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o First Trimester

The latest information about the 2019 Novel Coronavirus, including vaccine clinics for children ages 6 months
and older.

The First Trimester

The first prenatal visit
The first prenatal visit is the most thorough. A complete medical history is taken, a
physical exam is done, and certain tests and procedures are performed to assess the
initial health of the mother and her unborn baby. The first prenatal visit may include
the following:
 Personal medical history. This may include taking record of any of the
following:
 o Previous and current medical conditions, like diabetes, high blood
pressure (hypertension), anemia, and/or allergies
o Current medicines. Prescription and over-the-counter.
o Previous surgeries
 Maternal and paternal family medical history, including illnesses, such as
diabetes or intellectual or developmental disabilities, and genetic disorders, like
sickle cell disease or Tay-Sachs disease
 Personal gynecological and obstetrical history, including past pregnancies—
stillbirths, miscarriage, deliveries, terminations—and menstrual history (length
and duration of menstrual periods)
 Education, including a discussion regarding the importance of proper nutrition,
regular exercise, the avoidance of alcohol, drugs, and tobacco during
pregnancy, and a discussion of any concerns about domestic violence
 Pelvic exam. This exam may be done for 1 or all of the following reasons:
o To note the size and position of the uterus
o To determine the age of the fetus
o To check the pelvic bone size and structure
o To perform a Pap test (also called Pap smear) to find the presence of
abnormal cells
 Lab tests, including the following:
o Urine tests. These are done to screen for bacteria, sugar, and protein.
o Blood tests. These are done to determine blood type.

All pregnant women are tested for the Rh factor during the early weeks
of pregnancy. A mother and fetus may have incompatible blood types.
The most common is Rh incompatibility. Rh incompatibility happens
when the mother's blood is Rh-negative and the father's blood is Rh-
positive and the fetus' blood is Rh-positive. The mother may make
antibodies against the Rh-positive fetus, which may lead to anemia in the
fetus. Incompatibility problems are watched and appropriate medical
treatment is available to prevent the formation of Rh antibodies during
pregnancy.
 Blood screening tests. These are done to find diseases, like rubella, an
infectious disease that is also called German measles.
 Genetic tests. These are done to find inherited diseases, like sickle-cell anemia,
Tay-Sachs disease.
  Screening tests. These are done to find infectious diseases, like sexually
transmitted diseases.
The first prenatal visit is also an opportunity to ask any questions or discuss any
concerns that you may have about your pregnancy.
What to expect during the first trimester
A healthy first trimester is crucial to the normal development of the fetus. The
mother-to-be may not be showing much on the outside, but inside her body all the
major body organs and systems of the fetus are forming.
As the embryo implants itself into the uterine wall, several developments take place,
including:
 Amniotic sac. A sac filled with amniotic fluid, called the amniotic sac,
surrounds the fetus throughout the pregnancy. The amniotic fluid is liquid made
by the fetus and the amnion (the membrane that covers the fetal side of the
placenta) that protects the fetus from injury. It also helps to regulate the
temperature of the fetus.
 Placenta. The placenta is an organ shaped like a flat cake that only grows
during pregnancy. It attaches to the uterine wall with tiny projections called
villi. Fetal blood vessels grow from the umbilical cord into these villi,
exchanging nourishment and waste products with the mother's blood. The fetal
blood vessels are separated from the mother's blood supply by a thin
membrane.
 Umbilical cord. The umbilical cord is a rope-like cord connecting the fetus to
the placenta. The umbilical cord contains two arteries and a vein, which carry
oxygen and nutrients to the fetus and waste products away from the fetus.
It is during this first trimester that the fetus is most susceptible to damage from
substances, like alcohol, drugs, certain medicines, and illnesses, like rubella (German
measles).
During the first trimester, both the mother's body and the fetus are changing rapidly.

Click to Enlarge
Fetal development during the first trimester
The most dramatic changes and development happen during the first trimester. During
the first 8 weeks, a fetus is called an embryo. The embryo develops rapidly and by the
end of the first trimester it becomes a fetus that is fully formed, weighing
approximately 1/2 to 1 ounce and measuring, on average, 3 to 4 inches in length.
First trimester growth and development benchmarks
Just as each child grows and matures at different rates and at different times, so does
that same child as it begins its life in the womb. The chart below provides benchmarks
for most normal pregnancies. However, each fetus develops differently.

