When and how do the first signs of pregnancy appear?

Gynecologists consider the first day of the last menstruation to be the beginning of gestation. 1 week of pregnancy after conception is a conditional and approximate concept, because the exact date of fusion of sperm and egg is difficult to find out, so it is more convenient for doctors to use the obstetric system for calculating the period.

According to it, in fact, in the first week there is no pregnancy yet, because there is no fertilized egg. But this time is very important, because from the first day of the cycle the woman’s body prepares for possible conception.

Changes in a woman's body

In the first week after conception, pregnancy practically does not manifest itself at all, but changes are already beginning to occur in the body. Over the next 9 months (40 weeks), they will become more and more noticeable: the body will begin to rebuild itself to ensure the embryo’s full and safe development. During pregnancy, the so-called functional systems “mother-fetus” and “mother-placenta-fetus” are formed [1], the ultimate goal of which is the birth of a healthy child. This mechanism is unique and has no analogues: it is not the embryo that adapts to the characteristics of the mother’s body, but the body that creates within itself an optimal environment for the development of the fetus. Even before conception, the processes occurring in a woman’s body during the menstrual cycle are aimed at preparing suitable conditions for fertilization of the egg. During a certain phase of the cycle, called ovulation, it is easiest to get pregnant: the cell is mature, all conditions are met.

Menstruation.

A woman's menstrual cycle is divided into several periods:

• menstruation, during which the endometrium lining the walls of the uterus separates and comes out along with the unfertilized egg. This happens if pregnancy did not occur during the previous cycle. With menstruation, the follicular phase of the ovaries begins. A dominant follicle is determined and developed, which will later give birth to a mature egg;
• The ovulatory phase begins approximately on the seventh day of the cycle and lasts about three days. During this time, the follicle reaches maturity and at the end of the phase ruptures, releasing an egg ready for fertilization;
• Ovulation is the process during which an egg is released from the follicle and descends from the ovary into the fallopian tube. This takes about an hour, the cell retains the ability to be fertilized for about another day;
• The luteal phase, which makes up the second half of the cycle, proceeds differently depending on whether fertilization has occurred or not. Either implantation of a fertilized egg occurs, or gradual death of the endometrium.

Conception.

Ovulation lasts a short time, and the egg’s ability to fertilize only lasts about a day or two. It is impossible to track this process on your own: some women talk about characteristic symptoms and even pain, but this is a very individual and unreliable indicator. Sometimes characteristic discharge (cervical mucus) and an increase in basal temperature can serve as a marker, but all these signs have an error and are not able to give accurate results. However, pregnancy can also occur if sexual intercourse occurs several days before ovulation: healthy sperm, entering the uterine cavity, remain viable for 3-4 days.

What's going on inside

Since the previous menstrual cycle did not end with pregnancy, the level of estrogen and progesterone decreases, and in the first week menstrual bleeding begins, during which the body, as unnecessary, gets rid of the inner layer of the uterus - the endometrium. It is to it that the fertilized egg is attached, and then the placenta is subsequently formed from it.

The most important hormone in the first obstetric week of pregnancy is follicle-stimulating hormone, or FSH, which, as its name suggests, stimulates the production of follicles in the ovaries. These are the “sacs” in which the eggs mature. At first there are several of them, but as the amount of FSH decreases, only one dominant follicle remains.

Fertilization will become possible a couple of weeks after the start of the cycle, during the period of ovulation, when the egg matures and is released from the follicle.

It is important!

• The sperm is able to reach the egg pushed into the fallopian tube in about 2 hours, after which fusion occurs.
• One sperm, the first to penetrate the membrane, merges with the egg, after which it becomes impenetrable to others. A zygote is formed - a cell from which the embryo will begin to develop.

Implantation of fertilized egg.

Over the next few days, under the influence of muscle contractions and cilia of the mucous membrane, the fertilized egg moves towards the exit of the fallopian tube, that is, to the uterus. Around the same period, the process of fragmentation begins: the cells of the zygote begin to divide, but its overall size does not increase, each subsequent cell becomes smaller than the previous one. Having descended into the uterus, the zygote reaches the blastocyst stage in a few days, after which it gets rid of the membrane and is implanted inside the endometrium - the lining of the uterine walls. Under the influence of the hormone progesterone, aimed at maintaining pregnancy, the endometrium becomes thicker and surrounds the fertilized egg on all sides. Implantation allows you to protect the embryo and additionally nourish it with the secretion produced by the endometrial glands. Several days usually pass from conception to implantation, and the countdown of the first embryonic week does not begin with it, but with the formation of the zygote.

