Dr. Varshali's Gynecology Clinic

So you have just found out that you are pregnant and you and your partner are over the moon about it! While congratulations are in order, so are a host of tips which will help you settle into the pregnancy. It is important to remember that the first trimester of your pregnancy is a crucial phase where you may not change that much physically, but will be prone to many emotional changes. Some of the symptoms of early pregnancy include nausea, vomiting, breast pain, bloating, frequency of urination etc. It is also a phase where you will make way for the changes that will inevitably come in the next two trimesters and for a long time after delivery of the baby too.

Read on to unravel our first trimester guide.

• Pregnancy Test: You must ensure that you know you are pregnant by monitoring your menstrual cycles closely so that even one missed period points at the possibility of pregnancy. This test can be a home based kit available at the chemists' or can even be conducted with a lab test based on a urine sample. Despite the results that you may get on a home pregnancy test, it is best to get a professional opinion as well.
• Finding the Right Doctor: In this phase of your pregnancy itself, it is imperative to home in on a gynaecologist who will put you ease. Take care to pick someone who may be recommended by family and friends. Have a talk with the doctor a few times to see how well he or she engages you as a patient and if you are suitably convinced with the sessions and appointments.
• Activity: While heavy activities may not be recommended by all doctors as the foetus needs to latch on, one can indulge in plenty of walks and a normal routine as well. Ensure that your pregnancy is a normal one and ask your doctor about any precautions that you may need to take with the progressing trimesters. Also, find ways to deal with any morning sickness with the help of the doctor. 
• Supplements: In this crucial phase, ensure that your doctor gives you a diet supplements like iron, folic acid, calcium that you must ingest on a regular basis. This will keep any risk of neural tube birth defects at bay. Along with food supplements, daily 400mcg Folic acid should be consumed to prevent neural tube defects.
• Other Medication: Find out more about over the counter drugs or any medication that you may have been taking as this may have to be stopped or adjusted for the pregnancy. The doctor should be able to guide you on this aspect too.
• Travelling during first trimester of pregnancy: Couples should try and avoid travelling during first trimester of pregnancy as it may harm your progeny.
• Intercourse during first trimester of pregnancy: Its absolutely alright to have physical relations (sex, intercourse) during first trimester of pregnancy unless doctor has advised to avoid it.

The other activities during the first trimester include taking pre natal appointments and choosing and interacting with your caregiver who will also be a support after you have had the baby.

Vaginal itching is a condition which occurs when the vagina comes in contact with irritants or because of a vaginal infection. Menopause may also lead to conditions that trigger itching in the vagina. In some cases, sexually transmitted diseases and skin allergies also lead to vaginal itching. The conditions in itself is not a major cause of concern, however, one should consult a doctor to treat the underlying condition, if any.

Causes-

The main component of vaginal itching is the trigger, as there can be many of them. The various causes of vaginal itching are-

1. Irritants: Vaginal contact with certain irritants can be the cause behind vaginal itching. Some common substances that irritate the vagina are:

   1. Creams

   2. Ointments

   3. Detergents

   4. Harsh soaps

   5. Topical contraceptives

   6. Scented toiletries

2. Infections in the Vagina: Infections in the vagina such as bacterial vaginosis and yeast infection can lead to vaginal itching. In addition to the vaginal itching, they can also lead to a foul-smelling discharge from the vagina.

3. Sexually Transmitted Diseases: STDs such as gonorrhea and chlamydia are disorders, symptoms of which include itching in the vagina.

4. Medical Conditions: Medical conditions like Diabetes Mellitus, recent antibiotic use, wearing the Intrauterine device.

5. Menopause: During menopause, the estrogen levels in the body dip, thus resulting in a dry vagina. A dry vagina can sometimes lead to vaginal itching.

6. Skin Problems: Certain skin problems such as eczema and psoriasis can result in itching and redness in the genitals. Eczema is a condition which is akin to allergies. Psoriasis is a condition which is characterized by itchy, scaly and red patches on the skin. These symptoms may slowly start spreading to the vagina.

Treatments-

The treatment for vaginal itching begins with a diagnosis of the underlying condition that might be causing it in the first place. The treatment for this disorder is cause specific; hence the underlying condition needs to be identified. Antibiotics and antifungal medications may be administered to treat vaginal itching. For menopause related causes, estrogen creams or tablets are required.

You can also take preventive measures such as:

1. Avoid using scented soaps.

2. Use protection during sex.

3. Wear cotton based underwear.

4. Maintain personal hygiene.

5. Stop vaginal douching, or any other over-the-counter vaginal hygiene products. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

There are so many reasons for you to think that you might be pregnant. Your period is missing or it’s late. You forgot to take pills. You are feeling some changes in your body. Missed or delayed period is the most common first sign of pregnancy. There are many other symptoms of early pregnancy like morning sickness, fatigue, light bleeding, breast changes and many others. 

