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2.1
First Trimester Pregnancy
Early Placental Phase

Presentation

The classification score of early pregnancy loss was equal to (1.66 × Maternal age) + (0.84 × Mean sac diameter) + (-0.38 × Crown-rump length) + 8.69 (if cardiac activity is present) + 1.60 (if intrauterine hematomas are present) - 34.77. [ncbi.nlm.nih.gov]

Gastrointestinal

  • Loss of Appetite

    (Call your doctor if you have nausea, loss of appetite, vomiting, jaundice or fatigue combined with itching. These can be signs of a serious liver problem.) Swelling of the ankles, fingers, and face. [womenshealth.gov]

Musculoskeletal

  • Back Pain

    […] chuna for acute low back pain during the early stages of pregnancy. [kci.go.kr]

    However, you may experience a whole new set of symptoms, such as back pain, abdominal pain, leg cramps, constipation and heartburn. Somewhere between 16 weeks and 20 weeks, you may feel your baby's first fluttering movements. [ucsfhealth.org]

    Severe abdominal pain, especially if it is accompanied by bleeding, nausea, vomiting or swelling of the hands and face. Slight vaginal spotting. Heavy vaginal bleeding, especially if it is accompanied by abdominal or back pain. [womenandinfants.org]

    Core work and pelvic floor strengtheners, exercises common to disciplines like Pilates, help reduce back pain as pregnancy progresses, but be sure to seek out adaptations or prenatal classes to prevent diastasis recti (separation of the ab muscles, especially [vogue.com]

    It is advisable to contact your physician in case you have any of the alarming signs such as severe lower back pain, bleeding, passing blood clots and extreme nausea as these might indicate a miscarriage [11]. [pregmed.org]

Fetus

  • Quickening

    Although the fetus begins to move during the first trimester, it is not until the second trimester that movement, known as quickening, can be felt. [en.wikipedia.org]

Breast

  • Large Breast

    There had been other signs such as my ravenous appetite and my surprisingly large breasts but that could be chocked up to getting my period. [staceyschaedler.com]

Neurologic

  • Headache

    Have periods of activity and then of rest; stop before you become overtired Eat small meals several times a day and drink plenty of water If you're working, try to rest on your breaks and at lunchtime Headaches Headaches are common and usually due to [healthyfamiliesbc.ca]

    Evidence-based assessment of pregnancy outcomes after sumatriptan exposure Headache 2002; 42:8-15 5) Kallen B, Lygner PE, Delivery outcomes in women who used drugs for migraine during pregnancy with special reference to sumatriptan Headache 2001; 41: [jhsnet.org]

    Occasional slight headaches, faintness or dizziness - Many health care providers will say that it is okay to take Tylenol for headaches, even in the first trimester. Before taking anything, however, check with your own health care provider. [womenandinfants.org]

    Many health care providers approve the use of over-the-counter medicines to treat pain, headaches, cough, colds and other discomforts. [allinahealth.org]

    Other early include symptoms include headaches, an increased urge to urinate, constipation, heartburn and indigestion, light-headedness and, of course, nausea. [irishtimes.com]

  • Dizziness

    The most common side effects included diarrhea (27%), dizziness (22.2%), nausea (15.9%), and chills (15.6%). [ncbi.nlm.nih.gov]

    As long as you don't feel dizzy when you lie on your back, then plenty of blood is reaching your brain. If you feel dizzy when lying on your back, roll to your side or onto your stomach. [healthyfamiliesbc.ca]

    Some of the most common changes or symptoms you might experience in your first trimester are: Tiredness Nausea and vomiting Frequency of urination Constipation Dizziness Varicose veins Hemorrhoids ( see Hemorrhoids During Pregnancy ) Leg cramps Nosebleeds [pregnancy.emedtv.com]

    See a doctor immediately if you have pain in your shoulder, especially when you lie down or if you show any signs of shock (clammy skin, weak pulse, dizziness) because these are symptoms of a ruptured ectopic pregnancy. [livestrong.com]

    The pregnancy symptoms you might experience include nausea, vomiting, exhaustion, shortness of breath, more urination, dizziness, and moodiness. [pregnancy.lovetoknow.com]

