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<p>There are many relevant topics besides sonography and prenatal testing in the first trimester. The first symptoms of pregnancy are often recognized around 5–6&#xa0;gestational weeks. Especially hyperemesis gravidarum and fatigue can significantly impair quality of life. For the pharmacological management of hyperemesis gravidarum, doxylamine–pyridoxine is an approved first-line treatment. If insufficient, medications such as ondansetron may be effective; however, ondansetron should be avoided during the first trimester due to safety concerns. Fatigue during pregnancy is frequently attributable to sleep apnea syndrome. Other potential causes include restless legs syndrome and increased evening exposure to artificial light. Regular physical activity during pregnancy has numerous beneficial effects and should be an integral component of antenatal counseling. Vaginal bleeding in early pregnancy is common, with a&#xa0;prevalence of approximately 15%, but does not lead to miscarriage in most cases. In the case of threatened miscarriage (<i>abortus imminens</i>), expectant management is recommended. Bed rest has not demonstrated benefit and should not be advised. A&#xa0;rare but serious complication is posterior uterine sacculation in the context of a&#xa0;retroverted/retroflexed uterus. This condition carries the risk of uterine rupture, fetal growth restriction, and preterm birth later in pregnancy. Repositioning the uterus before 20&#xa0;weeks of gestation is essential. If the uterus remains retroverted/retroflexed, a&#xa0;cesarean section at 36&#xa0;weeks’ gestation should be planned. Due to changed anatomy, the uterine incision should be made more cranially than usual.</p>

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Die Frühschwangerschaft

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月9日

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  • Christina Louisa Coelius,
  • Tilo Burkhardt

摘要

There are many relevant topics besides sonography and prenatal testing in the first trimester. The first symptoms of pregnancy are often recognized around 5–6 gestational weeks. Especially hyperemesis gravidarum and fatigue can significantly impair quality of life. For the pharmacological management of hyperemesis gravidarum, doxylamine–pyridoxine is an approved first-line treatment. If insufficient, medications such as ondansetron may be effective; however, ondansetron should be avoided during the first trimester due to safety concerns. Fatigue during pregnancy is frequently attributable to sleep apnea syndrome. Other potential causes include restless legs syndrome and increased evening exposure to artificial light. Regular physical activity during pregnancy has numerous beneficial effects and should be an integral component of antenatal counseling. Vaginal bleeding in early pregnancy is common, with a prevalence of approximately 15%, but does not lead to miscarriage in most cases. In the case of threatened miscarriage (abortus imminens), expectant management is recommended. Bed rest has not demonstrated benefit and should not be advised. A rare but serious complication is posterior uterine sacculation in the context of a retroverted/retroflexed uterus. This condition carries the risk of uterine rupture, fetal growth restriction, and preterm birth later in pregnancy. Repositioning the uterus before 20 weeks of gestation is essential. If the uterus remains retroverted/retroflexed, a cesarean section at 36 weeks’ gestation should be planned. Due to changed anatomy, the uterine incision should be made more cranially than usual.