The first symptoms of pregnancy differ from a woman to another. Some women notice early pregnancy symptoms one day after the first missed menstruation. Others experience them within the first two or three weeks of pregnancy while many do not experience them at all. We will discuss these most common early signs of pregnancy in this article.

Early signs of pregnancy

Whether you were trying to have a baby or just wondering if you were pregnant. Here are 10 early signs of pregnancy.

Missed or delayed period

Does missing your menstruation mean you are pregnant? A delayed period is considered as the earliest and most obvious symptom of pregnancy. After conception, the body starts producing and releasing the human chorionic gonadotropin (hCG) pregnancy hormone to maintain pregnancy. This hormone sends a message to your ovaries telling them to stop releasing eggs every month and that's how your period won't be arriving on the regular time.

You should know that not every delayed period means you are pregnant. There are plenty of explanations for your missed menstruation other than pregnancy. You might have been sexually inactive, still taking pills or stopped taking them recently. Stress, fatigue, fast weight gain or loss and hormonal problems are other possibilities for a missed period. 

If your period is not regular, or you weren’t trucking your menstruation monthly, the following signs can appear before you notice your delayed period.

Morning nausea

A couple of weeks after conception, some women experience morning nausea or sickness. Morning nausea is an early sign of pregnancy that can occur even before noticing that the period is missing. The rising estrogen in the body causes this ill feeling. Most women are relieved by the 14th week of pregnancy, while for others, it persists throughout all the pregnancy.

Light bleeding or spotting

For any woman who is planning to get pregnant, seeing any bleeding can be disappointing. It could be mistaken for a period bleeding. If the spotting is lighter than usual, it could be an implantation bleeding. It happens when the fertilized egg attaches to the uterine lining.

Breast changes

The rising level of hormones related to pregnancy, causes breast sensitivity and soreness. It is the first physical sign of early pregnancy. It is felt as heaviness or tenderness of the breast. This symptom appears usually in the first trimester of the pregnancy and decreases typically after several weeks. You may also notice the area around your nipple (areola) getting darker, it is also due to hormonal changes.

Fatigue

Feeling tired all the time? even exhausted, all of a sudden, doing minimal efforts? It can be a symptom of pregnancy. As the body passes through multiple changes in preparation for carrying a baby, fatigue sets in. It's a nonspecific sign of early pregnancy. The rapidly increasing level of the progesterone hormone also causes unusual sleepiness.

Food cravings

Food cravings are sudden desires to eat a certain kind of food. They can affect any woman during pregnancy and the craving can be for very uncommon types of food. Many women describe it as a sudden urge to eat unusual food combinations including those that they normally don't like at all. Unlike cravings, food aversion is feeling nausea or sickness for some kind of food.

Mood swings

One of the common signs of early pregnancy is mood swings. Experiencing intense emotions or suddenly falling in tears for no reason are other consequences of hormonal changes of pregnancy. Don’t worry, it is totally normal and can be related to stress or other factors.

Increased urination

If you start going to the bathroom more often than usual, that might be a sign of pregnancy. Increased urination is an early sign of pregnancy that appears shortly after conception. The growing uterus and the hormonal changes cause your bladder to fill more quickly leading to frequent urination. Make sure you stay hydrated.

Vaginal discharge

In the first weeks of pregnancy, some women notice a milky thick vaginal discharge. In the early stage of pregnancy, the vaginal walls thicken, and the vaginal secretions increase to protect the baby from infections. Non-associated with itching or burning (signs of infection), this vaginal discharge might be a sign of pregnancy.  If you feel itching or burning, you must consult a doctor, it can be a sign of infection that needs treatment.

Constipation

Another reason to blame hormones is constipation. The increased levels of the progesterone slow down the digestion and, in turn, causes constipation.

There are plenty of other early signs of pregnancy like headaches, shortness of breath, dizziness, fainting, sensitivity to certain smells. Many of them can persist during the second and third trimesters of pregnancy like mood changes, increased urination, fatigue, food cravings, and aversions.

These symptoms may differ in quality or severity. The same woman may have a different experience with different signs in every pregnancy. You can still not experience none of these signs of early pregnancy and be pregnant. Some women don’t figure out they are pregnant from the first weeks, it can take them months to know.

What is next if I had early signs of pregnancy?

