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First Trimester: When to Call Your Doctor

Pregnant? Here are 7 changes that may need immediate action.
WebMD Feature
Reviewed by Nivin Todd, MD, FACOG

Discovering that you're expecting is emotional and exciting. Especially if it's your first baby, you may have a lot of questions about what's normal, what's not, and when you should call your doctor.

Most women will have healthy pregnancies. Taking care of yourself and heeding any changes in your health will probably go a long way towards easing your mind. Many of the changes your body will go through while pregnant are perfectly normal. Still, some deserve swift attention.

Pregnancy Week by Week

Pregnant Belly
If you are newly pregnant, or trying to conceive, you have many questions about what to expect. How will your body change? What's happening inside you? Here's what to expect week by week.

Here are seven symptoms, what they may mean, and what you should do about them. Of course, you should feel free to raise questions with your doctor at any point during your pregnancy, even if it's not on this list.

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 nausea and 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.

What it may mean: “Vomiting that interferes with your day-to-day activities can lead to weight loss, dizzinessdehydration, 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."

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