The emotion of the positive test is probably one of the strongest a woman can experience: the two dashes are enough to make a future mother and a future father go crazy with joy. But once the first understandable euphoria has passed, you need to start taking care of yourself more carefully. Because the first three months of pregnancy are the most delicate and sometimes difficult ones. The vast majority of pregnancy-related problems are discovered in this very early period. And you need to know how to deal with it in the best way. The professor explains it to us Luigi Alio and the doctor Laura Giambanco, respectively director and gynecologist of the complex operational unit of Obstetrics and Gynecology of the Arnas-Civico of Palermo.
Laura Giambanco-Luigi Alio
The first quarter is undoubtedly the most delicate. Because?
“The first weeks of pregnancy are among the most delicate for many reasons. First of all, we need to consider the psychological impact of knowing how to become a mother. It is a wonderful moment but, at the same time, anxieties and expectations arise… Will everything be okay? I'm ready? And the job? From a strictly medical point of view, in the first trimester from the meeting of two cells (oocyte and sperm) an individual is formed with all the organs, tissues and systems that the human body possesses! In a few centimeters there is a lot of work: heart, brain, limb development, 'choice' of sex… And obviously something can go wrong with the appearance of malformations or even the spontaneous termination of pregnancy ”.
When a woman finds out that she is pregnant, what are the main "rules" to follow?
“The 'rules' useful in pregnancy concern lifestyle in general and there are some specific ones. Obviously it is recommended to stop smoking, not to abuse alcoholic beverages (yes to a glass of wine, no to spirits and cocktails), to exercise, to eat healthy. Speaking of food, there are some foods to avoid during pregnancy if you have never come into contact with Toxoplasma Gondii (do you know the so-called "cat disease"?): No to raw meats (including some sausages), special care and hygiene with salad and fruit to eat with the peel ".
The first visit to the gynecologist: what does it consist of?
“The first visit is very important to determine if the pregnancy is to be considered low or high risk. Therefore, an accurate identification of some factors is essential, for example gestosis or diabetes in previous pregnancies, maternal obesity, maternal diseases, blood pressure control. In addition, a pap test will have to be carried out if more than 18 months have passed since the last one; the obstetric visit (which does not hurt the baby, let's dispel this myth!) serves to reveal the presence of any anomalies of the woman's genital system or infections. The transvaginal ultrasound allows to confirm the time of pregnancy, the correct location, the number of embryos (children) and the presence of cardiac activity ".
First trimester screenings: how reliable are they?
“There is a lot of confusion about first trimester screenings and prenatal diagnosis, probably generated by incorrect advertising of the methods. First of all, it is necessary to clarify that screenings, as such, are not tests capable of making a diagnosis, that is, giving certainty of anomalies in the number or shape of chromosomes. They are, however, very reliable non-invasive tests. Therefore, their execution is advisable, as they are able to identify pregnancies at risk of chromosomal abnormalities and allow the execution of further tests such as the search for fetal DNA circulating in the maternal blood or amniocentesis ".
Are there any additional risks in the case of a twin pregnancy?
“Someone yes, it is useless to deny it. But there are notable differences in the context of twin pregnancies: the evaluation of the number of placentas and amniotic sacs is important. Monochorionic pregnancy (with a placenta) requires much closer checks to promptly highlight the onset of fearful complications such as blood transfusion from one fetus to another ".
Preconception health is often overlooked and this is probably a mistake. What to do before starting to look for pregnancy?
"Thanks for the question! It is true, not all expectant mothers know that their preconception health can influence the course of pregnancy! Stopping smoking at least six months before conception would ensure the elimination of the risks related to cigarettes for the baby, correcting an anemic state of the woman and suspending any therapies with drugs contraindicated in pregnancy is also essential. Regarding pre-pregnancy tests, it is useful to know if you are a healthy carrier of beta thalassemia (two healthy carriers could give birth to a child with the disease), if you are immune to rubella, an infectious disease that can lead to malformations of the baby when contracted in pregnancy. Furthermore, starting to take folic acid is recommended by all scientific societies for the prevention of defects in the closure of the neural tube, the so-called spina bifida ”.