If after reading all the explanations of the early signs of pregnancy, you’ re still not sure of your pregnancy, there is one only way to be confirmed, the pregnancy test. Except for ultrasonography test, all the other pregnancy tests measure the level of human chorionic gonadotropin (hCG) which is the pregnancy hormone.

Read the pregnancy test guide article, which gives more detailed information about all the possible tests you can take to confirm your pregnancy. If you have any doubts, it is important to you to consult the pregnancy doctor, you can ask questions and get all the answers you want and make sure everything is alright. The doctor will provide you with all the information you need for your pregnancy and helps you plan for it. You can also have advice about your self-care. Book an appointment to consult with doctor.

Could these signs be premenstrual syndrome?

Many of early signs of pregnancy can be mistaken for premenstrual syndrome (PMS). In the last half of a woman’s menstrual cycle, the premenstrual syndrome can occur. It’s a combination of psychological and physical disturbances that end with the period flow.

These symptoms are fatigue, mood swings, stress, breast tenderness and soreness. You may notice that these signs can be very similar to those experienced in early pregnancy. They are not specific and the only way to distinguish between them is to take a pregnancy test. The arrival of a period is a confirmation of premenstrual syndrome.

The premenstrual syndrome can be different from cycle to cycle and, like the early signs of pregnancy, each symptom can vary in duration and severity from a woman to another.

Whether you are having early signs of pregnancy or just experiencing the premenstrual syndrome, it is important to manage your stress, dietary changes, and medication.

Tips and advice

Some early signs of pregnancy can cause discomfort. There are some good self-care tips and remedies to help you relieve some unpleasant symptoms.

• Eat small frequent meals to combat nausea. And make sure you are well hydrated
• Wear a comfortable bra that could support your sore breasts
• Avoid constipation by eating fibers. Have a good quantity of fruits and vegetables in your meals
• Keep your weight controlled by following a suitable diet. You can consult the doctor to see what is good for your pregnancy
• Once pregnant, don’t take any medications without consulting with your doctor. Many antibiotics and medications are safe during pregnancy, but you must see the doctor to confirm it
• Stay away from alcohol, cigarette, and drugs. They are not good for you and for your growing baby
• Both PMS and early signs of pregnancy need emotional support.

If you think you might be pregnant, but you are not sure about the results and reliability of home pregnancy test, or you want to know if you are pregnant, but it is too early for a urine test, you may consider the blood pregnancy test. These tests are taken at doctor's clinic. A laboratory tests your blood to detect hCG. These tests are more sensitive than the home pregnancy test. Blood pregnancy test can pick up the low concentration of hCG compared to a home pregnancy test and helps to identify pregnancy status, baby health, and problems.

Types of blood pregnancy test: There are two types of blood pregnancy tests. Qualitative hCG blood serum tests check to see if hCG is present in your blood or not. A positive result means you are pregnant and a negative result means you are not pregnant. It just gives "yes" or "no" answer about your pregnancy. Quantitative hCG blood serum tests check both the presence and quantity of hCG present in the blood. It detects even very low level of hCG which helps to determine whether the pregnancy is normal and healthy, and problems like ectopic pregnancy may be detected with this test.

"Blood pregnancy tests have a 99% accuracy rate, so they are almost always accurate. Relatively, they are more accurate than a home pregnancy test. The qualitative test only answers "yes" or "no", while the quantitative test measures quantity of hCG and help to identify the pregnancy status and problems if any. In many cases, the choice between blood and urine pregnancy test is based on convenience, cost, and accuracy. The blood pregnancy test helps to monitor and detect pregnancy problems."

Home pregnancy test or blood test? Like many of fertility and pregnancy questions, there is no straightforward answer to this question. Both determine if you are pregnant or not, but the choice might depend on factors like convenience, expense, accuracy and your fertility history. When deciding if you should use a home pregnancy test or have a blood pregnancy test done at the lab, there are few items to consider like convenience, cost, and accuracy. Many times, the blood pregnancy test is preferred to remove uncertainty in home pregnancy test and acts as a confirmatory test to detect pregnancy. In case of fertile histories like miscarriage or ectopic pregnancy in the past, the doctor generally monitors hCG levels closely in first several weeks of pregnancy. If hCG levels do not rise appropriately in those very early days, it can signal a problem with the pregnancy. Neither a qualitative blood test nor an HPT allows this type of monitoring, as they do not reveal exact amounts of hCG, and cannot determine if levels are increasing appropriately.

After missed periods, after unprotected sex, you want to know if you are pregnant. You probably do not want to tell this to the world but what you need is just a confirmation that you are pregnant or not. Home Pregnancy Test (HBT) is a quick and easy way to find out if you are pregnant or not. The HBT works on detecting the hCG hormone in your urine (pee). This hormone is generated in your body only if you are pregnant. 

