Know Your Blood Type
All pregnant women are tested for the Rh factor during the early weeks of pregnancy. A
mother and fetus may have incompatible blood types, the most common is Rh incompatibility.
Rh incompatibility occurs when the mother's blood is Rh-negative and the father's blood is
Rh-positive and the fetus' blood is Rh-positive. The mother may produce antibodies against
the Rh-positive fetus which may lead to anemia in the fetus. Incompatibility problems are
monitored and appropriate medical treatment is available to prevent the formation of Rh
antibodies during pregnancy. |
The First Trimester (0-12
Weeks)
The first prenatal visit:
The first prenatal visit is the most thorough. A complete medical history is taken, a
physical examination is conducted, as well as certain tests and procedures are performed
to assess the initial health of the mother and the embryo. The first prenatal visit may
include:
- personal medical history - this may include taking record of any of the
following:
- previous and current medical conditions - such as diabetes, high blood pressure
(hypertension), anemia, and/or allergies
- current medications - prescription and over-the-counter
- previous surgeries
- mother's and father's family medical history - including illnesses such
as diabetes or mental retardation, and genetic disorders such as sickle-cell disease or
Tay-Sachs disease
- personal gynecological and obstetrical history - including past
pregnancies --stillbirths, miscarriage, deliveries, terminations -- and menstrual history
(i.e., length and duration of menstrual periods)
- education -including a discussion regarding the
importance of proper nutrition, regular exercise, and the avoidance of alcohol, drugs, and
tobacco during pregnancy
- pelvic examination - this type of examination may be performed for
one/all of the following reasons:
- to note the size and position of the uterus
- to determine the age of the fetus
- to check the pelvic bone size and structure
- to perform a Pap test (also called Pap smear) to detect the presence of abnormal cells
- laboratory tests - including:
- urine tests - to screen for bacteria, sugar, and protein
- blood tests - to determine blood type
- blood screening tests - to detect diseases (i.e., rubella, also called German measles)
- genetic tests - to detect inherited diseases (i.e., sickle-cell anemia, Tay-Sachs
disease)
- screening tests - to detect infectious diseases (i.e., sexually transmitted diseases)
The first prenatal visit is also an opportunity to ask any questions or discuss any
concerns that you may have about your pregnancy.
What to expect during the first trimester (0-12 weeks):
A healthy first trimester is crucial to the normal development of the fetus. The
mother-to-be may not be showing much on the outside, but inside her body all the major
body organs and systems of the fetus are forming.
As the embryo implants itself into the uterine wall, several developments take place,
including:
- amniotic sac
A sac filled with amniotic fluid, called the amniotic sac, surrounds the fetus throughout
the pregnancy. The amniotic fluid is liquid made by the fetus and the amnion (the membrane
that covers the fetal side of the placenta) that protects the fetus from injury and helps
regulate the temperature of the fetus.
- placenta
The placenta, an organ shaped like a flat cake and only grows during pregnancy, attaches
to the uterine wall with tiny projections called villus. Fetal blood vessels grow through
the umbilical cord into these villus, exchanging nourishment and waste products with the
mother’s blood. The fetal blood vessels are separated from the mother’s blood
supply by a thin membrane.
- umbilical cord
The umbilical cord is a rope-like cord connecting the fetus to the placenta. The umbilical
cord contains two arteries and a vein, which carry oxygen and nutrients to the fetus and
waste products away from the fetus.
It is during this first trimester that the fetus is most susceptible to damage from
substances such as alcohol, drugs, certain medications, and illnesses such as rubella
(German measles).
During the first trimester, both the mother’s body and the fetus are changing
rapidly.
Fetal development during the first trimester (0-12 weeks):
The most dramatic changes and development occur during the first 12 weeks of fetal life.
During the first eight weeks after conception, a fetus is called an embryo. The embryo
develops rapidly and by the end of the first trimester it becomes a fetus that is fully
formed, weighing approximately 1/2 to one ounce and measuring, on average, three to four
inches in length.
