General Information Regarding Early Pregnancy at CARE Fertility: Dallas and Fort Worth, Texas
Congratulations on your positive pregnancy test! The following covers some of the frequently asked questions regarding "do's and don'ts" in early pregnancy. It is also important for you to "touch base" with your OB/Gyn. Please call to share your news. Typically we transition your care to your OB around 8 to 10 weeks. If you do not have an OB/Gyn, please research and choose one as soon as possible.
- Please continue to take your pre-natal vitamins daily. Some patients find it beneficial to take their pre-natal vitamin just prior to going to bed to minimize nausea. CAR will provide refills during the first trimester; however, during the remainder of the pregnancy and during the post-partum period, your OB would prescribe the pre-natal vitamins.
- Naturally smoking is contraindicated in pregnancy and should be stopped immediately. Even as little as just a few cigarettes a day can have harmful effects on the developing fetus. Likewise alcohol is to be avoided in pregnancy. Even a very small amount of alcohol may harm the developing fetus.
- Caffeine should be limited in pregnancy. Consume one cup of coffee (or equivalent drink) or less in early pregnancy.
- Vaginal bleeding is not an uncommon occurrence in early pregnancy. Pinkish or dark brown spotting or bleeding does not usually indicate a problem with the pregnancy. Although not typically serious, we would like you to document this and you should contact one of our nurses at your convenience to report. Bright red bleeding is concerning and is termed a "threatened miscarriage". Although 50% of pregnancies will continue through delivery without complication, we must do all we can to prevent loss of a normal pregnancy. We typically will recommend restriction of activities (bedrest with bathroom privileges including a restriction of sexual activity) throughout the duration of bleeding and for approximately 48 hours following the termination of bleeding. You should note that brownish spotting may follow the active "bright red" bleeding and does not require an additional length of bedrest.
On rare occasions, a pregnancy may cause severe hemorrhage. When this happens, a D&C may be required to complete the miscarriage and terminate the pregnancy. This is a medical emergency. If you feel that you may be experiencing significant bleeding or hemorrhage (continuous or prolonged heavy bleeding) you should immediately go to the closest emergency room.
- Bathing: Tub baths or showers are perfectly acceptable in the first trimester of pregnancy.
- Douching is not recommended at any time during pregnancy.
- Constipation is a very common occurrence during pregnancy. Pregnancy as well as the additional vitamins and iron that are taken in pregnancy may worsen these symptoms. It is recommended that one drink 6 to 8 glasses of water daily. Increased fluid intake may help to keep constipation from becoming a problem. However, if you do become constipated, you may take a variety of stool softeners or bulk-forming agents such as Surfak, Senekot, Fibercon or Metamucil. All of these may be purchased over the counter without a prescription. Milk of magnesia can be used if stool softeners are ineffective.
- Hemorrhoids may become a problem with pregnancy. Avoiding constipation will certainly help in preventing hemorrhoids. However, if they do become a problem, soaking in a tub and using topical agents such as Preparation H or Anusol may be helpful.
- Exercise during pregnancy is not well studied. Many women can continue a high level of activity / exercise throughout the entire pregnancy without complication. On the other hand, in some patients with decreased reproductive potential it may be appropriate to limit the amount of exercise. Theoretically, this might limit the diversion of blood flow from the uterus to muscle. An excessive rise in body temperature may also be detrimental. We feel that most women can go about normal day-to-day activities at home or at work. This includes lifting, bending or stretching. You may wish to avoid athletic activities that result in a sustained increase in heart rate or heavy perspiration. Moderate activity such as walking is encouraged unless bright red vaginal bleeding is experienced.
- Regular daily exercise is important in pregnancy. Generally, you may continue any exercise program you were in prior to pregnancy as long as your heart rate is 140 or less. Walking is one of the best forms of exercise.
- Sexual relations are safe during pregnancy unless you are having complications such as bleeding.
- Routine dental care is generally safe during pregnancy. If your dentist has questions regarding the safety of a specific procedure or antibiotics, please have them contact your OB/Gyn.
- Nausea with or without vomiting is a common complaint in early pregnancy. Small frequent meals may be helpful. Crackers, dry cereal or dry toast eaten between meals and at bedtime may be helpful. It is very important to maintain your fluid intake. If you find that you can not tolerate your pre-natal vitamins, you may stop them until the nausea improves. If you do that it is very important to take 1 mg of folic acid daily. This may be bought over the counter and do not require a prescription. If your nausea and vomiting is not improved by these simple measures, please contact us or your OB/Gyn's office.
- Headaches are also common in pregnancy. Tylenol or Extra-Strength Tylenol may be taken for relief. Generally aspirin and NSAIDs (ibuprofen, etc) is not recommended. If your headache persists, please contact your OB/Gyn's office.
- Indigestion is common. It is safe to take Maalox, Mylanta or Tums. Other GI complaints such as gas or diarrhea may be safely treated during pregnancy. Mylicon 80 may be used for gas and Immodium for diarrhea.
- Cold symptoms in pregnancy should be treated with increased hydration, rest and Tylenol. Chloraseptic Spray or lozenges such as Cepacol throat lozenges may be taken for a sore throat. Robitussin may be taken for a cough.
- Pelvic ultrasound may be safely done during the first trimester of pregnancy. Generally your first pregnancy sonogram is scheduled for 2 ½ weeks after your first pregnancy test if you went through a treatment cycle or 2 ½ weeks after your missed period if you conceived spontaneously. These are performed Monday through Friday. Please review your doctor's clinic schedule with the receptionist when scheduling. This is a special time and we all enjoy the opportunity to share our patient's joy and excitement.
- Certain prescription medications may be less safe than others during pregnancy. If you have not already done so, please notify your prescribing physician that you are pregnant and verify that you are on the safest medication for your health problem(s).