Being pregnant for the first time can be a very exciting yet scary time in a woman’s life. There are many physical and emotional changes, which occur with pregnancy. Understanding these changes will help you and your partner prepare for the weeks and months to come and will help you differentiate what is normal and what should be a cause of concern which you should address with your physician. Table 1 lists some of the normal symptoms of pregnancy. Dr. Rodriguez is a board-certified perinatologist and co-director of maternal-fetal medicine at the Pomona Valley Hospital Medical Center in Pomona , Calif.

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Many of the changes that you will experience are triggered by hormones that nurture the baby and prepare your body for childbirth and nursing. Additionally, as your baby grows, the size of your uterus increases to about 1000 times its original size putting strain on the organs that surround the uterus, on your back muscles and causing a change in your posture.
 

Table1.            Symptoms of Pregnancy      NORMAL       ABNORMAL Breast tenderness Constipation Frequent urination Heartburn Hemorrhoids Mood swings Nausea Stuffy nose Bleeding Headache unrelieved by analgesic. Painful urination Stomach pains Swelling of one leg Visual problems  Weight loss

Changes in your breasts may be one of the first signs of your pregnancy. By 6 - 8 weeks your breasts will be noticeably larger they will continue to grow in size and weight throughout the first trimester. They are usually firm and tender and the nipples and areolas will darken. The small glands in the areola will become raised and bumpy. By 12 -14 weeks the breasts may begin producing colostrum, this fluid may leak from your breast by itself or if you massage your breasts.

Nausea and vomiting are also common findings during the first 3 months, but may occur throughout the pregnancy. Although it is referred to as morning sickness it can occur any time during the day particularly on an empty stomach. It is not unusual for a woman to loose some weight during the early part of the pregnancy but if this becomes excessive you should notify your physician. 

Heartburn , indigestion and constipation during pregnancy are common because changes in hormones slow the movement of food through the digestive tract. During the last part of pregnancy pressure on your rectum to your uterus often worsens the constipation. 

Bleeding that occurs when the fertilized egg attaches to the uterus (womb) is called implantation bleeding. Implantation bleeding  is common and may be mistaken for a menstrual period. The bleeding usually lasts for 1 to 2 days. Spotting during the first trimester is also common and occurs in up to 1 in 4 pregnancies. Heavy  bleeding that lasts a long time is not common. You should contact your health care provider if you have concerns about vaginal bleeding, especially if the bleeding is heavy or you have additional symptoms such as abdominal pain, dizziness, shoulder pain, or you are passing tissue.

Hemorrhoids, swollen veins in the rectum, are also very common and can sometimes cause bleeding while having a bowel movement. If the bleeding is excessive notify your physician. Swollen veins (varicosities), also appear frequently in the legs but can also be found in the vulva and vagina. Varicosities can be uncomfortable but usually they are not a serious condition.
 

Table 2.       Safe Medications For Some Common                           Problems During Pregnancy Symptom  Medication Heartburn TUMs® Constipation Metamucil® , Citrucel®, Docusate (Colace®, Ducolax ®) Milk of magnesia. Hemorrhoids Tucks® Preparation H® Anusol®