  • Irritability

    Heartburn happens when acid bubbles up from your gut and irritates your esophageal lining, causing discomfort or pain. You’ll have a burning feeling in your chest, behind your breastbone. [thebump.com]

    Also restless leg syndrome - an uncontrollable urge to keep moving my right leg, that can strike at any time, and irritates anyone nearby who finds their cup gradually dancing off the table. [theguardian.com]

    Irritability, mood swings, irrational behavior, and/or weepiness, comparable to premenstrual syndrome. Apprehension, fear, joy and/or elation about your pregnancy. [womenandinfants.org]

    Being moody and easily irritated. You may be a bit tearier and not as even tempered as you usually are. It is very normal to feel anxious about the possibility of miscarriage. [huggies.com.au]

    Being moody and easily irritated. You may cry easily and not be as even-tempered as you usually are. Feeling anxious about the possibility of miscarriage. This is very normal and most commonly occurs in the early weeks. [huggies.co.za]

  • Confusion

    After a few confused and surprised moments (and some humble pie--which, given my cravings, I would have eaten as well), I decided to put all that medical training to good use--for me and for you. [sharecare.com]

    However, some of those first symptoms: tiredness, bloating, sore breasts, mood swings, even bleeding, may mean that you initially confuse pregnancy with PMS. [irishtimes.com]

    The first week of pregnancy is included in the first trimester, in the time when you may be having your period, confusing as it sounds. This is because it is seen as a time marker for when ovulation is most likely to have occurred. [huggies.com.au]

    Whether this is all new to you or a refrain, you may find pregnancy to be amazing, confusing, overwhelming, and everything in between (sometimes at the same time). [pregnancy.about.com]

    And they were confused for a second but eventually they clued in. It was funny. March 17 (13 weeks) : We told Eric’s parents the big news today! We mailed them a package that said do not open until St Patrick’s day [on Skype with us]. [ohsheglows.com]

  • Giddiness

    And then I’d be giddy. Moods change so fast while pregnant, so just expect that. And tell your spouse to expect it as well. They can be hard to deal with, but if you both are ready for them…it makes them a little more endurable. [clarkscondensed.com]

    Giddy with excitement, I buy two adorable little girl outfits. Week 6 I could swear I'm showing. Proud as a mama peacock, I tell close friends. Week 7 Suddenly seized with morning, afternoon and evening sickness. [fitpregnancy.com]

Urogenital

  • Urinary Incontinence

    Here are some tips for navigating the Ultrasound War. » Read more Urinary Incontinence During Pregnancy By Laura Leavitt It is a little embarrassing, but it is usually a pretty natural and small part of pregnancy. » Read more [justmommies.com]

    Some of the physical symptoms you may experience during this period include shortness of breath, hemorrhoids, urinary incontinence, varicose veins and sleeping problems. [ucsfhealth.org]

    Do kegel exercises Focusing on strengthening the pelvic floor can help during vaginal delivery and also to prevent urinary incontinence during and after birth. [womenshealthmag.com]

  • Hegar's Sign

    […] portion of the cervix) Hegar's sign (softening of the uterus isthmus ) Pigmentation of the linea alba – linea nigra, (darkening of the skin in a midline of the abdomen, caused by hyperpigmentation resulting from hormonal changes, usually appearing around [en.wikipedia.org]

  • Chadwick's Sign

    […] in the uterus during the third or fourth week after last menstrual period increased basal body temperature sustained for over 2 weeks after ovulation Chadwick's sign (darkening of the cervix, vagina, and vulva ) Goodell's sign (softening of the vaginal [en.wikipedia.org]

Workup

Procedures When the diagnosis is unclear, the following procedures may be performed: Culdocentesis Diagnostic dilation and curettage See Workup for more detail. [reference.medscape.com]

[…] procedures that may be helpful in specific scenarios include the following: Fluorescein staining and slit-lamp examination of the cornea for keratitis Flexible fiberoptic bronchoscopy with bronchoalveolar lavage or bronchial brushing Thoracocentesis See Workup [emedicine.medscape.com]

