Symptoms of Pregnancy

Signs And Symptoms

Duration of Pregnancy - It is calculated by clinicians as 10 lunar months or 9 calendar months and 7 days or 280 days or 40 weeks calculated from first day of the last menstrual period. This is called menstrual or gestational age.

As fertilization occurs 14 days prior to the expected missed period and in previously normal cycle of 28 days duration, it is about 14 days after the first day of the period. Thus the true gestation period is to be calculated by substracting 14 days from 280 days i.e. 266 days. This is called fertilization or ovulatory age.

SIGN & SYMPROMS OF PREGNANCY
Pregnancy is divided into three trimesters

First trimester (0-12 weeks)
Second trimester (13-28 weeks)
Third trimester/last trimester (29-40 weeks)

First Trimester - Presumptive/ subjective symptoms of early months of pregnancy are :

Objective Signs

1. Breast Changes - Breast signs are valuable only in primigravidae (in first pregnancy) changes are evident from 6-8 weeks. There is enlargement of breast and delicate veins visible under the skin.
   
   Nipple and areola became more pigmented especially in dark women. Thick yellowish secretion can be expressed from nipple as early as 12th week.
   
   
2. Pelvic changes - Uterus remains a pelvic organ till 12th week. These changes may help in the diagnosis of pregnancy.
   
   Vaginal Sign - Copious non-irritative mucoid discharge from the vagina.
   Uterine Sign - Pregnant uterus feels soft and elastic and is enlarged in size. Regular and rhythmic uterine contractions can be elicited during bimanual examination by 4th week.
   

Second Trimester
The symptoms of nausea & vomiting and frequency of micturition usually subside. The new features that appears are:

1. Quickening: It denotes the perception of active fetal movement by the women. It is felt about 16-18th week. It can be a useful guide to calculate the expected date of delivery.
   
   
2. Progressive enlargement of the lower abdomen.
   
   
3. Appearance of secondary areola in breast at about 20th week
   
   
4. Chloasma: pigmentation on the forehead and cheek may appear at about 24th week.

Signs
The symptoms of nausea & vomiting and frequency of micturition usually subside. The new features that appears are:

1. Linea nigra - A linear pigmented line appears on abdomen below umbilicus in midline and can be seen from 20th week.
   
   
2. Striae (both pink and white) are visible on the lower abdomen.
   
   
3. Uterus is further enlarged till above the umbilicus and is ovoid in shape.
   
   
4. Imegular spasmodic infrequent and painless contraction can be felt on the uterus - Braxton Hicks contractions.
   
   
5. Active foetal movement can be felt by 20th week.
   
   
6. 5. Foetal heart sounds can be hard with a stethoscope by 18-20 weeks. It is the most conclusive clinical sign of pregnancy.

Third Trimester Symptoms

1. Amenorrhoea Persists.
   
   
2. Enlargement of the abdomen is progressive which produces mechanical discomfort to the patient such as palpitation or dyspnoea following exertion.
   
   
3. Lightening - At about 38th week a sense of relief of the pressure symptoms is obtained due to descent of the head of the fetus into pelvis.
   
   
4. Frequency of micturition reappears.
   
   
5. Foetal movements are more pronounced.
   
   
   Signs
   

1. Cutaneous changes - Increase in pigmentation and striae.
   
   
2. Uterine shape becomes spherical from cylindrical beyond 36th week.
   
   
3. Braxton Hicks contractions are more evident.
   
   
4. Palpation of the foetal parts become much easier
   
   
5. Foetal heart sound is heard distinctly
   
   
6. Radiology or sonography gives conclusive evidence of pregnancy.
   

Physical Activity and Pregnancy
The more active and fit you are during pregnancy, the easier it will be for you to cope comfortably with your changing shape and weight gain. You are also more likely to get back into shape after the birth. Physical activity is also an excellent way of relaxing.

Keep up your normal daily physical activity or exercise (sport, or dancing, or just walking to the shops and back) for as long as you feel comfortable. Try to keep up regular exercise at least three times a week. If you can't manage that, any amount is better than nothing. Don't exhaust yourself and remember that you will need to slow down as your pregnancy progresses, or if your doctor advises you to. If in doubt, consult your doctor or midwife.

Exercises for a fitter pregnancy
Try to fit these exercises into your daily routine. They will strengthen muscles to take a bigger load, make joints stronger, improve circulation, ease backache and generally make you feel well.

Foot exercises
Foot exercises can be done sitting or standing. They improve blood circulation, reduce swelling in the ankles, and prevent cramp in the calf muscles.

Bend and stretch your foot vigorously up and down 30 times. Rotate your foot eight times one way and eight times the other way.

Trunk Curls
Start in a box position (kneeling on all fours) with knees under hips, hands under shoulders, fingers facing forward. Keep your stomach muscles tight and back straight.

Pull in your stomach muscles and raise your back up towards the ceiling, curling your spine and allowing your head to drop gently forward. Take care not to allow the elbows to lock. Slowly return to the box position. Never allow your back to hollow. It should always return to a straight position.

Pelvic floor exercises
Pelvic floor exercises help strengthen the muscles of the pelvic floor which come under great strain in pregnancy and childbirth. If your pelvic floor muscles are weak, you may find that you leak urine when you cough or sneeze. However, you can strengthen the muscles by doing the following exercise: close up your back passage as if trying to prevent a bowel movement; at the same time, draw in your vagina; hold for five seconds; repeat this exercise in sets of five, ten times a day.

Protect your back
Sit up straight with your bottom against the back of your chair. Tuck a small cushion behind your waist if you wish. When you pick something up, bend your knees, not your back. Try to stand tall.