Patient's question:
Doctor, hello: I have a friend who is pregnant. Recently, she has been having poor appetite, sometimes nausea, general fatigue, and feels bloated when sleeping at night. Upon waking, she feels her limbs are extremely heavy, as if they are not her own. However, her symptoms have improved significantly over the past two days. So far, she has been pregnant for 48 days. She also has a habit of squatting in the toilet, sometimes staying for more than 20 minutes at a time. I wonder if this is harmful to the fetus? Additionally, she is always afraid that she might be carrying a miscarriage. Since her symptoms have not been severe in the past two days, she wonders if the fetus is not doing well. If pregnancy results in a miscarriage, what symptoms would she experience? Or is the only way to do an ultrasound?Doctor's answer:
Hello, after women become pregnant, especially in the early stages of pregnancy, they often experience poor appetite, food preferences, mild nausea, vomiting, general weakness, and dizziness. These symptoms are generally more severe in the morning and have little impact on normal life for most. However, a small number of women may experience severe nausea and vomiting in the early stages of pregnancy, to the point where they cannot eat or drink. In more severe cases, symptoms such as hypotension, fever, jaundice, and even coma may occur.What should be done if these symptoms occur?
(1) For mild early pregnancy symptoms, treatment is not necessary, and the symptoms will naturally disappear after three months.
(2) For severe symptoms to the extent that eating and drinking are not possible, it is necessary to go to the hospital to check if the urine shows positive ketones. If necessary, intravenous fluids should be administered to supplement a certain amount of glucose, vitamins, and fluids.
(3) The most important thing is to be mentally prepared for pregnancy. Many scholars abroad have confirmed through research that early pregnancy symptoms are very closely related to the pregnant woman's emotions. People who maintain a normal mindset and stable emotions tend to experience fewer symptoms. The future mother's psychological state after pregnancy is a mix of happiness and worry. Often, because it is the first pregnancy, there are more worries. These worries may include concerns about whether her body can handle it, whether the fetus will develop properly, what to do if she gets sick and cannot take medication, changes in family finances, or changes in her status and social relationships. This series of worries causes emotional instability in the pregnant woman. Emotional instability can lead to early pregnancy symptoms, and at this time, the care of her husband is crucial. The husband should understand the pregnant woman's psychology and address her biggest concerns, which is often better than the best medicine. In addition to her husband's care, relatives and friends around her should also show concern, making the pregnant woman feel that she is living in a very warm family and social environment. The pregnant woman herself should also recognize that pregnancy is a normal physiological phenomenon and should not have a fear of it. She will be the mother of a future child, and a lively and adorable baby will be added to the family—how wonderful is that! This way, early pregnancy symptoms will be easier to alleviate or even disappear.
Early pregnancy symptoms generally have no significant impact on the pregnant woman or the fetus and will gradually subside after a period of time. However, if severe pregnancy symptoms occur and last for a long time, this can have adverse effects on the growth and development of both the pregnant woman and the fetus. Severe anorexia, nausea, and vomiting can prevent the pregnant woman from getting enough nutrients. As the fetus grows, its need for nutrients increases. If the pregnant woman also suffers from dehydration, acidosis, and ion imbalances, it can directly threaten the lives of both the pregnant woman and the fetus.
Treatment:
- Adequate rest and sleep, with comfort and support from her husband, and addressing her concerns.
- Trying to eat something to suppress nausea.
- Avoiding foods and odors that make you uncomfortable.
- Eating small, frequent meals throughout the day.
- Taking oral vitamin B6, 10mg per dose, three times a day.
If vomiting persists frequently even after these adjustments, especially when urine ketones are positive, hospital treatment may be necessary. In some cases, pregnancy may need to be terminated.
Early pregnancy refers to the first three months after conception (i.e., 12 weeks), also known as the early stage of pregnancy, or the embryonic period. This is the stage when the embryo forms, so it can also be called the embryonic period. Any damage during this period can affect the normal development of the embryo, even causing early miscarriage or congenital deformities. Therefore, ensuring the health of early pregnancy women is very important.
First, pay attention to the nature of the work and conditions of early pregnancy women. If they are exposed to harmful substances, such as mercury, benzene, radiation, or noise, they should request temporary transfer from these jobs to avoid these harmful factors from affecting the embryo's development and causing deformities.
Second, maintain a pleasant mood and relaxed mindset. During the early pregnancy period, if there are pregnancy symptoms (i.e., "morning sickness"), they will generally return to normal after proper treatment within three months. To avoid or reduce nausea, vomiting, and other gastrointestinal discomforts, small, frequent meals can be helpful. A light diet is recommended, avoiding greasy and spicy foods, but it is essential to continue eating, as this will affect the health of the pregnant woman and hinder the development of the embryo. The pregnant woman can consume acidic foods, such as raspberries, oranges, or vinegar, to increase appetite and aid digestion. Sometimes, takingB andC or calcium supplements can also help replenish nutrients. Vitamin B6 may alleviate pregnancy symptoms. Avoid taking "anti-nausea drugs," "folk remedies," or "home remedies" without consulting a doctor, as this could lead to adverse consequences.
During early pregnancy, it is important to avoid infections, especially viral infections. If an early pregnancy woman contracts rubella, it can lead to congenital heart disease, microcephaly, neural deafness, intellectual disabilities, and other complications in the fetus. If a severe cold occurs in the early stages of pregnancy, it can cause fetal cleft lip, giant cell inclusion virus, hepatitis B virus, and other conditions that may lead to miscarriage or deformities. Therefore, early pregnancy women should pay attention to hygiene, avoid going out or visiting others, and avoid contact with sick individuals to prevent the transmission of various diseases. If illness occurs, seek medical attention and inform the doctor that you are pregnant. Do not self-medicate and follow the doctor's advice strictly.
Additionally, family members should show concern for early pregnancy women, especially the husband, who should be considerate and avoid sexual activity during early pregnancy to prevent miscarriage. Help the pregnant woman overcome the discomfort of pregnancy symptoms and smoothly navigate the early pregnancy period.
Stillbirth
After 20 weeks of pregnancy, if the fetus dies inside the uterus, it is called a stillbirth. If the fetus dies more than four weeks before delivery, it may lead to coagulation disorders. If the fetus dies during the delivery process, it is called a stillbirth, which is also a type of stillbirth.
Key Diagnostic Points
(1) Medical History
1. Inquire about the time when fetal movement ceased and the approximate time when the uterus stopped growing, the breasts became softer, and the sense of fullness disappeared.
2. Ask if there are symptoms such as fatigue, low fever, chills, bad breath, poor appetite, lower abdominal pain, and weight loss.
3. Inquire if there are any conditions that may lead to placental dysfunction, such as postterm pregnancy, severe pregnancy-induced hypertension syndrome, hypertension, diabetes, and chronic nephritis.
(2) Physical Examination: The uterus is smaller than the gestational age, with low tone, and no fetal heart or movement can be heard. If caused by chronic conditions, corresponding physical signs may be found.
(3) Auxiliary Tests
1. Doppler ultrasound may not detect fetal heart sounds, assisting in diagnosis. During ultrasound, there may be no fetal heart or movement reflexes. If the fetus has died for a long time, the head may appear flattened.
2. X-ray: One to two days after fetal death, signs of gas accumulation in the fetus may be observed, commonly seen in the heart, aorta, inferior vena cava, and portal vein. As fetal tissues soften, overlapping sutures of the skull, loss of normal spinal curvature, and scattered limb bones without physiological alignment may be seen.
3. In the late stages of pregnancy, the 24-hour urine E3 value