The first trimester of pregnancy produces a whirl of varied emotions, including: excitement, hope, misgivings and fear. These are all normal, as is the desire to know what might go wrong during this time. The developing embryo is most fragile in the first trimester, making miscarriage a top concern. Rest assured, though, that most pregnancies continue on without incident. Before you know it, you will be researching the second trimester.
Miscarriage
The most common time to experience a miscarriage is in the first trimester, the American Pregnancy Association (APA) reports. The APA notes that "anywhere from 10-25% of all clinically recognized pregnancies will end in miscarriage." Unfortunately, this means that 4,780 American women experience a pregnancy loss each day, the APA says. The most common cause of first-trimester miscarriage is chromosomal abnormalities. Other causes include advanced maternal age, improper implantation and maternal health issues, reports the APA. Warning signs include vaginal bleeding, cramping and/or a sudden decrease in pregnancy symptoms. Although the threat of miscarriage may loom large in your mind, the odds are on your side. In addition, know that the majority of miscarriages occur early on, before the heartbeat is ever detected on the first ultrasound. Even so, in a 2004 issue of "Women & Therapy," psychologist Lisa Cosgrove, Ph.D., reports that the duration of the pregnancy is unrelated to the the amount of distress experienced after a loss. That is, even early pregnancy losses can cause extreme heartache.
Ectopic Pregnancy
Ectopic pregnancy is the leading cause of pregnancy-related death during the first trimester. An ectopic pregnancy occurs when the embryo implants outside of the uterus, typically in the fallopian tube. If left untreated, as the embryo grows, the narrow fallopian tube becomes stretched beyond its limits and, eventually, ruptures. This rupture can cause massive blood loss and maternal death. The number of cases of ectopic pregnancy is rising, "from 4.5 cases per 1,000 pregnancies in 1970 to 19.7 cases per 1,000 pregnancies in 1992," says Julie Tenore in the "Ectopic Pregnancy" article published in "American Family Physician." Despite this rise, however, Tenore notes that the rate of death has actually decreased. This is largely due to earlier detection and treatment. If you are experiencing vaginal bleeding while pregnant, see your doctor. She will rule out an ectopic pregnancy by performing an ultrasound and a series of blood tests to monitor your level of beta-hCG, a pregnancy hormone. If an ectopic pregnancy exists, it can be treated with a drug called methotrexate, if caught early on, or via laparoscopic surgery, Tenore says.
Hyperemesis Gravidarum
Most women experience morning sickness during the first trimester, which is nausea and/or vomiting that happens at any time of day. Very rarely, a pregnant woman develops hyperemesis gravidarum, which consists of severe, persistent nausea and vomiting. Hyperemesis gravidarum can result in dehydration and require hospitalization, so that IV fluids can be administered, says the National Institutes of Health (NIH). Most cases of hyperemesis gravidarum resolve as the first trimester comes to a close. The NIH reports that warning signs of hyperemesis gravidarum include losing more than 2 pounds and/or vomiting more than three times a day.
References
- American Pregnancy Association: Miscarriage
- AAFP: Ectopic Pregnancy
- NIH: MedlinePlus: Hyperemesis Gravidarum
- NIH: MedlinePlus: Vaginal Bleeding in Pregnancy
- "The Aftermath of Pregnancy Loss: A Feminist Critique of the Literature and Implications for Treatment"; "Women & Therapy"; Lisa Cosgrove, Ph.D.; 2004