 All major systems and organs begin to form

 The embryo looks like a tadpole
 The neural tube (which becomes the brain and spinal cord), the
By the end digestive system, and the heart and circulatory system begin to
of 4 weeks form
 The beginnings of the eyes and ears are developing
 Tiny limb buds appear (which will develop into arms and legs)
 The heart is beating

 All major body systems continue to develop and function,

including the circulatory, nervous, digestive, and urinary systems
 The embryo is taking on a human shape, although the head is
larger in proportion to the rest of the body
 The mouth is developing tooth buds (which will become baby
teeth)
 The eyes, nose, mouth, and ears are becoming more distinct
By the end
 The arms and legs can be easily seen
of 8 weeks
 The fingers and toes are still webbed, but can be clearly
distinguished
 The main organs continue to develop and you can hear the baby's
heartbeat using an instrument called a Doppler
 The bones begin to develop and the nose and jaws are rapidly
developing
 The embryo is in constant motion but cannot be felt by the mother

From After 8 weeks, the embryo is now referred to as a fetus (which means
 offspring).
embryo to
fetus Although the fetus is only 1 to 1 1/2 inches long at this point, all major
organs and systems have been formed.

 The external genital organs are developed

 Fingernails and toenails appear
 Eyelids are formed
 Fetal movement increases
 The arms and legs are fully formed
During  The voice box (larynx) begins to form in the trachea
weeks 9 to
The fetus is most vulnerable during the first 12 weeks. During this period
12
of time, all of the major organs and body systems are forming and can be
damaged if the fetus is exposed to drugs, German measles, radiation,
tobacco, and chemical and toxic substances.
Even though the organs and body systems are fully formed by the end of
12 weeks, the fetus cannot survive independently.

Changes in the mother's body

During pregnancy, many changes are also happening in the body of the mother-to-be.
Women experience these changes differently. Some symptoms of pregnancy continue
for several weeks or months. Others are only experienced for a short period of time.
Some women experience many symptoms. Other women experience only a few or
none at all. The following is a list of changes and symptoms that may happen during
the first trimester:
 The mammary glands enlarge causing the breasts to swell and become tender in
preparation for breastfeeding. This is due to an increased amount of the
hormones estrogen and progesterone. A supportive bra should be worn.
 A woman's areolas (the pigmented areas around each breast's nipple) will
enlarge and darken. They may become covered with small, white bumps called
Montgomery tubercles (enlarged sweat glands).
 Veins become more noticeable on the surface of the breasts.
 The uterus is growing and begins to press on the woman's bladder. This causes
her to need to urinate more often.
 Partly due to surges in hormones, a pregnant woman may experience mood
swings similar to premenstrual syndrome. This is a condition experienced by
 some women that is characterized by mood swings, irritability, and other
physical symptoms that happen shortly before each menstrual period.
 Increased levels of hormones to sustain the pregnancy may cause "morning
sickness." This is feelings of nausea and sometimes vomiting. However,
morning sickness does not necessarily happen just in the morning and rarely
interferes with proper nutrition for the mother and her fetus.
 Constipation may happen as the growing uterus presses on the rectum and
intestines.
 The muscular contractions in the intestines, which help to move food through
the digestive tract, are slowed due to high levels of progesterone. This may, in
turn, cause heartburn, indigestion, constipation, and gas.
 Clothes may feel tighter around the breasts and waist, as the size of the stomach
begins to increase to accommodate the growing fetus.
 A woman may experience extreme tiredness due to the physical and emotional
demands of pregnancy.
 Cardiac volume increases by about 40% to 50% from the beginning to the end
of the pregnancy. This causes an increased cardiac output. An increased cardiac
output may cause an increased pulse rate during pregnancy. The increase in
blood volume is needed for extra blood flow to the uterus.
Related Topics
 Calculating a Due Date
 First Trimester
 First Trimester Screening
 First Trimester Fatigue
 Common Changes During Pregnancy
 Common Tests During Pregnancy
 Folic Acid for a Healthy Baby
 Medical Genetics: Teratogens
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