Pregnancy occurs when an egg is fertilized by a sperm, grows inside a woman’s uterus (womb), and develops into a baby. In humans, this process takes about 264 days from the date of fertilization of the egg, but the obstetrician will date the pregnancy from the first day of the last menstrual period (280 days 40 weeks).
The doctor will use certain terms when discussing a pregnancy. Some of the following definitions are useful:
• Intra-uterine pregnancy: A normal pregnancy occurs when a fertilized egg is implanted in the uterus (womb) and an embryo grows.
• Embryo: The term used for the developing fertilized egg during the first 9 weeks of pregnancy.
• Fetus: The term used for the developing embryo after 9 weeks of gestation.
• Beta human chorionic gonadotropin (also called beta-hCG): This hormone is secreted by the placenta and can be measured to determine the presence and progression of the pregnancy. Urine or blood can be tested for its presence, and it is the hormone involved in the performance of a home pregnancy test. A positive result means a woman is pregnant; however, this test result can stay positive for several weeks after delivering a baby or following a spontaneous miscarriage.
• Trimester: The duration of an individual pregnancy is divided into three periods called trimesters (approximately three months in duration). Each trimester is characterized by specific events and developmental markers. For instance, the first trimester includes the differentiation of the different organ systems.
• Estimated date of delivery (EDD): The delivery date is estimated by counting forward 280 days from the first day of the woman’s last period. It is also called the estimated date of confinement (EDC).
A pregnant woman and her doctor will monitor the pregnancy to exclude or prevent certain pregnancy conditions. The physician will also treat non pregnancy-related medical conditions in such a way as to promote the appropriate physical and neurological development of the fetus. Conditions of particular importance include:
• High-risk pregnancy: If a woman is considered prone to certain complications during pregnancy, she will be classified as high risk. Examples include pregnancies in women with diabetes and/or high blood pressure. Age-related complications can occur in women such as teenagers, women who are over the age of 35, or those who have been treated for infertility and have pregnancies resulting from the use of assisted reproductive technology.
• Ectopic pregnancy: This is a pregnancy in which the egg implants somewhere other than the uterus. This complication can be life-threatening. Ectopic pregnancy must be diagnosed early to avoid damage to the Fallopian tubes and to prevent serious maternal illness or death. It is also called tubal pregnancy (if the egg implants in the Fallopian tubes) or extra-uterine pregnancy.
• Cervical incompetence: This is a condition in which the cervix begins to open (widen) and/or efface (thin) without contractions before the pregnancy has reached term. Cervical incompetence can be a cause of mid-pregnancy miscarriage.
• Preterm Labor: In this condition, the uterus begins to contract before the baby has reached full-term.
• Preeclampsia/eclampsia: Preeclampsia is a systemic disease that can affect various organ systems. Vascular effects cause the blood pressure to rise in a pregnant woman. The condition may cause kidney damaged, generalized swelling, hyperactive reflexes, as well as deleterious abnormalities in blood chemistry and nerve reflexes. If left untreated, preeclampsia can proceed to eclampsia, a serious condition which may result in seizures, coma, and even death.
• Multiple Gestation (e.g. twins, triplets): Preterm births are twice as likely in twin pregnancies than in singleton pregnancies. The percentage of preterm birth is even greater for triplet pregnancies and higher order pregnancies. Preeclampsia is also seen three to five times more frequently with multiple gestation.
Early Pregnancy Symptoms and Signs
Symptoms of pregnancy include the following:
· B##### tenderness
· Nausea, vomiting, or both
· Missing a period or having an abnormal period
· Weight gain
· B##### enlargement, nipples darkening, or b##### discharge
· Urinating more frequently than usual
· Fetal movement (may be perceived after 20 weeks for new mothers)
When to Seek Medical Care During Pregnancy
If a woman suspects that she may be pregnant or if she has a positive home pregnancy test, she should make an appointment with a health-care professional, which could be a doctor, an obstetrician (women’s health specialist), a family physician, a midwife, or a nurse practitioner. Early prenatal care is essential to insure a favorable pregnancy outcome.
A woman who is pregnant should call her health-care professional if any of the following conditions develop:
· Labor or rupture of membranes (leaking fluid)
· Serious abdominal or v###### pain
· Bright red v###### bleeding
· Vomiting more frequently than three times per day or vomiting blood
· Severely elevated blood pressure (above 140/90)
· Sudden and rapid weight gain
· Severe headache or visual changes
· Severe leg or chest pain
Seek care in a hospital’s emergency department if pregnant and experiencing any of these conditions:
· V###### bleeding through more than one pad per hour
· Having severe pain in the abdomen or shoulder or severe dizziness
· Passing pink, gray, or white material from the vagina that does not look like a blood clot (The woman who is pregnant should take the material to the hospital.)
· Having a bloody discharge or gush of fluid from the vagina during late pregnancy (this may indicate that the onset of labor is imminent).
· Seizure activity but without a history of epilepsy (This may indicate eclampsia, a complication of pregnancy).
· Having an injury, such as a fall, a blow to the stomach or pelvis, or a car accident
· Lower abdominal pain during late in pregnancy may indicate the onset of labor. Labor pains occur secondary to uterine contractions. A patient may attempt consumption of clear liquids or lying on her left side for a short time to determine if the contractions will resolve spontaneously. If the pain persists, her health care provider should be notified.