Safe anesthesia options for pregnant women

Dental treatment under anesthesia during pregnancy is clearly prohibited - only local painkillers can be used. However, local anesthesia for dental treatment during pregnancy is very important: severe pain during treatment can cause a surge of adrenaline, which can dangerously affect the unborn baby and even cause premature birth.

Novocaine and lidocaine should be excluded from local anesthetics - they can cause muscle weakness, cramps, pressure changes, dizziness and vomiting. Ubistezin, ultracaine, artifrin, alfacaine are considered safer painkillers for dental treatment during pregnancy, because they do not have a vasoconstrictor effect and almost do not penetrate the placenta.

Preparing for conception

To make your pregnancy successful, it is better to prepare for it. Couples planning a child adjust their lifestyle in such a way that the processes in the body that promote conception proceed without interruption, and the likelihood of pregnancy increases.

Visit to the gynecologist.

A woman who is planning to conceive a child should be regularly monitored by a doctor. The specialist will conduct an examination, tell you if there are any problems in the body that should be eliminated before conception, and give recommendations for adjusting your lifestyle. If problems are observed, the doctor will identify their cause and prescribe treatment. However, the gynecologist is not the only specialist who needs to be visited during this period. It is advisable to check your health in several areas: pregnancy is a serious burden on the body. It is advisable to eliminate in advance factors that may interfere or harm during pregnancy. A man should also be examined: the quality of sperm is no less important for successful conception than the condition of a woman’s body.

Implantation and prosthetics during pregnancy

Prosthetics in themselves are not prohibited during pregnancy. You can install removable and fixed dentures, and even crowns. But implantation will have to wait until the baby is born. Dental implantation during pregnancy requires a huge expenditure of vitality and body resources, and most importantly, the use of anti-inflammatory drugs, strong painkillers, and sometimes antibiotics.

Inserting an implant into bone tissue requires surgical cutting of the gum and drilling into the bone. And then the body must form new bone tissue around the implant. And all this during the period when the skeleton of the unborn child is intensively formed, when every milligram of calcium counts - so much so that the mother’s body is ready to weaken its own bone tissue and the structure of the enamel and dentin of the teeth so that the baby’s body does not experience a lack of calcium.

Therefore, during such a period, it is extremely unwise to further weaken the mother’s body and endanger the unborn child through the most complex surgical implantation operation. It is better to wait a few months and have implantation done after birth, without endangering the baby.

It is important!

• You should see a gynecologist regularly in order, firstly, to detect pregnancy in time, and secondly, to track and eliminate the slightest irregularities.
• You can ask your gynecologist what other doctors you should visit. Endocrine disorders, metabolic problems, excess or underweight can affect conception.

Taking vitamins.

If your body doesn't have enough nutrients, your chances of getting pregnant may decrease. In the case of severe vitamin deficiency or lack of weight, menstruation, and with it ovulation, simply does not occur, that is, fertilization is impossible.

What risks are associated with post-term pregnancy?

Having your baby a little earlier or later than your expected due date is normal. Your estimated due date is just an estimate of when you will be 40 weeks pregnant. After your expected due date, you still have a week before your pregnancy is considered post-term. Therefore, the doctor may ask you to be patient if the due date has approached, but the baby is not yet showing signs that it is ready to be born. When deciding the best course of action for your specific situation, your doctor will consider several possible risks. Here are the risks commonly associated with post-term pregnancy and delayed birth:

• higher baby weight;
• anomaly of labor;
• the need for operative vaginal delivery using obstetric forceps or vacuum extraction;
• the need for a caesarean section;
• the need for intensive care for the newborn;
• perineal ruptures;
• postpartum bleeding.

