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Pregnancy: 7 First Trimester Warning Signs to Never Ignore

Pregnant? Find out about warning signs in the first trimester that need immediate medical care.

By Denise Mann
WebMD Feature

Reviewed by Mikio A. Nihira, MD

Discovering that you are expecting is emotional and exciting, but it can also be worrisome. You may be anxious about many things -- from what type of mother you will be to the economics of raising a family -- in addition to all the changes going on in your body.

What’s normal? What's not? When should you call the doctor and when should you take a deep breath?

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To help put your mind at ease, WebMD talked with experts about serious symptoms that may occur during the first trimester, what they may mean, and what you should do about them. Of course, if you're concerned about anything during your pregnancy -- even if it's not one of these symptoms -- contact your doctor.

Serious symptom No. 1: Vaginal bleeding (with or without cramping and pain)

What it may mean: “Some spotting is normal, but heavy bleeding could be a sign of miscarriage or ectopic pregnancy,” says Natali Aziz, MD, 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,” she says. “The darker the blood color, the more likely it is blood from an older bleed leaving the body,” she says.

“If you have bleeding and bad cramping similar to period cramps, this can be a sign of threatened miscarriage,” says Manju Monga, MD, the Berel Held Professor and the division director of maternal-fetal medicine at the University of Texas Health Sciences Center 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,” she says.

Bottom line: “Most spotting or light bleeding is not a serious problem or condition, but you don’t want to ignore it if it is associated with cramping, heavy bleeding, or abdominal pain,” she says. “You are always better safe than sorry.”

Serious symptom No. 2: Excessive nausea and vomiting

Some nausea and vomiting during your first trimester is normal, but if it crosses the line and becomes excessive, it can have serious consequences.

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,” she says. “You may need hospitalization to treat the dehydration, and many medications are available to control nausea."

Bottom line: “Nausea and vomiting are normal occurrences during pregnancy, but the extremes can cause problems,“ says Stanley M. Berry, MD, corporate chairman of obstetrics and gynecology at 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.”