Watching and Taking Precautions During Initial Weeks of Pregnancy
Q: Hello Doctor, I am pregnant. My LMP date was 5th August. I got my early pregnancy sonography done on 17th September. The report mentioned- “GS measures 0.87 cm corresponding to 4w6d.” Rest all was reported normal but was asked to repeat sonography after 10 days to check for fetal heart beat. I got it done on 26th September. This time the report mentioned- “GS measures 1.36 cm corresponding to 5w3d CRL measures 0.25 cm corresponding to 5w6d; FHB was 103 bpm”.
Please let me know if there is any cause of concern. Is this abnormal? I have had a miscarriage when the fetus did not grow beyond 6 weeks. Hence I am stressed if this is abnormal. The doctor has asked me to repeat sonography after a week. Thanks and hope to hear from you.
Everything appears to be normal. Detection of fetal heart beat at this stage is promising. There is no visible cause of worry at this point.
Detecting Fetal Growth in Early Pregnancy
Let us discuss the journey of your baby till this stage. Your LMP was on 5th Aug. Sometime, 11-20 days after that, your egg may have got fertilized by a sperm. Fertilization occurs in the fallopian tube. There is nothing in the uterus at this stage.
Uterine wall start preparing for implantation of this egg. Ultrasound at this stage (1-2 weeks) is unable to provide any information.
As the fertilized egg travels through the tube to reach the uterus, it continuously divides to form a ball of cells. Any chromosomal anomaly which could have been a cause of abortion in early pregnancy occurs during this multiplication.
If there is no problem with the fetus, it gets implanted in the uterus.
A healthy pregnancy can be assured at this stage by two ways:
- Measurement of levels of two pregnancy hormones- Progesterone and HCG.
- Ultrasound uterus (done trans-vaginally preferably) shows thickened lining of uterus.
Gestational sac or the fetus inside it can still not be appreciated. The baby is of the size of an orange seed.
After 4th week, gestational sac can be seen. Fetus is usually seen in 5th week. Though these signs are not very suggestive of how the baby is performing.
The next important sign which clues to normal growth is fetal heart beat. We usually wait till 6th week to hear it.
Most of the cases of inevitable abortions occur in the 1st trimester (till 12 weeks) of pregnancy. After that, pregnancies are usually safe.
What to Monitor at This Stage?
It is good that your doctor is closely monitoring you. Repeat ultrasound is being done just to assure further that all this well. The gestational sac grows at the rate of 1mm per day till the end of pregnancy. Also, the fetal heart rate will slowly increase to 130-140 bpm.
In closely monitored pregnancies, the hormonal levels of the patient are also measured. Both progesterone and HCG needs to be measured. HCG increases in its level every 48 hours in early pregnancy.
Their optimum levels are essential for the maintenance of pregnancy. Any deficiency in their level is promptly compensated by giving external supplements.
Symptoms of Pregnancy
Another important and reliable clue of healthy pregnancy are the symptoms a women experiences during this phase. It is healthy to perceive a lot of smells, feel tired more often, nausea, vomiting or being emotionally more sensitive. All these symptoms tell us that the hormonal milieu of the body is alright.
We would advice you to take care of the following points:
- Take rest whenever required.
- Avoid lifting heavy weights or strenuous activities like climbing up a lot of stairs.
- Limit on your exercises.
- Take your antenatal vitamins regularly.
- Avoid taking any other medicine; if you have to take any, consult your doctor first.
- For a close monitoring of the development of pregnancy, get your hormonal levels checked regularly (HCG in particular).
- If required, weekly injections of HCG can be given throughout the first trimester.
When to Notify Your Doctor:
Contact your doctor Immediately if you feel any of these signs:
- Contractions in your uterus
- Any pelvic pain
- Spotting of any kind.