First trimester growth and development benchmarks:
Just as each child grows and matures at different rates and at different times, so
does that same child as it begins its life in the womb of his/her mother. The chart
provided below provides benchmarks for most normal pregnancies. However, each fetus
develops differently.
| by the end of 4 weeks |
- all major systems and organs begin to form
- the embryo looks like a tadpole
- the neutral tube (which becomes the brain and spinal cord), the digestive system, and
the heart and circulatory system begin to form
- the beginnings of the eyes and ears are developing
- tiny limb buds appear (which will develop into arms and legs)
|
| by the end of 8 weeks |
- all major body systems continue to develop and function, including the circulatory,
nervous, digestive, and urinary systems
- the embryo is taking on a human shape, although the head is larger in proportion to the
rest of the body
- the mouth is developing tooth buds (which will become baby teeth)
- the eyes, nose, mouth, and ears are becoming more distinct
- the arms and legs are clearly visible
- the fingers and toes are still webbed but can be clearly distinguished
- the main organs continue to develop and you can hear the baby’s heartbeat using an
instrument called a doptone
- the bones begin to develop and the nose and jaws are rapidly developing
- the embryo is in constant motion but cannot be felt by the mother
|
| from embryo to fetus |
After 8 weeks, the embryo is now referred to as a fetus
(which means offspring). Although the fetus is only 1 to 1 1/2 inches long at this
point, all major organs and systems have been formed. |
| during weeks 9-12 |
- the external genital organs are developed enough for the baby’s gender to be
determined by using a pregnancy ultrasound test
- fingernails and toenails appear
- the arms and legs are fully formed
- the voice box (larynx) begins to form in the trachea
The fetus is most vulnerable during the first 12 weeks. During this period of time, all
of the major organs and body systems are forming and can be damaged if the fetus is
exposed to drugs, German measles, radiation, tobacco, and chemical and toxic substances.
Even though the organs and body systems are fully formed by the end of 12 weeks, the
fetus cannot survive independently. |
Changes in the mother's body:
During pregnancy, many changes are also occurring in the mother-to-be's body. Women
experience these changes differently. Some symptoms of pregnancy continue for several
weeks or months, while others are only experienced for a short period of time. Some
women experience many symptoms, while other women experience only a few or none at all.
The following is a list of changes and symptoms that may occur during the first trimester
and includes:
What are Kegel exercises?
Kegel exercises are pelvic floor exercises that help tone the muscles in the vagina and
perineum, which is important for delivery. Conditioned muscles will make the birthing
process easier. In addition, these exercises, when done after delivery, can help to speed
up the recovery process. Doing a Kegel exercise is simple:
- Tighten the muscles around your vagina and anus. (The exercise
is similar to stopping urination midstream.)
- Hold the muscles tightened as long as you can, working up to 8
to 10 seconds each time.
- Relax the muscles.
- Tighten and relax the muscles several times a day.
|
- The mammary glands cause the breasts to swell and become tender in preparation for
breastfeeding. This is due to an increased amount of the hormones estrogen and
progesterone. A supportive bra should be worn.
- A woman's areolas (the pigmented areas around each breast's nipple) will enlarge,
darken, and may become covered with small, white bumps called Montgomery’s tubercles
(enlarged sweat glands).
- Veins become more prominent on the surface of the breast.
- The uterus is growing and begins to press on the woman's bladder, causing the need for
her to urinate more frequently.
- Partly due to surges in hormones, a pregnant woman may experience mood swings similar to
premenstrual syndrome (a condition experienced by some women that is characterized by mood
swings, irritability, and other physical symptoms that occur shortly before each menstrual
period).
- Increased levels of hormones to sustain the pregnancy may cause "morning
sickness," which is feelings of nausea and sometimes vomiting. However, morning
sickness does not necessarily occur just in the morning and rarely interferes with proper
maternal and fetal nutrition.
- As the growing uterus presses on the rectum and intestines, constipation may occur.
- The muscular contractions in the intestines, which help to move food through the
digestive tract, are slowed due to high levels of progesterone. This may, in turn, cause
heartburn, indigestion, and gas.
- Clothes may feel tighter around the breasts and waist, as the size of the abdomen begins
to increase to accommodate the growing fetus.
- A woman may experience fatigue due in part to the hormonal changes in early pregnancy.
- Cardiac volume increases by approximately 40 to 50 percent from the beginning to the end
of the pregnancy, causing an increased cardiac output. An increased cardiac output may
cause an increased pulse rate during pregnancy. The increase in blood volume is needed for
extra blood flow to the uterus.
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