Treatment

RESULTS: Medical treatment was successful in 57 and surgical treatment was needed in 7 women. Average pain and bleeding intensity were 5.8 and 5.3, respectively. [ncbi.nlm.nih.gov]

[…] in a five-year trial, called PROMISE (Progesterone in Miscarriage Treatment). [medicaldaily.com]

After inadvertent treatment with an ACT, the miscarriage rate was 24 per cent, comparable to the rate associated with other treatments. [sciencedaily.com]

Prognosis

Correlation of clinical findings, quantitative human chorionic gonadotropin levels and diagnostic ultrasound findings can maximize the efficiency of the work-up, provide a definitive prognosis and identify early ectopic pregnancy. [ncbi.nlm.nih.gov]

Pseudomonas causes a wide spectrum of diseases; therefore, prognosis is varied. [emedicine.medscape.com]

©ThePracticalMommy This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. [wehavekids.com]

Etiology

BACKGROUND: The etiology of early pregnancy loss is multifactorial and may include viral pathogens. [ncbi.nlm.nih.gov]

Etiology In the first trimester, embryonic causes of spontaneous abortion are the predominant etiology and account for 80-90% of miscarriages (see the image below). [reference.medscape.com]

Overview of the etiology and evaluation of vaginal bleeding in pregnant women." UpToDate. Updated: Sep 14, 2017. CONTINUE SCROLLING FOR RELATED SLIDESHOW [medicinenet.com]

Epidemiology

KEYWORDS: Congenital anomaly; Depression; Epidemiology; Medication; Registry; SSRI [ncbi.nlm.nih.gov]

Chemistry and Biochemistry (17) Histology, Embryology (15) Obstetrics, Gynaecology (14) Endocrinology, Metabolism (13) General Practice Medicine (13) Microbiology (12) Anaesthesiology and Intensive Care Medicine (12) Nuclear Medicine (11) Haematology (10) Epidemiology [portal.mefanet.cz]

Manitoba and Saskatchewan administrative health care utilization databases are used differently to answer epidemiologic research questions. J Clin Epidemiol 2008 ;61: 192 - 197 26. Misset B, Nakache D, Vesin A, et al. [nejm.org]

Spread of extensively resistant VIM-2-positive ST235 Pseudomonas aeruginosa in Belarus, Kazakhstan, and Russia: a longitudinal epidemiological and clinical study. Lancet Infect Dis. 2013 Jul 8. [Medline]. Edgeworth JD, Treacher DF, Eykyn SJ. [emedicine.medscape.com]

Pathophysiology

OBJECTIVES: The contribution of local inflammation to the pathophysiology of abnormal choromosomally miscarriages remains unclear The objective of this study was to investigate the inflammatory response at the maternofetal interface of women presenting [ncbi.nlm.nih.gov]

Orthopaedics (187) Internal Medicine (175) Paediatrics, Neonatology (165) Pathology and Forensic Medicine (146) Respiratory Medicine (85) Radiology and Imaging (65) Cardiology, Angiology (64) Gastroenterology and Hepatology (62) Dentistry (53) Physiology and Pathophysiology [portal.mefanet.cz]

Most studies do not differentiate separately between the epidemiology and pathophysiology of each entity. [reference.medscape.com]

Pathophysiology P aeruginosa is an opportunistic pathogen. It rarely causes disease in healthy persons. [emedicine.medscape.com]

Prevention

• The hormone progesterone also increases as it is needed to relax the muscles in the uterus to prevent early labor. [visembryo.com]

Preventive Services Task Force. Repeating the test in the third trimester is of value to those at high risk for HIV infection. [labtestsonline.org]

Intravenous ampicillin, with or without gentamicin, effectively sterilizes the placenta and prevents maternal and fetal illness and death in cases of listeriosis in early pregnancy. [wwwnc.cdc.gov]

To this end and to prevent inadvertent harm to early normal pregnancies, the Society of Radiologists in Ultrasound convened a consensus panel of radiologists, obstetricians, and emergency medicine physicians in 2012 with the goal of reviewing current [ncbi.nlm.nih.gov]

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2.1
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