Pregnancy health centre

Pregnancy: Seven first trimester warning signs never to ignore

Finding out that you are expecting is emotional and exciting, but it can also be nerve-racking. You may be worried about many things, from what type of mother you will be to the economics of raising a family, not to mention all the changes going on in your body.

What’s normal? What’s not? When should you seek medical advice and when should you take a deep breath?

To help put your mind at ease, we spoke with experts about serious symptoms that may occur during the first trimester, what they may mean and what you should do about them. Of course, if you’re concerned about anything during your pregnancy - even if it's not one of these symptoms - seek medical advice.

Serious symptom no. 1: Vaginal bleeding (with or without cramping and pain)

What it may mean: “Some spotting is normal, but heavy bleeding could be a sign of miscarriage or ectopic pregnancy,” says Dr Natali Aziz, a maternal-foetal medicine specialist at a US children's hospital in California. “The brighter red the bleeding, the more significant it is,” she says. “The darker the blood colour, the more likely it is an older bleed leaving the body,” she says.

“If you have bleeding and bad cramping similar to period cramps, this can be a sign of threatened miscarriage,” says Dr Manju Monga, director of maternal-foetal medicine at a the University of Texas in the US. “If this is coupled with sharp lower abdominal pain, it may be a sign of ectopic pregnancy,” a serious complication that occurs when the fertilised egg implants outside the uterus, usually in the fallopian tubes.

What to do: Seek medical advice, Monga says. You may be referred for an ultrasound scan or advised to see a gynaecologist.

Bottom line: “Most spotting or light bleeding is not a serious problem or condition, but you don’t want to ignore it if it is associated with cramping, heavy bleeding or abdominal pain,” she says. “You are always better safe than sorry.”

Serious symptom no. 2: Excessive nausea and vomiting

Some nausea and vomiting during your first trimester is normal, but if it crosses the line and becomes excessive, it can have serious consequences.

What it may mean: “Vomiting that interferes with your day-to-day activities can lead to weight loss, dizziness, dehydration and an imbalance of electrolytes,” Aziz says.

What to do: Tell your GP. “You may need hospitalisation to treat the dehydration, and many medications are available to control nausea.”

Bottom line: “Nausea and vomiting are normal occurrences during pregnancy, but the extremes can cause problems,” says Dr Stanley Berry, an obstetrics and gynaecology specialist at a hospital in Michigan in the US. “The majority of women who have nausea and vomiting in their first trimester will go on to have normal, healthy pregnancies.”