Early Pregnancy Problems

The most common signs and symptoms of early pregnancy are:

Cessation of periods, nausea with or without vomiting, breast tenderness,
urinary frequency and fatigue.

Other symptoms that can be worrying include vaginal bleeding and abdominal pain or discomfort.

Vaginal bleeding

Bleeding in early pregnancy that can vary from spotting to heavy bleeding and might be accompanied by pain, may represent an ectopic pregnancy or impending miscarriage.

Very often though the bleeding no matter how heavy it is does not lead to a pregnancy loss.

Every woman who experiences vaginal bleeding in the first trimester of pregnancy requires an ultrasound scan.
Sometimes repeated scans and blood tests may be required before a conclusive diagnosis of pregnancy loss can be made.

Pelvic or abdominal pain

Pelvic or abdominal pain in pregnancy that presents as moderate to severe, persistent or progressive could represent an ectopic pregnancy, and impending or ongoing spontaneous miscarriage.

Every patient with similar symptoms requires an ultrasound scan.

If the symptoms are mild and self-limited then it is very likely that they represent normal early pregnancy changes.

Ectopic pregnancy

An ectopic pregnancy is a pregnancy developing outside the uterine cavity. Most of the ectopic pregnancies occur in one of the fallopian tubes. Other possible locations include the cervix, caesarean scar, ovaries or elsewhere in the abdomen.

The diagnosis of ectopic pregnancy is based upon a combination of transvaginal ultrasound scan findings and sometimes hormonal tests.

In some cases an ectopic pregnancy may lead to serious internal bleeding so a timely and correct diagnosis is of imperative value.

Treatment of ectopic pregnancy involves surgery (keyhole surgery in the vast majority of cases), medication or expectant management. It depends on the symptoms, the ultrasound findings and the level of the pregnancy hormone (beta-HCG).

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Miscarriage

First trimester miscarriage or early pregnancy loss can be accompanied by vaginal bleeding or pain but can also occur without any warning signs. Sometimes repeated scans and blood tests may be required before a conclusive diagnosis of pregnancy loss can be made.

In many cases pregnancy tissue is expelled naturally from the uterus with contractions. An ultrasound scan will determine whether the womb spontaneously removed all the tissue or surgery or medical intervention may be needed.

Surgery can be done with general or local anaesthetic.

Nausea and vomiting

Nausea with or without vomiting is very common in early pregnancy and mild symptoms may be considered normal.

However when these symptoms are persistent and/or severe can affect the woman’s quality of life.
Hyperemesis gravidarum is the term used to describe the severe nausea and vomiting in pregnancy.

It is a condition that necessitates medical input and even hospital admissions.
There is a variety of treatments available and it is advised to seek help early as the condition can deteriorate rapidly