Pregnancy is an enigmatic process, particularly at the very beginning, when very impatient women want to know about its occurrence even before the delay of menstruation. The first signs of early pregnancy can be confused with the phenomena of premenstrual syndrome, but laboratory and instrumental research methods will help to confirm conception. Why is it so important to establish the presence of a long-awaited pregnancy as early as possible? To revise your lifestyle and diet, if this was not done in advance, eliminate, if possible, harmful factors and prepare to become a mother.
The process of conception: how it happens
Conception is a series of processes that happen after fertilization, as a consequence of which a new organism is born and continues to grow in the female body, that is, pregnancy. The moment of pregnancy is preceded by various factors:
- Sexual intercourse between a man and a woman (no protective equipment)
- Fertilization After sexual intercourse, male reproductive cells (sperm) penetrate the uterine cavity, from where they continue their way to the fallopian tubes. Fertilization arises directly in the fallopian tube (one or both at once), where the sperm should meet with the egg. For a successful date between the female reproductive cell and the sperm, full ovulation is necessary. During ovulation, the main follicle ruptures in the ovary, from which a physiologically normal egg is released, ready for fertilization. Its path also lies in the direction of the fallopian tube. When several hundred million spermatozoa collide with an egg in the tube cavity, only one merges with it. A fertilized egg is called a zygote, which continues to move towards the uterus, simultaneously splitting, This process is not yet a pregnancy, since a fertilized egg may not reach the uterine cavity, die, or, on the contrary, getting into the uterus and not having time to the implant for any reason, is expelled from the fetus along with the menstrual flow. This phenomenon is called spontaneous interruption of biochemical pregnancy.
- Implantation As soon as a fertilized egg (now a blastocyst) enters the uterus, it begins to intensively penetrate the thickness of the endometrium – to the implant. At the same time, the uterine mucosa, under the influence of progesterone, continues to thicken and envelops the blastocyst around the entire circumference. A chemical and physical relationship is formed between the future embryo and the endometrium, the trophoblast of the blastocyst begins to synthesize chorionic gonadotropin, which makes the ovarian corpus luteum continue to secrete progesterone, which is necessary for further prolongation of pregnancy. As a consequence, menstruation does not happen, and we may talk about the onset of pregnancy.
The time from the moment of sexual intercourse to implantation takes 7 – 12 days, therefore, it is premature to talk about the first signs of pregnancy in the early stages of 1 week after coitus.
Early pregnancy diagnosis
It is quite difficult to diagnose pregnancy at the earliest stages, since the first symptoms, which both the woman and the doctor can regard as the onset of pregnancy, are possible with various pathologies. Disorders such as premenstrual syndrome, disruption of the endocrine organs, neuropsychiatric diseases, or overdose of certain drugs are not excluded.
But if a joyful moment has happened, then the first signs of gestation that confirm its presence are laboratory and instrumental studies. Early signs of pregnancy are caused by hormonal changes (production of hCG and progesterone ).
From laboratory methods confirming the pregnancy, the determination of hCG in urine and blood serum is used. Determination of the level of hCG in the blood can be carried out 14 to 21 days after intercourse when conception has already occurred, and the trophoblast of the embryo begins to intensively synthesize hCG. An increment in the level of the hormone in the blood is identified in a special laboratory.
Such tests are an alternative to laboratory determination of the level of hCG and are carried out at home. It is recommended to conduct a test no earlier than 4 – 5 weeks after coitus, that is, after a delay in menstruation. But it is possible to find out about pregnancy earlier, even before the expected menstruation, subject to a long (35 days or more) menstrual cycle. The test is based on the detection of hCG in urine.
- Conduct a test with morning urine (morning urine is concentrated, which means that the hCG content in it is higher);
- Do not increase fluid intake if the test needs to be done during the day (urine is diluted and the concentration of the hormone decreases);
- Carefully read the instructions before performing the test and act according to them;
- Do not use tests that have expired.
- 1 – 1.5 months ago there was a miscarriage or childbirth (hCG is not right away excreted from the body);
- Expired shelf-life;
- Treatment with hCG-including drugs;
- Trophoblastic disease (cystic drift, chorionic carcinoma).
A false-negative result is also possible if:
- The test was performed too early (fertilization has occurred, but implantation has not yet been completed);
- The threat of termination of pregnancy (the level of hCG in the blood drops);
- Violation of the test instructions;
- A lot of liquid was drunk before the test;
- Renal pathology;
- Arterial hypertension.
In any case, after a negative result, the procedure must be repeated after a few days.
Observation after the ultrasound is another sign of early pregnancy. However, in too early terms, an ultrasound scan cannot serve as a 100% guarantee, since the future embryo, until it reaches a certain size, the doctor may not notice. When performing this instrumental study, in addition to confirming the pregnancy, the following indicators are revealed:
- Localization of the ovum (in the uterus or in the tube, ovary, etc.);
- Determination of the viability of the embryo (is there a heartbeat);
- The presence of the embryo itself in the ovum.
The first indications of pregnancy before the retardation of menstruation
When do the first signs of pregnancy appear? As already noted, not earlier than 7 days after sexual intercourse.
The following indications allow to suspect gestation even before the delay in menstruation:
This symptom is determined by the graph of basal temperature, which is measured in the rectum. Only a woman who is careful and for a long time (at least 3 months) keeps a graph of the temperature curve is able to identify this sign.
On the eve of ovulation, the temperature drops by 0.2 – 0.4 degrees, but from the moment the egg leaves the follicle, the temperature rises sharply and becomes above 37 degrees. At this stage, it stays for about 12-14 days, and before the onset of menstruation, it starts to decline. Before the introduction of the egg into the endometrium, the production of progesterone is somewhat reduced (after all, it is towards the end of the menstrual cycle), since the body is not yet aware of the fertilization that has taken place. But as soon as implantation has occurred and connections are established between the ovum and the mother’s body, the trophoblast begins to produce hCG, thanks to which the body is rebuilt to the program of maintaining pregnancy. That is, the corpus luteum keeps producing progesterone, which supports the further growth and development of the embryo, and, accordingly, the basal temperature rises.
