This guide is designed to help mothers-to-be understand these changes, trimester by trimester, so that they can distinguish physiological sensations from symptoms requiring specialist assessment.
Understanding medical terms
When monitoring a pregnancy, two temporal concepts are regularly used: Amenorrhea Weeks (SA) and Pregnancy Weeks (SG). These benchmarks enable healthcare professionals to accurately assess the progress of the pregnancy and organize the necessary examinations.
- Weeks of Amenorrhea: This is the number of weeks since the first day of the last menstrual period. This method is universally used in medical practice, as it is based on a date that is generally known with precision.
- Weeks of Pregnancy: These count the time elapsed since actual fertilization of the egg, i.e. around two weeks after the start of the last period
Why is this distinction important?
All follow-up examinations (ultrasounds, screening tests, growth assessments) are based on gestational age expressed in SA.
Understanding this difference enables patients to correctly interpret the various stages of their medical follow-up, and to anticipate the various consultations and examinations planned
Common pregnancy symptoms: what's normal?
Pregnancy brings a multitude of physiological changes which, although uncomfortable at times, are a sign that gestation is progressing well. It's essential to recognize these symptoms as normal manifestations of the body's adaptation.
Digestive system
- Nausea and vomiting: Frequent in the first trimester, often referred to as “morning sickness”, they tend to diminish in the second trimester.
- Constipation: The result of slowed intestinal transit due to pregnancy hormones. This stagnation of bowel movements, aggravated by the compression of the intestine by the uterus over the months, can lead to the appearance of hemorrhoids, which are also common among pregnant women.
- Heartburn: The growing uterus exerts pressure on the stomach, promoting gastroesophageal acid reflux.
Cardiovascular and venous system
- Mild shortness of breath: Normal with exertion, linked to increased oxygen requirements.
- Leg and foot edema: Frequent at the end of the day in the third trimester.
- Varicose veins: Often appear on the legs, but are not serious in most cases.
Urinary system
- Frequent urination: Compression of the bladder by the uterus explains this symptom, present as early as the first trimester.
- Bladder leakage: May occur at the end of pregnancy, particularly during exertion (coughing, laughing, sneezing).
Musculoskeletal system
- Back pain: Due to shift in center of gravity and relaxation of ligaments.
- Nocturnal cramps: localized mainly in the legs, becoming more frequent over the months.
- Ligament pain: caused by progressive distension of the round ligaments that support the uterus as it increases in volume. Pain is felt in the groin, lower abdomen and even flanks, and may radiate to the hips or lower back.
Nervous system
- Hand numbness: Mostly nocturnal, often associated with carpal tunnel syndrome of pregnancy. These sensations are due to compression of the median nerve in the carpal tunnel, located at wrist level. This compression is often caused by localized oedema (swelling), linked to the water retention common at the end of pregnancy.
- Mild headaches: Frequent and not serious when they are occasional and respond to rest or good hydration.
Reproductive system
- White, odorless vaginal discharge: Resulting from a normal increase in cervical secretions.
- Light bleeding (spotting): a few brownish marks may occur, but are not serious, especially in early pregnancy.
- Tightness in the lower abdomen: Reflects mechanical adaptation to uterine growth.
- Tender or painful breasts: Result from hormonal stimulation and prepare the breasts for breast-feeding.
- Braxton-Hicks contractions: Irregular, painless uterine contractions, normal from the second trimester onwards.
General condition
- Significant fatigue: Occurs mainly in the first and third trimesters, due to hormonal changes and increased energy requirements.
- Sleep disorders: Common, due to physical discomfort and emotional changes.
Warning signs: when to seek medical advice?
Certain symptoms should never be overlooked during pregnancy. They require rapid medical evaluation to prevent possible complications.
Vaginal bleeding
- Slight brownish spotting (blood loss outside the menstrual period) may be benign in early pregnancy.
- Bright red, abundant bleeding, or bleeding accompanied by abdominal pain, should be reported to a doctor.
Intense, localized or radiating abdominal pain
- Mild, diffuse pain is common.
- Acute, intense, unilateral, persistent or sudden pain should raise the alarm, especially if accompanied by other symptoms (fever, abnormal discharge).
Regular contractions before 37 weeks
- Braxton-Hicks contractions are irregular and painless.
- Painful, regular and close contractions before term suggest a threat of childbirth.
Loss of vaginal fluid
- Abundant - or small but continuous - loss of clear fluid may indicate premature rupture of the membranes, and requires immediate assessment.
- Green, yellow, foul-smelling or irritating discharge is suspicious and may indicate a vaginal infection (mycosis, bacterial vaginosis) requiring treatment.
