Pregnancy problems in each trimester

Even when the mother is in good health and follows her doctor’s recommendations, there are hundreds of complications that can appear during pregnancy, after all, the hemodynamic, hormonal, psychological and physiological changes that the mother goes through in just 9 months, are enough to upset the balance if you are not careful.

And as a cautious woman, it is worth two, Dr. Carlos Monsalve, specialist in maternal-fetal care at Creafam, explains to us the most common complications that appear in each trimester, as well as ways to prevent and treat them, remember that knowledge is success.

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First trimester. Hyperemesis gravidarum (Vomiting)

The first complication through which many mothers are going through are nausea, which occur because when the embryo is implanted in the uterus the chorionic gonadotropin hormone is released that tells the mother’s body that all changes and preparations must begin to maintain to maintain the Pregnancy, but in some cases nausea are so extreme that they produce dizziness, fainting and when they are accompanied by constant vomiting they produce dehydration or nutrition problems, these cases are known as tax hyperemisis, fortunately there are few cases that require hospitalization.

The first recommendation is to consume a soft diet in small portions but several times a day, drink a lot of water and preferably cold is how you will tolerate it best and avoid irritating foods. If nausea still persists, I recommend watching our video on nausea. And nutrition, we can also prescribe antiemetics, but it is necessary to go to consultation. Very often they write to us that folic acid produces nausea and that is why they stop taking it, please remember that folic acid is essential for the development of your baby’s brain, think about that and take their folic acid from the first quarter.

Ectopical pregnancies

Ectopic means “out of place,” so an ectopic pregnancy happens when the embryo implants outside the uterine cavity, usually occurs in the fallopian tubes, and is usually due to a blockage of the tube or a malfunctioning tube.

When a pregnancy occurs in the tubes, the amount of gonadotropin hormone produced is less than that of a normal pregnancy… Some women are scared when they take a pregnancy test and the second line on the test is barely visible, but before If they are worried, it would be worth going to the doctor to perform an ultrasound to confirm where the embryo is located, even if only a small dot is visible.

Unfortunately, if it is in the tube, the pregnancy must be interrupted since the baby will not have room to grow and if we let time pass, it will end up bursting the tube and causing hemorrhage that will take you urgently to the hospital.

Flows or stains

I have already said it in several videos and I will continue saying it: No flow or bleeding is normal during pregnancy… Although there could be a single exception, if on the day your period is supposed to arrive you have slight spotting, which More likely, it is implantation bleeding, which is what is called when period bleeding stopped in time but a little blood still came out, but this bleeding should be light and appear only one day, if it lasts. last more days or if you have any other type of discharge or bleeding you should go to a consultation, it is better to prevent.

Uterine fibroids and cysts in pregnancy

We have had that concern from many mothers who say: “I have fibroids and I am already pregnant. What can we do?” Don’t worry, it is very difficult for a fibroid during pregnancy to cause difficulties for the baby unless they were very large and were occupying that uterine cavity.

Ovarian cysts will not represent a risk for pregnancy either, unless they are large cysts or unless the cyst becomes twisted, this does represent an emergency in which the cyst would have to be operated on, but as long as the cyst does not cause pain and does not If you have a sprain of the ovary, there is no reason to do any surgery.

Dental problems Can I go to the dentist?

If it is important that your teeth be cared for during pregnancy, if there is an infection, a bite, it is better to treat it because all these infections can also be transmitted to the baby, then it is very important, go to your dentist.

Spontaneous abortion or recurrent abortions

Spontaneous abortion. It is estimated that up to half of fertilized eggs die spontaneously before week 7, even before the mother realizes she was pregnant, however, recurrent miscarriages can occur up to week 12 of pregnancy and are usually not They are the mother’s fault, they are due to problems with the health of the embryo that could no longer continue growing on its own, and entering the second trimester the embryo should continue growing without stopping.

If you have already had positive pregnancy tests but then get your period normally or if you have had abortions before, I recommend that you watch our master class on repeat abortions. And now we are going to continue with the most common problems in the second trimester.

Second quarter. Placental complications

There are many gynecologists who, from the first consultation, worry patients by telling them that the placenta is underdeveloped or that it was placed out of place, but the truth is that just as the baby develops little by little, the placenta also develops, therefore That is until the second trimester that we can assess if there is a true complication such as hematomas, placenta previa or abruption of the normal placenta.

Hematomas are like small bruises or accumulations of blood that on ultrasound look like dark bags. It is very common for them to appear because the placenta grows and sends out roots to absorb nutrients. Some of these roots or blood vessels form well and others do not. Bruises develop and usually disappear, but it is important to monitor them with ultrasound to ensure that they do not grow and if so, control them with medication.

Placenta previa can only be diagnosed after week 24 and is a placenta that blocks the birth canal partially or completely. Depending on how severe the obstruction is, you can proceed with normal delivery or opt for a Caesarean section.

Placental abruption is a more severe complication, frequently caused by heart problems, hypertension, preeclampsia, fibroids, or strong blows to the abdomen. The first line of defense is usually to stay on bed rest, although in extreme cases it may be necessary to advance delivery.

Infections and sexually transmitted diseases durante el embarazo

Fortunately, with medications we can prevent most sexually transmitted diseases caused by viruses, such as the HIV virus, from crossing the placental barrier and thus we can ensure that a baby is free of HIV. There are other diseases caused by bacteria, which we can combat with antibiotics.