To make sure the baby is okay, the doctor may do some tests, such as a fetal non-stress test to measure the baby's heart rate or an ultrasound to check the amniotic fluid as well as the fetal breathing. The doctor will also check the position and size of the baby and monitor his movements. And if everything is in order, the doctor may recommend delaying induction of labor for another couple of days or weeks.

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It is important!

• There are ready-made vitamin and mineral complexes designed to increase the likelihood of conception. If no serious abnormalities requiring observation by a doctor are identified, you can use them.
• This point also applies to men: the state of the body directly affects the motility and viability of sperm, as a result of which they may lose the opportunity to reach the egg.
• If your doctor does not recommend vitamins in a particular case, it is better to listen to his words. It is also worth choosing supplements after consultation with a specialist.

Nutrition.

Problems leading to failure to conceive are often caused by insufficient or unhealthy nutrition. For pregnancy to occur, an optimal weight is necessary: ​​a lack of it leads to inhibition of reproductive processes, an excess is harmful due to possible endocrine disorders.

Ovulation and conception

The day of the beginning of each menstruation is the start for preparing the body for the upcoming pregnancy. At this time, the old layer of the endometrium comes off and is replaced by a new one. It has a loose structure and is excellent for implanting an embryo.

Hormonal changes contribute to the maturation of the egg. This complex process begins in the early years, even at the moment of puberty of the girl. It is at this time that follicles begin to develop.

Each menstrual cycle, several follicles mature in the ovary. However, one of them is growing faster than the others. It is from this that an egg will be released during ovulation, ready for fertilization.

After ovulation occurs, a mature egg passes from the abdominal cavity into the fallopian tube. It is there that the female reproductive cell most often meets the sperm and conception occurs.

Ovulation occurs 12-16 days from the start of the menstrual cycle. But this process can happen a little earlier or a little later: on the 8th or even 19th day. That is why it is difficult to establish the exact date of birth of the future fetus. However, if partners are planning a pregnancy, the preparation process must be approached responsibly.

It is important!

• Protein is needed for normal sperm viability and motility, so it is important for a man to monitor the amount in his diet. The female body must also receive enough proteins: this is a building material for the body.
• It is important to control the amount of fat. Both a lack and excess of fats in the diet can affect hormonal levels. It is worth observing the golden mean.
• It is better for both men and women to avoid foods containing large amounts of chemical additives, as well as alcohol.

Physical exercise.

Physical inactivity harms all systems of the body, including reproductive. Moderate physical activity is indicated to improve metabolism, which in turn increases the likelihood of conception. Of course, excessive fanaticism, as in the case of nutrition, is inappropriate: excessive overload will only harm the body and reduce the likelihood of getting pregnant. It is necessary to maintain a level of physical activity that does not cause serious stress to the body. This will allow:

• keep the body in good shape;
• normalize metabolism;
• strengthen muscles, which is especially important for successful pregnancy;
• improve sleep;
• increase libido.

The effect of physical activity on emotional well-being is also important. Stress reduces your chance of getting pregnant, and moderate activity is a good way to relieve it. It is recommended for both parents to reconsider their lifestyle: both the female and male reproductive systems will benefit from healthy exercise. If the couple has already practiced sports or fitness, they can continue, but avoiding overload.

Oral sex

The answer to the question of whether it is possible to have oral sex during pregnancy depends on what type of oral sex is meant. If we are talking about blowjob, then there are no restrictions, except for those cases when it is unpleasant for a woman and does not bring pleasure.

As for cunnilingus, firstly, when expecting a baby, the vagina increases in volume and changes taste and smell, as a result of which men themselves do not strive to engage in this type of love games. Secondly, due to air blowing into the vagina, blood vessels can become clogged, which is harmful for both mother and child. Cunnilingus is especially contraindicated if there is a risk of miscarriage.

First signs of pregnancy

In the first week of pregnancy, as a rule, there are no sensations at all: there is no stomach yet, nothing hurts, movements begin when the fetus has already reached a respectable size. Women planning to conceive tend to be anxious about their well-being, so they may attribute the slightest changes to pregnancy. In fact, the main signs appear around the fourth or fifth obstetric week. These include:

• nausea in the morning;
• chest pain;
• delays and absence of menstruation;
• changes in figure (hormonal changes affect weight gain);
• changes in the genitals (swelling, color change, etc.).

