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Missed menstruation is the main sign of early pregnancy. Pregnancy is suspected whenever a woman misses a menstrual period, which practically means that she notices that a week or more has gone by without menstruation.

If there is a history that there has been no or ineffective contraception, then the suspicion that the woman could be pregnant is increased. 100 percent compliance with contraceptive measures does not mean that a woman cannot get pregnant because no measure is 100 percent effective.

Vaginal bleeding could be relatively common in the early part of pregnancy. Nine percent of women experienced vaginal bleeding in the first eight weeks of pregnancy, in one study. Bleeding was noticed at the expected day of menstruation and was light requiring one to two pad changes

The most common signs and symptoms of early pregnancy are:

  • Loss of menstruation
  • Vomiting and/or nausea
  • Enlargement of the breasts with pain
  • Going for urination multiple times without burning in the urine
  • Fatigue

Additional signs and symptoms include:

  • Uterine cramps without bleeds
  • Bloating of abdomen
  • Constipation
  • Heartburn
  • Feeling stuffy in the nose
  • Feeling out of breath
  • Craving for some food and aversion to others
  • Changes in mood
  • Lightheadedness
  • Spider-like change in blood vessels (often very small) present on the back or chest
  • Redness in the hands
  • Increased pigmentation of face, areola and midline of abdomen

The hormone hCG is primarily used for diagnosis of pregnancy. Ultrasound can be used to see the fetus or the fetus heart beating but it will depend on how many weeks the pregnancy is. Transvaginal ultrasound can detect it as early as 5 weeks of pregnancy.

The most sensitive way to check hCG is to test the blood for it.

A urine pregnancy test could be less sensitive than a blood pregnancy test, but almost all women will have a positive urine pregnancy test one week after the first day of missed period.

Home pregnancy tests depend on the accuracy of the test kit and the user's interpretation as well as the technique a woman used. As much as 46 percent of women might have a negative test on the first day after a missed period. If a home kit tests positive, it should always be confirmed with a blood test at the doctor's visit or an alternative method could be to visualize the fetus' heart beats with ultrasound.

When to be cautious:

1. Any bleeding associated with pain or which is more than spotting which is the normal bleeding some pregnant women tend to have as described above. There may be a chance of miscarriage or ectopic pregnancy.

2. Vomiting. If it starts after 10 weeks, it should be concerning. Other causes should be considered. If you lose more than five percent of body weight because of vomiting, then you must be managed in a hospital. Or if you vomit more than 3 or more times a day with a weight loss of more than 3 kg of body or five percent of body weight.

3. If you have burning while urinating, a urine infection should be suspected.

4. If breathing difficulties (not the normal pregnancy "out-of-breaths") starts suddenly or is associated with cough, wheezing, coughing up blood, then you need medical attention.

5. Pseudocyesis. This is a psychiatric illness in which a woman has a false belief in being pregnant. Other signs and symptoms of pregnancy may be present. Confirmation is done by methods described above.

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