Patient's question:
Doctor, hello: I have a friend who is pregnant. Recently, she has been experiencing poor appetite, occasional nausea, general fatigue, and a feeling of abdominal fullness 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 for extended periods, 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 miscarried fetus. Since her symptoms have been less severe in the past two days, she wonders if the fetus is not doing well. If a pregnancy results in a miscarried fetus, what symptoms would one experience? Or is the only way to find out through 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, or 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 that prevent eating or drinking, 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 have psychological preparation for pregnancy. Many scholars abroad have confirmed through research that early pregnancy symptoms are very closely related to the pregnant woman's emotions. Those with 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, first-time pregnancies lead to more worries. These worries may include concerns about physical fitness, fetal development, the inability to take medication if sick, changes in family finances, or shifts in personal status and social relationships. This series of worries can cause emotional instability in pregnant women. Unstable emotions can lead to early pregnancy symptoms, and at this time, the care of the husband is crucial. The husband should understand the pregnant woman's psychology and address her biggest concerns, which is often more effective than the best medicine. In addition to the husband's care, relatives and friends around should also show concern, making the pregnant woman feel that life in this family and society is very warm. The pregnant woman herself should also recognize that pregnancy is a normal physiological phenomenon and should not be feared. 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! With this mindset, early pregnancy symptoms are likely to ease or even disappear.
Early pregnancy symptoms generally have no significant impact on the pregnant woman or the fetus and will gradually subside over time. However, if severe pregnancy symptoms occur and last for an extended period, 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 obtaining adequate nutrition. As the fetus grows, its nutritional needs increase. If the pregnant woman also experiences dehydration, acidosis, or electrolyte imbalances, it can directly threaten the lives of both the mother and the fetus.
Treatment:
- Adequate rest and sleep, with comfort and support from the husband, and addressing her concerns.
- Trying to eat something to suppress nausea.
- Avoiding foods and odors that cause discomfort.
- 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 of pregnancy (i.e., 12 weeks), also known as the early stage of pregnancy, which is the stage of embryo formation. Therefore, it can also be called the embryonic period. Any damage during this period may affect the normal development of the embryo, potentially leading to early miscarriage or congenital deformities. Therefore, ensuring the health of early pregnancy women is very important.
First, attention should be paid to the work nature and conditions of early pregnancy women. Those working in environments that involve exposure to harmful substances, such as mercury, benzene, radiation, or noise, should request temporary reassignment to avoid these harmful factors from affecting embryonic development and causing deformities.
Second, maintaining a cheerful mood and relaxed mindset is essential. Early pregnancy symptoms (such as "morning sickness") generally subside gradually after three months with proper management. To avoid or reduce nausea, vomiting, and other gastrointestinal discomforts, small, frequent meals can be helpful. A light diet, avoiding greasy and spicy foods, but ensuring regular food intake, is important to maintain the health of the pregnant woman and support fetal development. Pregnant women can consume acidic foods like sour plums, oranges, or vinegar to stimulate appetite and aid digestion. Sometimes, takingB andC or calcium supplements can also help. Vitamin B6 may alleviate pregnancy symptoms. Avoid taking "anti-nausea drugs," "folk remedies," or "unconventional treatments" 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, or intellectual disabilities in the fetus. Severe colds during early pregnancy can also cause fetal cleft lip, inclusion body virus, or hepatitis B virus, leading to miscarriage or deformities. Therefore, early pregnancy women should pay attention to hygiene, minimize outings or visits, and avoid contact with sick individuals to prevent infections. If illness occurs, seek medical attention and inform the doctor of the pregnancy to avoid self-medication. Always follow medical advice.
Additionally, family members should show concern for early pregnancy women, especially the husband, who should be considerate. Sexual activity should be avoided during early pregnancy to prevent miscarriage. Help the pregnant woman overcome early pregnancy symptoms and smoothly transition through this stage.
Stillbirth
A fetus that dies in the uterus after 20 weeks of pregnancy is referred to as a stillbirth. If a stillbirth occurs more than four weeks prior, it may lead to coagulation disorders. A fetus that dies during delivery is also considered a 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 softened, and the sensation of fullness disappeared.
2. Ask about symptoms such as fatigue, low-grade fever, chills, bad breath, poor appetite, lower abdominal pressure, and weight loss.
3. Inquire about any conditions that may impair placental function, such as postterm pregnancy, severe pregnancy-induced hypertension, hypertension, diabetes, or chronic nephritis.
(2) Physical Examination: The uterus is smaller than the gestational age, with low tone, and no fetal heartbeat or movement can be heard. If caused by chronic conditions, corresponding physical signs may be present.
(3) Auxiliary Tests
1. Doppler ultrasound may fail to detect fetal heartbeat, aiding in diagnosis. Ultrasound may show no fetal heartbeat or movement reflexes. If the fetus has died for an extended period, the head may appear flattened.
2. X-ray imaging: One to two days after fetal death, signs of gas accumulation in the fetus may be observed, often initially in the heart, aorta, inferior vena cava, and portal vein. As fetal tissues soften, overlapping cranial sutures, loss of normal spinal curvature, disorganized limb bones, and loss of physiological state may be seen.
3. In late pregnancy, 24-hour urinary E3 levels