First Trimester

A. Recommendations for exercise in pregnancy are individualized and based upon common sense. Be sure to stay hydrated, avoid getting overheated and decrease your activity if you experience any pain while walking. Be aware that sometimes in pregnancy you’ll be fine during the actual walk, but later in the day, or the next day, you’ll develop back or hip pain. Th us, moderation and staying in close touch with your body’s signals are key. Your body will tell you your limits far better than anyone can. Of course, if you have any pregnancy complications like bleeding or premature labor, you should consult your ob/gyn.

A. Yes. Bleeding should be reported immediately, and evaluated by your doctor.

A. This is a very common first-trimester symptom. Unless it is quite severe, there is no danger to the baby as its nutritional needs are quite minimal at this point.

A. Not very good unless there’s an incorrect date involved (which does often happen). By seven weeks from the last menses, a fetus with an active heart beat should be seen easily. At this point, the main issue is going to be whether or not you have an ectopic pregnancy or simply an intrauterine pregnancy which has failed (miscarriage).

A. Any moisturizing cream or lotion will help prevent dryness. This doesn’t have anything to do with whether or not you will develop stretch marks. There’s been a lot of interest in Vitamin E oil and its reported ability of improve skin flexibility, but there is no definitive proof of this.

A. Nothing’s wrong. You are simply retaining water, which a very normal result of the massive increase in the amount of estrogen you are producing from your pregnancy. Resting on your left side will somewhat help enable the kidneys to excrete the extra water.

A. You may not. Not everyone has the same experience. That said, it’s unusual not to experience some degree of breast soreness, fatigue, nausea or urinary frequency.

A. There is not the faintest evidence that any harm can be caused to a fetus by the use of ultrasound, although this fear continues to be stoked by folks with an alarmist bent.

A. Not sure I know what is meant by your sac being weak, but I assume you mean that your membranes ruptured prematurely. This is not something your doctor could have predicted, as it’s generally believed to be due to infection. You should not be at any increased risk for this happening in the future.

A. It is most unlikely that there is anything wrong with your pregnancy. It is to be expected that your long cycle will throw off predictions as to the length of your pregnancy. What that means is that you likely conceived on around day 38 of your cycle rather than day 14. You will likely have another sonogram soon which should reassure you and also help pin down a reliable due date.

A. This is a very common event in pregnancy. Fully one-third of the time, the correct gestational age as determined by ultrasound does not square with menstrual dates. From what you tell me, it is most likely that you got pregnant a few weeks later than you thought you did as a result of delayed ovulation. If, for example, your pregnancy test first showed positive in late May, you could have conceived around the middle of that month and still be only six to seven weeks by mid-June. This is why many of us are encouraging that ultrasound be done quite early in the pregnancy, so that a reliable due date can be established.

A. Cramping in the first trimester which is not accompanied by bleeding is a normal stretching phenomenon. It does not imply any higher than normal risk of miscarriage and does not require you to be at restricted activities.

A. By “bleeding at the top” I suspect you mean that there was blood between the implanted egg and the wall of the uterus, what we call subchorionic hemorrhage. In most cases it subsides with no adverse potential for the fetus. It can be expected to stop on its own. However, if this does not occur by 7 to 10 days later, another sonogram is warranted to determine if the pregnancy is continuing.

A. It means nothing by itself other than that there is, or recently was, a pregnancy. What matters is how the number is changing. In a normal first trimester, the value should double every 72 hours from about 6 to 10 weeks. So, in order to take any valuable information from this test, it needs to be repeated in a few days in order to see if it’s increasing as it should.

A. Yes, that is quite possible. This situation requires close follow-up with sonograms and possibly serial HCG levels. However, the visualization of a heart beat is a very favorable sign that at least one of the embryos will survive.

A. A miscarriage is very likely under the conditions you describe. HCG levels should consistently rise throughout the first 10 to 12 weeks.

A. It appears likely that you have already miscarried. Very early, there may not be more than a light bloody, brown discharge. An easy way to confirm this is to measure blood levels of the hormone HCG. If it is going down the pregnancy has been lost.

A. Not if the event occurred two weeks ago and has not recurred. If anything important, such as a miscarriage were occurring, the bleeding would not be brief and limited, but would persist. Your doctor should be able to reassure you at your next visit.

A. Not if the event occurred two weeks ago and has not recurred. If anything important, such as a miscarriage were occurring, the bleeding would not be brief and limited, but would persist. Your doctor should be able to reassure you at your next visit.

A. All it means is that the HCG hormone level is low, which can mean a very early pregnancy or a later one that is in the process of being lost. If the pregnancy is healthy, the test should turn strongly positive in five to seven days.

A. At less than 12 weeks, a fetal Doppler is not going to be able to reliably detect fetal heart tones, so most likely you are hearing the pulsation of your own arteries. Blood circulating through an artery can cause a sound a bit like the rushing of wind.

A. The risk would be extremely low, as the conditions which can adversely affect an early fetus are things that you almost certainly have had as a child yourself and, therefore, are immune from. That said, if you know for a fact that you’ve never had common childhood illnesses such as measles, mumps, chicken pox or German measles, then there is some risk involved and it would be best not to risk exposure until you’re past the first trimester.

A. If they actually saw a “GS” (gestational sac) in the uterus, then ectopic pregnancy is most unlikely, almost a zero possibility. At four weeks, three days, no definitive signs of pregnancy are going to be seen on ultrasound. Serial quantitative HCG levels are helpful in a situation like this.

A. There are several questions here. As to the hormone numbers, there are no hard and fast rules, but 14 is considered extremely low and raises the possibility of early miscarriage. The next test will be important in answering that question. If you had a cerclage before, you’ll need it again. There’s no scientific evidence that bed rest adds anything to the success rate of pregnancy. You should discuss this with your doctor.

A. Not necessarily. You might not be as far along as you think; one third of menstrual pregnancy dates turn out to be incorrect. On the other hand, if you are essentially certain when you got pregnant, then by two months, or eight to nine weeks, a heartbeat should be easily seen on vaginal ultrasound. The matter can be settled by a combination of blood pregnancy hormone levels and repeat ultrasound tests.

A. This depends upon what method the doctor used to try to detect the heartbeat. If it was a Doppler device in which only a sound is produced, then it would be quite a bit too early to hear the heartbeat. However, if this was a sonogram, in which a picture is produced, then the beating heart should definitely be detectable by eight weeks. Your doctor can follow this latter situation by repeating the sonogram in a week or two.

A. This is called “carpal tunnel syndrome” and is very common during pregnancy due to water retention. There is a brace device that can be applied and that is usually quite helpful. Talk to your ob/gyn about this.

A. It is possible to have intermittent bleeding episodes during pregnancy, usually for reasons that are not harmful. These episodes, however, are not “periods” in the traditional sense as menstrual activity ceases during pregnancy.

A. Yes, it is. Blood vessels in the genital area tend to become a bit fragile during pregnancy, so very light flow is not considered abnormal, although levels approaching menses certainly would be. Also, the stretching of the uterus will cause mild cramping.

A. This is a very common first-trimester symptom. Unless it is quite severe, there is no danger to the baby as its nutritional needs are quite minimal at this point.

A. The height of the uterus within the pelvis is very variable, so I wouldn’t put much emphasis upon it. Twins are always a possibility, but that will very soon be determined via ultrasound.