Pain or burning on urination
- Pain or burning on urination most often suggests a urinary tract infection, which is common during pregnancy. This type of infection must be treated promptly to avoid complications such as pyelonephritis and, in some cases, premature delivery.
Intense heartburn and severe reflux
- Intense heartburn that persists despite treatment, accompanied by chest pain, may indicate severe gastro-oesophageal reflux or, exceptionally, a digestive pathology requiring medical advice.
Baby's movements
- At the end of pregnancy, it is normal for the baby's movements to be less frequent or less ample, as the space in the uterus becomes progressively smaller.
- If you notice a significant reduction in your baby's usual movements, or if you have the slightest doubt, it's essential to seek medical advice.
Sudden shortness of breath or chest pain
- Unusual shortness of breath at rest, whether or not associated with chest pain or calf edema, may suggest a serious thromboembolic complication.
Sudden edema of the face and hands
- While it's normal to experience edema, especially at the end of the day in the third trimester, its sudden appearance, especially if accompanied by headaches and visual disturbances, may herald pre-eclampsia.
Persistent headaches and visual disturbances
- If they are intense, resistant to simple treatments and possibly associated with visual abnormalities (light flashes, blurred vision), they require urgent consultation.
Baby's movements: a helpful indicator
The perception of a baby's movements is one of the most accessible and valuable indicators of its well-being in utero. From the second half of pregnancy onwards, regular monitoring of fetal activity enables us to quickly identify any abnormalities and react in good time. When properly understood, this monitoring offers mothers-to-be an active and reassuring role in monitoring their pregnancy.
When do they start?
Fetal movements are first perceived between 16 and 20 weeks of amenorrhea, and generally earlier in subsequent pregnancies.
Normal variability and times of reduced perception
A decrease in perception of the baby's movements can be observed when the mother is moving or active. This decrease in sensation is also common during periods of fetal sleep, which can last up to 90 minutes.
How to monitor baby's movements
Practical advice:
- Lie calmly on your left side, a position that optimizes utero-placental blood circulation
- Have a sweet snack
- Concentrate for two hours on movements, noting their number, intensity and distribution.
When should you consult?
A consultation should be considered without delay in the following situations:
- A marked decrease or absence of movement for more than two hours, despite stimulating gestures.
- A sudden change in the baby's usual behavior (e.g., very few movements during a period of normal activity).
- A decrease in fetal activity is normal at the end of pregnancy, but unusual inactivity is cause for concern.
Normal symptoms and warning signs, trimester by trimester
Each trimester of pregnancy has its own specific symptoms. Here's an overview of the main symptoms to expect and the situations that should raise an alarm.
First trimester (1 to 15 SA)
Normal symptoms:
o Morning sickness
o Intense fatigue
o Light tugging in the lower abdomen
o Light brownish bleeding (spotting)
To watch out for / Consult:
o Severe vomiting with weight loss (hyperemesis gravidarum)
o Abundant bright red bleeding
o Unilateral abdominal pain (suspected ectopic pregnancy)
o Urinary burning or fever (risk of infection)
Second trimester (15 to 28 SA)
Normal symptoms:
o First perception of baby's movements
o Moderate ligament pain
o Discrete varicose veins
o Constipation and mild hemorrhoids
To watch for / Consult:
o Absence of movements after 22 SA
o Continuous, intense lower abdominal pain
o Frequent urinary tract infections
o Persistent headaches associated with high blood pressure
Third trimester (28 SA at birth)
Normal symptoms:
o Irregular, painless contractions (Braxton Hicks)
o Regular but “heavier” fetal movements
o Mild shortness of breath on exertion
o Fatigue and insomnia
What to look out for / Consult:
o Painful, close and regular contractions before 37 weeks' gestation should raise the alarm, as they may indicate a risk of premature delivery.
o Loss of clear fluid (suspected rupture of the water sac)
o Sudden swelling of the face, hands or feet
o Severe reduction or absence of baby's movements
o Bright red bleeding
Why seek medical advice early: the importance of responsive follow-up
When faced with an unusual or worrying symptom during pregnancy, it's crucial not to wait to seek help. Early treatment not only helps to rule out possible complications, but also ensures the safety of mother and child.
At Hôpital de La Tour :
- The emergency department is open 24/7, ready to welcome any pregnant woman presenting a warning sign.
- The specialized medical team is made up of gynecologists-obstetricians, experienced midwives and pediatricians, offering comprehensive expertise.
- Immediate assessment protocols (monitoring, ultrasound, biological tests) guarantee maximum responsiveness in critical situations.
Every pregnancy is unique, but recognizing the normal signs and those that merit particular vigilance can help you live through this period with greater serenity. In case of doubt or unusual symptoms, never hesitate to consult your healthcare professional: a verified concern is better than an ignored signal.