs as a result of a reaction to a decrease in oxygen in the blood - fetal hypoxia. In this case, the woman is prescribed inpatient treatment aimed at improving uteroplacental blood flow and intracellular metabolism.

If the thickness of the placenta exceeds the permissible normal values, this may indicate inflammation of the placenta (placentitis).

Normally, the placenta should be attached to the posterior wall of the uterus (rarely to the anterior or fundus). It should be 6 cm or more from the internal os of the cervix. Low attachment, marginal or central presentation with overlap of the internal os is a dangerous pathology that threatens the life and health of both mother and child. It often occurs in women who have given birth repeatedly, terminated pregnancies, or have inflammation or uterine fibroids. In this case, the woman needs careful hospital monitoring or at home with complete rest. With complete placenta previa, the birth of a child is possible only by caesarean section. If it is low, natural birth is possible, but there is a high risk of bleeding.

The reason for late maturation of the placenta may be smoking by a pregnant woman or the presence of chronic diseases, and premature maturation may be due to gestosis, intrauterine infections, endocrine pathologies, termination of a previous pregnancy, and also smoking.

If such a deviation is detected in a woman, she needs to undergo a Doppler ultrasound and be tested for infections. After which a course of therapy is prescribed aimed at treating fetal hypoxia, vitamin supplementation, reducing uterine tone and getting rid of infection (if necessary).

Deviation of indicators towards a smaller or larger direction indicates oligohydramnios or polyhydramnios, respectively. In case of polyhydramnios, a woman is prescribed mandatory treatment with antibiotics and drugs to improve uteroplacental blood flow. Oligohydramnios indicates a severe fetal malformation - the complete absence of kidneys. In this case, appropriate therapy is carried out to support the child.

An important indicator is the quality of the amniotic fluid. Normally, it should be transparent, without turbidity, mucus, or flakes. Otherwise, this may be a sign of the development of an infectious process.