One week later, Lisa came to Dr. Jack’s clinic again with the complaints of vaginal bleeding and vomiting in the morning. The bleeding was dark and thin, little in amount. She had nausea and vomiting several times a day. How do these issues affect the pregnancy outcome?
Actually, bleeding or spotting is quite common in the first trimester (the first three months of the pregnancy). One study showed that the incidence of these symptoms can occur up to 27% of total pregnancy. However, not all these cases had a bad outcome. Light bleeding or spotting can occur 1 to 2 weeks after fertilisation when the fertilised egg implants in the lining of the uterus. The cervix may bleed more easily during pregnancy because more blood vessels are developing in this area. In these cases, pregnancy is not affected at all. However, the risk of miscarriage could triple if the bleeding is heavy or even more if it was accompanied by lower abdominal pain (1).
Nausea and vomiting are also quite common in early pregnancy, there up to 50-80% pregnant women have nausea and 80% of them have vomiting. Most of the cases are mild to moderate and do not affect the pregnancy. There only 0.3 – 3% of pregnancies have a severe condition called hyperemesis gravidarum that requires hospitalisation, it can have a negative effect on the fetal growth. The exact cause of these conditions is unknown. Some theories were proposed including: hormonal stimulus, evolutionary adaptation, and psychologic predisposition. Non-drug therapy could help to relieve the symptoms including taking prenatal multivitamin one month before pregnancy, avoiding spicy or fatty foods, using ginger, or acupressure, acupuncture at the P6 or Neiguan point (located three finger breadths below the wrist on the inside of the wrist in between the two tendons). Sometimes, pregnant women who suffer from more severe symptoms need medications (2).
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After interviewing and examining
Dr Jack said: Your bleeding is not significant, so no need to use any intervention. While your vomiting is quite troublesome, it is not severe. You can use ginger capsules for help first. It still cannot help, so you need to use medication. I will give you the prescription, and you could buy it when needed. Generally, it is quite good, don't be worried.
Lisa: Thank you, Doctor. I really appreciate your help.
Dr Jack: You are welcome! Today you should do some blood tests to screen for some infectious diseases. The next visit should be in around 12 weeks. At that time, we will do the first trimester ultrasound and a test to detect chromosome abnormality of the baby. If you are busy, you can go home, I will send the results to you.
Lisa: It is ok, I will wait for the result. I just want to make sure that everything is ok.
The blood test was done. Several hours later, Dr Jack saw Lisa again to inform the test result.
Dr Jack: The test results are good. It is amazing that you still have a negative result for hepatitis C, while your husband is positive.
Lisa: Thank God.
Dr Jack: Do you keep practicing Falun Dafa regularly?
Lisa: Of course. I feel very relaxed and peaceful as I practice the exercises and read the book. But I find it quite difficult to maintain as often as before pregnancy.
Dr Jack: Keep going, and try your best. You are doing a good job. It is enough for today, see you 6 weeks later. Let me know if you have any problems.
Lisa: Thank you, see you.
Dr Jack: see you.
Lisa's pregnancy is in a good condition now. But there will be an initial sign of a high risk problem. What is that? Please see the next chapter.
https://www.ganjingworld.com/s/Enj4JgAG4g
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References
1. Hasan R, Baird DD, Herring AH, Olshan AF, Jonsson Funk ML, Hartmann KE. Association between first-trimester vaginal bleeding and miscarriage. Obstet Gynecol. 2009 Oct;114(4):860-867. doi: 10.1097/AOG.0b013e3181b79796. PMID: 19888046; PMCID: PMC2828396.
2. ACOG Practice Bulletin No. 189: Nausea And Vomiting Of Pregnancy. Obstetrics & Gynecology 131(1):p e15-e30, January 2018. | DOI: 10.1097/AOG.0000000000002456