How to do the test? You can get the pregnancy test kit from most of the medical stores. These test kits are usually not that expensive. You can also get the pregnancy test kit from your doctor. For most home pregnancy tests, you either hold a test strip in your urine stream or you collect your urine in a cup and dip your test strip into the cup. If you are pregnant, most test strips produce a colored line, but this will depend on the brand you purchased. Read the instructions for the test you bought and follow them carefully. 

When to conduct the test? Home pregnancy tests are accurate when you take them after you’ve already missed your period, or your period is late. Doing the pregnancy test on the day of your missed period will give you correct results, but its advised to wait for a week after your missed period to get most accurate results. Few pregnancy test kits say they work a few days before a missed period, but the results are usually less accurate.  Sometime a pregnancy test can find the pregnancy hormones in your urine as early as 10 days after unprotected sex. But these results aren’t super reliable, and you may get a false positive or false negative test result. If your periods are very irregular, or you don’t get periods at all for one reason or another, your best bet for accurate results is to take a pregnancy test 3 week after sex.

How to get accurate results? To get good test results, it is recommended using midstream urine, which means peeing first into the toilet and then into the cup to collect the sample. You can improve your chances for an accurate result by using your first-morning urine for the test. If you are pregnant, it will have more hCG in it than later urines. A pregnancy test will be less accurate if it’s expired or if you don’t use it the right way. So always check the expiration date on the package, and carefully read the directions that come with your pregnancy test.

What are false positive and false negative results? In some cases, you might be pregnant, but your test results are negative. This is called false negative. This may happen if you have not used the test properly, or you have done the testing too early. In this case, if your period does not arrive after few days, repeat the test after few days or consult pregnancy doctor. In some cases, you might not be pregnant, but the test results are positive. This is called false positive. This may happen if you have used the kit past its expiration date or if you have given an hCG injection during infertility treatment. A false positive pregnancy test result may also be seen in some cancers and other medical conditions that may produce elevated hCG levels.

If your results are positive, or you have some confusion about the outcome, consult pregnancy doctor to confirm the test results. The doctor might ask you to repeat the urine test at a clinic or may suggest blood test or other options to confirm your pregnancy. Always confirm your home test result with the pregnancy doctor.

“Home Pregnancy Test (HBT) is qualitative in nature and will tell you only if you are pregnant or not. This will not tell you how long you have been pregnant. The results are most accurate if you take the test a week after your missed period and when use midstream first-morning urine. For reliable results, its advised to repeat the test twice. Always consult a pregnancy doctor to confirm the test results.”

What is clinical urine test? A clinical urine test is not different than home pregnancy test and is not necessarily more accurate. However, pregnancy doctor at the clinic will help eliminate any possible errors that might affect the accuracy of the test results. Based on the outcome of results, you can consult pregnancy doctor about further steps and options.

Am I pregnant? The suspense created by this question is killing you. The question can be triggered by many events and incidents. You had an unprotected sex. Your periods are missing. Your body is behaving differently than usual. You are experiencing early pregnancy symptoms and signs. This question brings anxiety, curiosity, excitement and sometimes stress too. You want to get the answer as soon as possible. This complete pregnancy test guide gives details about all the pregnancy tests including home pregnancy test, clinical urine pregnancy test, blood pregnancy test, and ultrasonography pregnancy test.

How does the pregnancy tests work? Except for ultrasonography test, all these tests work on detecting the hormone called human chorionic gonadotropin (hCG). This hormone is only found in the body during pregnancy. About six to twelve days after fertilization, a fertilized egg attaches to the wall of a woman's uterus. The cells of fertilized egg produce hCG which builds up rapidly in your body. It doubles every 2 to 3 days in the first few weeks of pregnancy reaching a peak level by 8-12 weeks. Pregnancy tests detect this hormone in urine and blood.

Pregnancy test works on detecting the hormone called human chorionic gonadotropin (hCG). This hormone is generated in woman body during pregnancy and builds up rapidly. It doubles every 2 to 3 days in first few weeks of pregnancy reaching a peak level by 8-12 weeks.

When should I take the pregnancy test? You can take a pregnancy test any time after your period is late - that's when they work the best. You'll likely get accurate results from a pregnancy test one day after your first missed period. However, it's best to wait at least a week after your missed period, to be sure that you get the most accurate test results. The Pregnancy test is done before a missed period usually gives less accurate results. Sometimes a pregnancy test can find pregnancy hormones in your urine as early as 10 days after unprotected sex. But these results aren't super reliable, and you may get a false positive or false negative test result.

Read the complete pregnacy guide here..