The first month is considered the so-called critical period [2], during which the slightest influence can lead to a miscarriage, and the woman will not even know that she was pregnant. Therefore, the best thing that can be done in the early stages is not to be nervous and wait for signs to appear that will confirm or refute the assumptions that have appeared.

How does a woman feel?

No specific signs of pregnancy are observed at 1 obstetric week. All the woman’s sensations now are typical symptoms of regular menstruation:

• bloody issues;
• pulling in the lower abdomen;
• headache and lower back pain;
• The mammary glands enlarge and become engorged.

When menstruation ends, all these unpleasant symptoms will disappear. And we can talk about early signs of pregnancy itself in 2-3 weeks, after ovulation and conception, when hormonal changes in the body begin.

Methods for determining pregnancy

Methods to detect pregnancy at an early stage include tests, tests and ultrasound. The choice of method depends on the period: some are indicative only at certain stages.

Ultrasound.

Usually carried out after a visit to the gynecologist, if pregnancy is confirmed. It gives accurate results, is informative and is used as one of the main diagnostic methods. The study is routinely carried out several times to track the development of the fetus: for example, at 6 weeks during an ultrasound, you can hear the baby’s heartbeat [3]. For the first time, a gynecologist will refer you for this procedure only if other factors suggest pregnancy. An ultrasound examination can detect the fertilized egg and assess its size and condition. It is not recommended to use ultrasound as an independent method; the procedure is carried out in combination with other methods to obtain a complete picture of what is happening. Before carrying out it is necessary to contact a gynecologist.

Pregnancy test.

Many manufacturers offer affordable and easy-to-use tests that supposedly allow you to track pregnancy in the first days after conception. In fact, this is almost impossible before implantation of the fertilized egg: such tools become informative at least a week after conception. It is then that hCG, a pregnancy marker hormone, appears in the blood and urine. Before using the test you must:

• make sure the expiration date is current;
• follow the recommendations specified in the instructions.

HOW TO SUNBATH DURING PREGNANCY

All is well, and the pregnant tourist is at the beach resort. Summer and the beach mean sunshine, and doctors have their own advice here too. The sun certainly brings positivity to the pregnant woman (more endorphins are released) and replenishes the vitamin D deficiency that is typical for residents of northern countries.

Firstly, pregnant women should avoid being in the sun and even swimming in the sea (due to the reflection of sunlight from the water surface) from 12.00 to 16.00.

Secondly, the rest of the time you need to pay close attention to protection from sunlight. “During pregnancy, women often experience hyperpigmentation. Taking into account exposure to the sun during vacation, there is a very high probability that age spots and freckles that appeared on exposed parts of the body during pregnancy will not disappear. Therefore, a pregnant woman needs to take sun protection with her on vacation, with a protection factor of at least 50 - preferably more. It is advisable that such a product contain vitamin E. And immediately after being in the sun, you need to apply a special after-sun product; it will additionally moisturize the skin,” says Natalya Badikova.

A pregnant woman should take with her on vacation sun protection with a protection factor of at least 50 - preferably more. It is desirable that the composition contains vitamin E

In particular, doctors consider such lines of protective equipment as Sanosan, Lierak, Uriage to be well-proven products, and budget ones, for example, Garnier. But everything is individual, and in choosing the brand and, most importantly, the composition of the product, it is better to follow the advice of the attending gynecologist.

Gynecologists strongly recommend that tourists take a closed swimsuit to the beach to prevent direct sunlight from hitting the abdominal area. “It would also be very good to take a cap with a large visor or a hat with a brim to prevent sun exposure on the face, since the risk of age spots appearing in pregnant women is very high,” advises Dr. Natalya Badikova.

It is important!

The method should be applied in the morning: this increases its reliability.
If there are gynecological diseases or errors in the procedure, it can give false results, and this must be remembered. If you have any doubts, it is recommended to consult a doctor. Blood for hCG.

