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FAQs for the First Trimester

Q1. Is it safe to get ultrasound scans during pregnancy? Could too many scans hurt my baby?

  • The ultrasound machines used nowadays are safe. They don’t emit harmful radiation like X-rays. But it’s best to avoid using the more intense types of ultrasound, like Color Doppler and Pulsed Wave Doppler, in the very early stages of pregnancy (around 5-6 weeks).
  • Studies have been done for many years on ultrasound safety, dating back to the 1960s when it was first introduced. So, we have lots of solid evidence showing that ultrasound doesn’t harm babies. Actually, it’s the most reliable way to check on your baby’s health. Just feeling your belly or listening to the heartbeat isn’t always enough!

Q2. Do you really need to hold your pee for an ultrasound during early pregnancy?

  • Yup, if the scan is on your belly and it’s early in your pregnancy. A full bladder helps push your uterus up and moves your bowels out of the way, so the ultrasound can get a clearer picture. It’s like making a clear window for the ultrasound waves to pass through. With a full bladder, your doctor can see things better, like if the baby’s heart is beating.
  • But you don’t need to feel like you’re going to burst! Sometimes it’s actually better to go to the bathroom if your bladder is too full.
  • If the scan is inside your vagina, though, you don’t need a full bladder.
  • After about 11-12 weeks of pregnancy, you don’t need a full bladder for the scan anymore.

Q3. Is a vaginal scan safe?

  • Yep, as long as the probe is cleaned well and has a clean cover.
  • Sometimes, if the placenta is low and covering the cervix, a vaginal scan needs extra care. But usually, the scan is safe because the probe doesn’t go too far inside.

Q4. When can we first see the baby’s heartbeat?

  • We can usually see the baby’s heartbeat clearly around 6.5 weeks, especially with a vaginal scan. When we say 6.5 weeks, we mean from the last menstrual period (LMP), not from the day of conception.
  • Sometimes, though, menstrual cycle irregularities can make the dates less accurate, so it’s best to confirm with an ultrasound.

Q5. If your menstrual cycles are irregular, figuring out your pregnancy weeks can be tricky. Here’s how to do it:

  • If your cycles are longer than the usual 28 days, like 35 days, your ovulation day would be later, around Day 21 instead of Day 14.
  • Count the days from the start of your period to when you ovulate (follicular phase), which can vary. Then, add around 14 days until your next period (luteal phase). For example, if your cycle is 42 days, you ovulate on Day 28.
  • If your cycle is longer, you ovulate later, which means your fetus might be smaller than expected or might not show up on scans.
  • Sometimes, even if your cycle is regular, the fetus might not have grown properly. In such cases, repeating a scan after a week can help determine if the fetus is just smaller due to timing or if there’s a growth issue.
  • Experienced professionals can assess other features on the scan, like the yolk sac, sac morphology, and chorionic reaction.

Q6. If you see a heartbeat around 7 weeks into your pregnancy, does that mean it’s likely to be successful?

  • Most miscarriages in the first trimester (less than 12 weeks) happen because of a problem with the embryo. This is usually just bad luck. Sometimes, if there’s a problem very early on (around 4 to 5 weeks), the embryo stops growing and the heartbeat stops. The body then naturally gets rid of the non-viable material, which is what we call a ‘miscarriage’.
  • So, if everything looks good around 7 or 8 weeks and there’s a strong heartbeat, chances are the pregnancy will continue normally. On average, more than 95% of pregnancies at this stage go on successfully, though the number might be lower for women who’ve had multiple miscarriages.

Q7. What causes bleeding in early pregnancy? Does it always mean a miscarriage?

  • It’s hard to say exactly why it happens in the first few months of pregnancy. Sometimes it’s just from the cervix or near the placenta, which isn’t usually a big problem. Even if bleeding continues into the second trimester and the baby’s heartbeat is okay, the pregnancy is usually fine over 97% of the time. Back in the day, any bleeding early in pregnancy was called a ‘threatened abortion’, but not all cases end in a miscarriage.
  • Still, it’s important to tell your doctor about any bleeding. They can do an ultrasound to check the baby’s health and look for any issues with the cervix, like polyps.

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