First Trimester Problems: When to Call Your Doctor

Watch for 7 warning signs of trouble with your early pregnancy.

From the WebMD Archives

You're expecting! It's an emotional and exciting time, especially if it's your first baby. You're going to notice a lot of changes in your body. Many of them are perfectly normal. And most women have healthy pregnancies.

Still, there are some symptoms you'll need to pay more attention to during your early months. For example, nausea, a little bleeding, and vaginal discharge aren't unusual, but they could also mean there's a problem. Should you call your doctor? Probably.

You might be tempted to dismiss these signs if you don't realize they're clues to avoid bigger troubles. Knowing what to watch for helps you take care of yourself and the little one growing inside you. Any time you're concerned about what's going on or how you're feeling, it's OK to talk to your doctor.

1. Vaginal Bleeding

What it may mean: "Some spotting is normal, but heavy bleeding could be a sign of miscarriage or ectopic pregnancy," says Natali Aziz, MD. She is a maternal-fetal medicine specialist at Lucile Packard Children's Hospital in Palo Alto, Calif. "The brighter red the bleeding, the more significant it is."

"If you have bleeding and bad cramping similar to period cramps, this can be a sign of threatened miscarriage," says Manju Monga, MD. She is a maternal-fetal medicine specialist at Baylor College of Medicine in Houston. "If this is coupled with sharp, lower abdominal pain, it may be a sign of ectopic pregnancy," a serious complication that occurs when the fertilized egg implants outside the uterus, usually in the fallopian tubes.

What to do: "Call your doctor," Monga says. "Your doctor will likely do an ultrasound, an exam, and some blood work based on your symptoms." Though most spotting or light bleeding may not be a serious problem, "you don’t want to ignore it if it is associated with cramping, heavy bleeding, or abdominal pain."

2. Excessive Nausea and Vomiting

It's normal to have some nauseaand vomiting during your first trimester. Most pregnant women go through that.

But if it's severe or makes you dehydrated, that's something to heed. If you can’t keep any water or fluids down for more than 12 hours, call your doctor.

Continued

What it may mean: “Vomiting that interferes with your day-to-day activities can lead to weight loss, dizziness, dehydration, and an imbalance of electrolytes,” Aziz says.

What to do: Tell your doctor. “You may need hospitalization to treat the dehydration, and many medications are available to control nausea," Aziz says.

Bottom line: "Nausea and vomiting are normal occurrences during pregnancy, but the extremes can cause problems," says ob-gyn Stanley M. Berry, MD, of William Beaumont Hospital in Royal Oak, Mich. "The majority of women who have nausea and vomiting in their first trimester will go on to have normal, healthy pregnancies."

3. High Fever

A fever greater than 101 degrees Fahrenheit or 38 degrees Celsius during pregnancy may be serious.

What it may mean: It could be a sign of infection, which could affect the baby.

Fevers during pregnancy that are accompanied with rash and joint painmay be a sign of infection such as cytomegalovirus (CMV), toxoplasma, and parvovirus. "CMV is the most common cause of congenital deafness, and it is not as uncommon as we think," Aziz says.

What to do: "Report any fever plus upper respiratory symptoms, body ache, and flu-like symptoms or rashes and joint pain to your doctor," Aziz says. And get your yearly flu vaccine.

4. Vaginal Discharge and Itching

Some vaginal discharge is normal. But in some cases, "These may be signs of treatable infections or sexually transmitted diseases that can have important consequences in pregnancy," Aziz says.

What this may mean: If it's an infection, it could harm the baby.

What to do: Don't be shy. Let your ob-gyn know what is going on down there because if there's a problem, treating it could make a difference to your baby.

5. Pain or Burning During Urination

What this may mean: "These can be signs of bladder or urinary tract infections, and if left untreated, they can lead to more serious illness, infection, pre-term labor, and pre-term birth," Aziz says.

What to do: If it's an infection, treating it can relieve your pain, and help assure a healthy pregnancy.

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6. Leg or Calf Pain, or Swelling on One Side/ Severe Headache

This won't happen in most pregnancies. But pregnancy does mean a greater chance of developing a blood clot.

A blood clot in the calf may lead to pain or swelling and can result in a blood clot that travels to the lung, which could be fatal.

A blood clot in the brain may be heralded by a severe headache. There are other possible causes of bad headaches during pregnancy.

What to do: If you have a history of blood clots, or if you get a severe headache, consult your doctor.

7. Flare-Ups of Chronic Diseases

Women who have certain pre-existing medical conditions -- such as thyroid disease, diabetes, high blood pressure, asthma, and/or lupus -- should note any changes in their condition during pregnancy.

What it may mean: If your underlying disease is flaring up or not well-controlled, it can have serious consequences for your health -- and your baby's.

For example, "if your thyroid hormone is too high or low, you can be at an increased risk of miscarriage," says Gayle Olson, MD. She is a maternal-fetal specialist at the University of Texas Medical Branch in Galveston. Or, "if your blood sugar levels are not tightly controlled, you may be at increased risk of miscarriage or fetal abnormalities," she says.

The bottom line: "Any flare in an underlying condition is a red flag and should be followed up," Olson says.

Still, most women will have healthy pregnancies, Berry says, so try to enjoy your pregnancy.

"Stress is no good, and the more positive the attitude, the better things are for mom and baby," he says. So make sure you have good prenatal care and a healthy diet, and get proper rest and take your prenatal vitamins.

WebMD Feature Reviewed by Nivin Todd, MD on September 09, 2013

Sources

SOURCES:

Natali Aziz, MD, maternal-fetal medicine specialist, Lucile Packard Children's Hospital, Palo Alto, Calif.

Manju Monga, MD, maternal-fetal medicine specialist, Baylor College of Medicine, Houston.

Stanley M. Berry, MD, William Beaumont Hospital, Royal Oak, Mich.

Gayle Olson, MD, maternal-fetal specialist, University of Texas Medical Branch in Galveston.

© 2010 WebMD, LLC. All rights reserved.

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