Among all the analyses, this one is considered reliable and at the same time accessible. The hormone hCG (human chorionic gonadotropin) begins to be produced by the female body immediately after conception, but its level becomes noticeable about a week after implantation of the fertilized egg. Its concentration in the blood is higher than in the urine, which increases the information content of the analysis. As a rule, a gynecologist sends a patient for testing if there is a possibility that she is pregnant. The analysis can be carried out independently with the help of specialized medical centers, but it is recommended to do this under the supervision of a doctor - he will be able to analyze the results and give the patient a detailed answer about her condition. Diagnosis should be made no earlier than a week after the expected conception.

Pregnancy management program in the 1st trimester

The examination plan during the 1st trimester of pregnancy was developed strictly in accordance with the regulatory documents of the Ministry of Health of the Russian Federation and does not contain “unnecessary” examinations.

The pregnancy management program includes:

• An initial consultation with an obstetrician-gynecologist, as well as a repeat consultation based on the results of the examinations completed,
  is your chief physician and mentor. At the first consultation, the doctor examines the expectant mother’s medical history, gives a referral for examination, and helps in resolving the most significant issues based on the data obtained about the woman’s health condition. A repeat appointment is scheduled after a prenatal ultrasound and biochemical screening. The obstetrician-gynecologist registers the patient for pregnancy, fills out all the documentation, and gives recommendations.
• Appointment with a general practitioner
  - this doctor will help assess your general health, predict the risks of developing the most likely diseases during pregnancy and take timely measures. This is very important because during pregnancy a woman is strictly limited in taking medications and drugs.
• ECG (electrocardiogram)
  - allows you to assess the condition of the heart and identify pathologies: rhythm disturbances, blood circulation.
• Appointment with an ENT doctor
  - no woman is insured against diseases of the ear, nose and throat (colds, acute respiratory viral infections, sore throats), so it is important to carry out sanitation in a timely manner to avoid drug treatment during pregnancy.
• Consultation with an ophthalmologist
  - the doctor checks vision and evaluates the condition of the retina, and also determines whether the woman can give birth on her own or by cesarean section. Not only childbirth can affect vision, but toxicosis and other complications of pregnancy.
• Ultrasound of the kidneys and bladder
  - allows you to assess the condition of internal organs, identify hidden diseases (inflammatory, urolithiasis) and neoplasms.
• Pelvic ultrasound
  helps to study the anatomy of the pelvic organs, identify gynecological diseases and possible risks of complications.
• Fetal ultrasound (performed by a perinatologist at 11-14 weeks of pregnancy)
  allows you to see for the first time during pregnancy how the baby is growing and whether everything is fine.
• Biochemical blood test
  - study of more than 15 important indicators (sugar, protein, iron, etc.).
• A general blood test
  is the most important test, as a result of which the doctor obtains indicators of platelets, hemoglobin, red blood cells, etc., and then can accurately assess the general condition of the expectant mother’s body.
• A general urine test
  allows you to evaluate how the kidneys and urinary system work, as well as identify pathologies such as gestosis and eclampsia.
• Blood group
  - the analysis allows you to answer the question of whether there is a Rh conflict in the blood type of mother and baby.
• A blood test for hormones
  is a very important test that provides an understanding of the specifics of metabolism and allows one to predict how the fetus will develop.
• Testing for HIV, syphilis, hepatitis B, C
  is mandatory for the expectant mother.
• PRC diagnostics
  is a laboratory analysis aimed at identifying many hidden infectious pathogens (from pneumonia to herpes).
• Laboratory examination of a gynecological smear
  - analysis of the microflora of the vagina, cervical canal, urethra allows us to identify hidden inflammatory processes and their causative agents (gonococcus, trichomonas)
• Biochemical screening (PAPP-A, hCG, risk calculation)
  is a very important examination that allows you to assess the risk of chromosomal pathology, obtain the most important indicators of fetal development, and also answer the question of whether it is advisable to prescribe invasive diagnostic methods.
• Extended coagulogram with determination of lupus type At+
  - allows you to assess the risk of thrombosis and bleeding, which can lead to miscarriage.

Find out more about pregnancy management at the Pirogov Clinic (St. Petersburg)

Let's sum it up

Pregnancy is a complex and multi-level process, during which a whole new organism is formed from one cell. The early stages, despite the absence of symptoms, are especially important: even before conception, you should pay attention to your lifestyle, adjust your diet and see a doctor. Even if there are no signs in the first week, the processes occur rapidly, so the optimal solution for a woman expecting pregnancy is not to be nervous, monitor her condition and wait. Calmness and well-being of the mother are the most important conditions for the healthy and full development of the embryo, so take care of yourself, avoid stress and follow the doctor’s recommendations. After some time, tests and studies will help you understand whether pregnancy has actually occurred.