The best way to combat them is by doing routine exams. Which ones? Urine examination and vaginal examination. What is this going to do for us? To detect problems that may cause premature births or membrane ruptures or infections in the baby at the time of birth, it is highly recommended that routine urine tests be performed during consultations and when necessary a vaginal culture is performed, in fact, the General urine examination also helps us detect or suspect complications such as preeclampsia or diabetes.

Pregnancy and anemia

In Latin America, 20% of pregnant women suffer from anemia. Imagine! One in five mothers has or had anemia, and during the first trimester the uterus is full of iron due to all the blood it was storing during the last menstrual period, in addition to the fact that the embryo is nourished by the yolk sac while the embryo is formed. placenta, but beginning the second trimester these reserves run out and the mother will need much more iron than she has ever needed in her entire life, so in addition to iron supplements it is recommended to eat lots of whole grains, seeds, fruits, vegetables, beans, lentils, egg. Don’t forget animal protein: Fish, chicken, meat.

Cervical insufficiency or cervical incompetence

There will be women who have had losses in the second trimester between weeks 20 and 25. Why? Because this pathology could not be diagnosed. What is it? A short neck, that is below 2.5 centimeters and above all that has an opening, millimeters but opening, any opening or any measurement less than 2.5 will have to make us suspect cervical insufficiency.

We recommend performing a cervical cerclage, it is nothing more than tying the cervix, with a special tape and a special technique, but it is a procedure that can save your baby’s life.

Blood incompatibility to Group RH

You may have heard people say, “My blood is not compatible with my baby’s.” When does this happen? When the mother is RH negative, the father is RH positive, it means the baby can be positive or negative. If a baby is negative there will be no problem because she will have the same RH as the mother.

The problem is when the baby is RH positive and the mother is RH negative, then there may be incompatibility. What does it mean? That the mother’s blood recognizes it as something foreign and her blood will attack the baby’s blood. Don’t worry, there are studies that can determine if this is happening, it is called COOMBS, it is a maternal blood sample that defines whether or not there is this production of antibodies, if there is there are also vaccines that can be applied During pregnancy.

Varicose veins during pregnancy

This is another condition that affects half of pregnant women to a greater or lesser extent. It is more common when there is a history of varicose veins in the family or in overweight patients. Therefore, the greatest recommendation is to take great care of your weight and diet. perform light exercises such as walking a couple of times a day, wearing low compression stockings and giving regular massages to the legs or affected areas.

We highly recommend not spending too much time in the same position, changing positions for every 30 to 40 minutes you were standing or sitting. There are some medications that can reduce the discomfort but the treatment will really take place after your pregnancy.


According to the World Health Organization, preeclampsia is the main cause of maternal and fetal death in Latin America, and particularly in Mexico it is estimated that one in ten women will suffer from preeclampsia. But, what is it about? Well, it is a condition in which very high blood pressure develops, this constant pressure can begin to cause headaches, breathing problems, nausea, ringing in the ears, little lights and if it is not reduced then there begins to be swelling and increased blood pressure. weight, and eventually vision will become blurred and the body begins to lose protein in the urine because the kidneys stop working.

We know that it is more common in new mothers, overweight women, diabetics or smokers, but there is no exact cause, which is why it is essential:

  • Follow a diet without excess sodium.
  • Check blood pressure.
  • Do the urine test regularly.

Even if the mother feels well, the symptoms usually appear until the problem is advanced.

Premature and post-mature or post-term birth

A full-term baby is born between weeks 37 and 42, but about 15% are born prematurely and 10% are postmature. As I had already mentioned, infections are one of the main causes of premature birth.

If we suspect that a premature birth occurs, the most important thing is to give the fetus medications to accelerate its lung development. On the contrary, when the baby is post-mature, the concern is that it will run out of space due to the lack of fluid that occurs in the last trimester. or that the oxygen supply decreases due to the same compression of the umbilical cord.

As long as the baby is a suitable size and has enough space we can continue waiting, but if it starts to be too big for the birth canal it would definitely be better to induce labor or perform a cesarean section.

Gestational diabetes or diabetes in pregnancy

Gestational diabetes is a very important condition in pregnancy, which we have to detect between weeks 24 and 28, which is why there is a study called “Gestational Screening” and this should be performed on every pregnant woman regardless of age and regardless of background.

Poorly treated gestational diabetes during pregnancy can have many repercussions on your baby.

Intrauterine growth restriction: Fetal growth problems

What is the main problem? Detect when a baby stops growing. A bigger problem is when it stops growing before week 28, a smaller problem is when growth stops after week 31. Why is this? Because before the 28th we consider that it is a very premature baby and after the 31st it may be premature, but it may already have a certain maturity to face life, which is why it is very important to go to your consultation every month and more importantly to have the ultrasound of your baby to see how the growth is going because from the beginning we can take measures to improve the baby’s condition, in case the baby is not growing adequately.

“Well mommies, these were the most common complications of pregnancy, if you recognize any of the symptoms please go to your obstetrician or come to Creafam, we can gladly help you have your Dream Fulfilled in your arms”

Dr. Carlos Monsalve
Dr. Carlos Monsalve
Specialist in gynecology and obstetrics

Perinatology, invasive techniques and obstetric ultrasound.
Hospital Universitario La Fe, Valencia, España.

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