Aside from the most common signs of early pregnancy (i.e. cessation of periods, nausea with or without vomiting, breast tenderness, urinary frequency and fatigue), other symptoms can be a little more worrying. These include vaginal bleeding and abdominal pain or discomfort but what’s causing them and what do they elude to?
Bleeding in early pregnancy can vary from spotting to a heavy loss of bleed. Typically speaking, this occurrence (no matter how heavy the bleeding) is not critical to the mother or her baby. Every woman who experiences vaginal bleeding in the first trimester of pregnancy requires an ultrasound scan. If the bleeding is accompanied by pain then it may represent an ectopic pregnancy or an impending miscarriage but repeated scans and blood tests should be taken before a conclusive diagnosis of pregnancy loss can be made.
Pelvic or Abdominal Pain
As a baby grows in the womb most women experience pelvic or abdominal discomfort. Indeed, if the symptoms are mild and self-limited then it is very likely that they represent normal early pregnancy changes. However, if the abdominal or pelvic pain is regarded to lie between moderate to severe, persistent or progressive then it could represent an ectopic pregnancy and an impending or ongoing spontaneous miscarriage. Again, every patient requires an ultrasound scan.
What Is An 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 but it may also occur in the cervix, ovaries or elsewhere in the abdomen.
The diagnosis of ectopic pregnancy is based upon a combination of trans-vaginal ultrasound scans and sometimes a series of hormonal tests. In some cases an ectopic pregnancy may lead to serious internal bleeding so a timely and correct diagnosis is of imperative value.
If the results show signs of an ectopic pregnancy then there are effective treatment options available. In the majority of cases, keyhole surgery is the chosen route but medication and expectant management are additional options. Essentially the treatment route for an ectopic pregnancy depends on the symptoms, the ultrasound findings and the level of the pregnancy hormone (beta-HCG).
First trimester miscarriage or early pregnancy loss can be accompanied by vaginal bleeding and/or abdominal pain but it can also occur without any warning signs. In many cases, pregnancy tissue is expelled naturally from the uterus with contractions. Sometimes repeated scans and blood tests may, therefore, be required before a conclusive diagnosis of pregnancy loss can be made. An ultrasound scan will also determine whether the womb spontaneously removed all the tissue or if surgery (with general or local anaesthetic) may be needed.
Nausea and Vomiting
Nausea with or without vomiting is very common in early pregnancy and mild symptoms are considered to be normal. However, when the symptoms persistent and/or severe it can significantly affect a woman’s quality of life. Hyperemesis gravidarum is the term used to describe the severe nausea and vomiting in pregnancy and it certainly warrants medical input and even hospital admission(s) to manage the condition. Fortunately, there are a variety of treatments available and it is advised to seek help early as the condition can deteriorate rapidly. Our Consultant Obstetrician, Demetri Panayi would be more than happy to give you his expert opinion.