WHAT A PREGNANT WOMAN NEEDS TO DO BEFORE VACATION AND WHAT DOCUMENTS TO TAKE

Before the trip (3-7 days), you must visit a general practitioner and your attending gynecologist, get a consultation and, if necessary, undergo prescribed tests and procedures.

You need to ask the doctor to issue a certificate for the airline about the stage of pregnancy and the absence of medical contraindications (without it, if there are external signs of pregnancy, some air carriers may not allow you to board the plane).

“In addition to insurance, travel documents and passports, you should also take an exchange card - especially if you are traveling to Russia. For the convenience and peace of mind of the vacationer, you can also take from the attending physician an extract with your medical history, prescriptions, results of the last ultrasound, screening, etc., and translate them, if not into the language of the host country, then at least into English,” the doctor advises. gynecologist Natalya Badikova.

It would also be good if the attending physician could be in touch with the tourist during her vacation. Modern telemedicine services allow this. For example, before traveling, you can check with your doctor whether he provides consultations remotely in a special application, or purchase a subscription to several telemedicine consultations from a trusted telemedicine operator. By the way, gynecologists also provide consultations remotely.

Examinations and tests in the first week of gestation

The first week of pregnancy is considered the planning stage. During this period, the woman is recommended to undergo the following examinations:

• Clinical urine analysis;
• Detailed blood examination;
• Blood for hepatitis and antibodies to toxoplasmosis, CMV, herpes;
• Analysis of vaginal discharge for infections.

An ultrasound examination may also be performed. It will not show the presence of an embryo, but it will be able to detect the presence of tumors, cysts, thinning of the endometrium and other pathological disorders. The listed pathologies can cause infertility, miscarriage, impaired egg implantation, etc.

After completion of menstruation, it is recommended to consult a therapist, gynecologist and dentist.

Tips and tricks for women in the 1st week of gestation

To ensure the full and proper development of the baby, starting from the first week of gestation, it is important to adhere to a healthy lifestyle and doctor’s recommendations, and to eat a healthy and balanced diet. The egg that is formed in the body is part of the child’s body, so any harmful influence can affect the development of the embryo.

Proper nutrition and bad habits

At this stage, the main thing is to learn to eat rationally and wisely. You should refrain from eating overly spicy, fatty and sweet foods, and eliminate sources of empty calories (buns, chips). It is necessary to reduce the consumption of tea and coffee to 1-2 cups per day.

The basis of the diet should be fruits, vegetables, lean meat and fish, greens, and whole grains. Women with lactose intolerance are advised to increase their consumption of dairy products. You should calculate how much energy the body needs per day and try to stick to this indicator. You need to eat 3-4 times a day, in small portions. Thin girls can gain weight, while plump ones can lose a little weight. This is a normal phenomenon, thus the body acquires its optimal shape before fertilization.

Nicotine and alcohol are contraindicated. It is better to quit smoking several months before conception.

Physical activity

Since the first week of gestation coincides with the period of menstruation, it is better to limit physical exercise. If a woman feels well, she can exercise. You can't lift heavy things and overwork yourself. Yoga, stretching or walking are allowed.

Taking vitamins

Experts have different views regarding the use of synthetic vitamin complexes during pregnancy. Many people believe that healthy women who eat a balanced diet do not need to take nutrients. As practice shows, it is almost impossible to obtain the required amount of folic acid from the diet, which is especially important in the first weeks of gestation. Therefore, women are recommended to take this drug during the period of planning conception and during the first trimester of pregnancy.

Taking special vitamin complexes for pregnant women is indicated for those women who live in unfavorable conditions and cannot eat properly. In other situations, drugs can provoke hypervitaminosis.

Sex at 1 week of pregnancy

It should be borne in mind that during this period the cervix is ​​slightly open, so the risk of infection is quite high. This can be avoided by using a condom or other barrier contraception.