OVERVIEW

What does early pregnancy mean?

The entire pregnancy lasts 40 weeks and is clinically divided into three periods: early pregnancy, mid-pregnancy, and late pregnancy. The details are as follows:

• Early pregnancy (first trimester): Also known as the first trimester, it refers to the period before 13 weeks + 6 days of pregnancy. Pregnancy weeks are calculated from the first day of the last menstrual period^[2];
• Mid-pregnancy (second trimester): Refers to weeks 14–27 + 6 days of pregnancy^[2];
• Late pregnancy (third trimester): Refers to week 28 of pregnancy and beyond^[2].

Which department should I visit for early pregnancy?

Obstetrics and Gynecology or Obstetrics.

Generally, visit the Obstetrics and Gynecology department to confirm the pregnancy duration.

Is pregnancy the same as being pregnant?

Pregnancy (pregnancy) simply refers to what is commonly called "being pregnant." It is the process from the formation of the fertilized egg to the expulsion of the fetus and its appendages (such as the placenta, fetal membranes, umbilical cord, and amniotic fluid) from the mother^[1].

This process is calculated from the first day of the last menstrual period and lasts approximately 280 days, or 40 weeks.

What are the symptoms of early pregnancy?

The following conditions should raise strong suspicion of early pregnancy^[1]:

• Missed period: Healthy women of childbearing age who are sexually active and have regular menstrual cycles should suspect early pregnancy if their period is delayed by more than 10 days. If the delay exceeds two months, the likelihood of early pregnancy is higher.
• Early pregnancy symptoms: Symptoms such as aversion to greasy food, nausea, morning vomiting, craving for sour foods, dizziness, fatigue, drowsiness, chills, and loss of appetite may indicate early pregnancy^[1];
• Breast tenderness, enlarged nipples, and darkened areola pigmentation;
• Frequent urination: Increased frequency of urination.

If these symptoms occur, seek medical examination at a reputable hospital to rule out cervical cancer or ectopic pregnancy. A gynecological examination may reveal an enlarged and softened uterus, providing preliminary confirmation of early pregnancy.

A urine pregnancy test can generally confirm pregnancy. However, if accompanied by other discomforts such as abdominal pain, vaginal bleeding, dizziness, or fatigue, ectopic pregnancy or cervical lesions must be ruled out^[2].

What are the common causes of early pregnancy?

Early pregnancy is a normal physiological stage for women and not a disease process^[1]. For women of childbearing age, normal sexual intercourse can lead to natural fertilization.

Couples planning pregnancy can consult an obstetrician. By providing the menstrual cycle and the start date of the last period, the doctor can estimate the next ovulation time. Conception can occur during this period, leading to early pregnancy.

For healthy women outside childbearing age, ovulation-period intercourse (ovulation occurs around the 14th day before the next period, with the fertile window spanning 5 days before and 4 days after ovulation), ovulation-inducing medications, or assisted reproductive technologies can also result in early pregnancy^[1].

What tests are needed if early pregnancy is suspected?

If typical symptoms are present, early pregnancy is highly suspected. The following tests can help confirm the diagnosis:

• Pregnancy test: The simplest and most common method, using a home pregnancy test strip to detect urine^[1]. Test strips are available at pharmacies. Two colored lines indicate a positive result, confirming pregnancy.
• Ultrasound: A non-invasive method and the gold standard for diagnosing early pregnancy^[1]. Visualization of a gestational sac, embryo, or fetal heartbeat confirms early pregnancy and a viable fetus. Ultrasound also estimates gestational age and assesses fetal development.
• Basal body temperature: A simple method involving daily temperature measurements. A sustained high temperature for 18 days suggests early pregnancy, and exceeding 3 weeks increases the likelihood^[1].
• Cervical mucus examination: Less commonly used, performed in hospitals. Microscopic examination of cervical mucus can indicate early pregnancy^[1].

What should be noted during early pregnancy?

Early pregnancy is a critical period for fetal development. The mother's physical and mental condition significantly impacts the fetus.

• Maintain a positive mood and manage work stress.
• Engage in moderate exercise (avoid intense activities). Walking daily in comfortable shoes can boost immunity.
• Ensure a nutrient-rich diet, including essential micronutrients.
• Avoid smoking, alcohol, drugs, and sexual intercourse during early pregnancy.
• Avoid medications that may cause fetal malformations, such as hormones or fluoroquinolone antibiotics.
• Monitor blood sugar, blood pressure, and thyroid function^[3].

How to terminate an unintended early pregnancy?

Options include medication abortion and surgical abortion.

• Medication abortion: Uses mifepristone to disrupt the uterine lining and misoprostol to induce contractions. Advantages include less pain and anxiety, but prolonged bleeding may require surgical intervention^[1].
• Surgical abortion: Similar mechanism but involves manual removal of the embryo. Advantages include a shorter procedure, but it may cause more pain and anxiety^[1].

Both methods should be performed at a reputable hospital.

How to prevent miscarriage during early pregnancy?

Some women mistake vaginal bleeding for a delayed period. Women with regular cycles should be vigilant and use pregnancy tests if needed. Seek medical attention for abnormal bleeding.

What causes recurrent miscarriages in early pregnancy?

Early pregnancy miscarriage refers to spontaneous termination before 12 weeks. Recurrent miscarriages may be due to:

• Genetic factors: Chromosomal abnormalities in either parent can cause miscarriage^[1]. Genetic testing is recommended, but miscarriages can still occur even with normal chromosomes.
• Acquired factors: Uterine abnormalities, scarring from cesarean sections, or implantation issues^[1].
• Psychological factors: Stress or anxiety can trigger hormonal changes leading to uterine contractions^[1].

Diet, environment, hormonal imbalances, and immune factors may also contribute^[1].