Later, after retardation in menstruation, the basal temperature exceeds 37 degrees and indirectly confirms pregnancy.
The process of insertion of the blastocyst into the thickness of the uterine mucosa may (but not necessarily) be accompanied by small bleeding. Blood discharge is due to the destruction of the walls of the vessels of the uterine mucosa. Do not expect obvious and too noticeable discharge. There can be a bloody or pinkish discharge in the form of a couple of drops on linen or toilet paper. Implantation bleeding must be expected within 7 to 12 days from the date of intercourse. If there were no “suspicious” discharge, this is not considered a pathology, just as it does not confirm or deny a possible pregnancy.
Feeling in the lower abdomen
After implantation, the blood supply to the genitals, in particular the uterus, changes. The blood flow to the pelvic organs, particularly to the uterus, increases significantly, which improves its blood supply and provides the embryo with nutrients and oxygen. Therefore, for some women, one of the first indications of gestation before the delay is a feeling of fullness in the lower abdomen. Light tingling and even stretching are also possible, which is not a pathology (after all, the uterus begins its increased growth).
For the same reason (increased blood flow in the small pelvis), hemorrhoids may appear or worsen or veins in the legs may appear (the first sign of varicose veins). Certainly, hemorrhoids and varicose veins are more intrinsic in the second half of gestation, when the uterus already has significant dimensions and compresses the inferior vena cava, but in multiparous these phenomena may show up very early, even before the delay.
Unstable emotional state
Before the onset of the expected period, most women, unaware of the new life that has arisen in them, become absent-minded and forgetful, or, on the contrary, too irritable and aggressive. Unexpected tears are suddenly replaced by laughter and vice versa. This is related to progesterone, which is produced to maintain pregnancy. But lability of the psyche is quite possible with premenstrual syndrome, therefore, only those women who had no PMS symptoms earlier can suspect pregnancy on the basis of this sign.
At a very short time, a woman may feel the signs of a cold: slight malaise, increased fatigue, headache. A slight increase in body temperature is also possible, which, again, is associated with the effect of progesterone on the center of thermoregulation. As early as the embryo is fixed in the uterine wall and began to actively “cooperate” with the mother’s body, there is a decrease in immunity in the mother’s body, which prevents the refusal of the ovum as a foreign body.
Feelings in the chest
This symptom can also be attributed to the phenomena of PMS. From the moment of conception, sensations in the mammary glands change dramatically. That is before a woman did not feel her bosoms at all, but now the slightest touching her breasts causes pain. Swelling of the breasts is also noted.
A decrease in blood pressure is noted from the first days of pregnancy. Under the action of progesterone, the tone of smooth muscles, including the muscle layer of the vascular wall, decreases, which leads to relaxation of the vessels and an increase in their diameter.
Urination from the first days of pregnancy becomes more frequent but remains painless. This symptom is the result of the action of the same progesterone, increased blood circulation in the pelvic organs, including in the bladder and kidneys, which increases renal filtration and urine production. Frequent urination persists until the very birth (in later periods, frequent visits to the toilet also provoke pressure from the pregnant uterus on the bladder).
Signs of early toxicosis
Nausea, perversion of taste and smell, intolerance to various odors, salivation – all these phenomena refer to early toxicosis, although they are possible with a number of other disorders (poisoning, pathology of the digestive tract, infection). Signs of early toxicosis are not so often noticed before menstruation is delayed, and even after the fact of pregnancy is established, not all women have.
Is a delay in menstruation pregnancy?
A delay in menstruation is not considered a reliable sign of pregnancy, especially in those women whose menstrual cycle was noted to be irregular. Before you run to the doctor with joy or in a panic, you should wait at least 5 – 7 days (counting from the first day of the expected and not coming menstruation). Then take a gestation test, taking into account all the rules. If the result is negative, it is suggested to repeat the test after 3, or at least 1 day.
In addition to a positive test, other signs of pregnancy are possible:
- Early toxicosis became more pronounced or only manifested;
- Breast tenderness, engorgement, and swelling;
- Bleeding through of the venous pattern on the mammary glands;
- Skin problems (the appearance of acne, even if it was not there before);
- Increased vaginal discharge, they became creamy and milky;
- Stretching in the lumbar region and/or lower abdomen;
- Constipation followed by diarrhea (the effect of progesterone );
- Sleepiness during the day, sleeplessness at night;
- Sudden mood swings;
- Fainting is possible (as a sign of arterial hypotension);
- Increased appetite or its complete absence (in case of toxicosis);
- A tendency to edema (swelling of the face after the legs, slight swelling of the arms and legs);
- Darkening of the white line of the abdomen and areolae;
- Basal temperature is steadily elevated (above 37);
- The appearance of headaches and migraines;
- Change in libido (increase or decrease).
To finally eliminate doubts, you should visit a doctor. During a gynecological examination (even in the early stages of pregnancy), the doctor reveals the following signs, indirectly confirming the “interesting situation”:
- Darkening of the skin, up to dark brown, of the external genital organs;
- Easing of the neck, changing its color from pale pink to cyanotic (cyanotic);
- Softening of the uterus, perhaps some rise in its early stages, and later the enlarged uterus is well palpated according to the delay time (8 weeks – female fist, 10 weeks – male fist, and so on).
To establish the final diagnosis, the gynecologist will prescribe an ultrasound scan (preferably with a transvaginal sensor), and in controversial cases, he will recommend donating blood for hCG.