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Week 5
MDAdvice.com Home > Health Library > Your Pregnancy: Week by Week > Previous Week > Contents > Next Week

If you've just found out you're pregnant, you might want to start by reading the previous sections.

How Big Is Your Baby?

Your developing baby hasn't grown a great deal. It's about 0.05 inch (1.25mm) long.

How Big Are You?

At this point, there are still no big changes in you. Even if you are aware you're pregnant, it will be awhile before others notice your changing figure.

How Your Baby Is Growing and Developing

As early as this week, a plate that will later become the heart has developed. The central nervous system (brain and spinal cord), and muscle and bone formation are beginning to take shape. During this time, your baby's skeleton is also starting to form.

Changes in You

Many changes are occurring now. You may be aware of some of them; others will be evident only after some kind of test.

Pregnancy Tests

Pregnancy tests have become more sensitive, which makes early diagnosis of pregnancy more common. Tests detect the presence of human chorionic gonadotropin (HCG), a hormone of early pregnancy. A pregnancy test can be positive before you have even missed a period! Many tests can provide positive results (pregnant) 10 days after you become pregnant. But it's usually best to wait until you have missed a period before investing money and emotional energy in pregnancy tests, whether done at a hospital, in a clinic or at home.

Most home tests range in price from $12 to $30. They vary in how effective they are in helping you ôdiagnoseö your pregnancy. Many hospitals or clinics offer free pregnancy testing, which can save you some money.

Nausea and Vomiting

An early symptom of pregnancy for some women is nausea, with or without vomiting. This is often called morning sickness, whether it occurs in the morning or later in the day. It usually starts early in the day and improves during the day as you become active. Morning sickness can begin around the 6th week of pregnancy and usually improves by the end of the first trimester (around 13 weeks).

Many women have nausea. It doesn't usually cause enough trouble to require medical attention. However, a condition called hyperemesis gravidarum (severe nausea and vomiting) causes a great deal of vomiting, which results in loss of nutrients and dehydration. The pregnant woman is often treated in the hospital with intravenous fluids and medications. Hypnosis has also been used successfully in treating the problem.

There is no completely successful treatment for the normal nausea and vomiting of pregnancy, nor are there currently any approved medications for it.

This is an extremely important period in the development of your baby. Don't expose your unborn baby to medication, herbs, over-the-counter treatments or any other ôremediesö for nausea that neither you nor your doctor know to be safe during pregnancy. Discuss ways to deal with nausea with your healthcare provider.

Other Changes You May Notice

In early pregnancy, you may notice you need to urinate frequently. It can continue during most of your pregnancy and become particularly annoying near delivery, as your uterus enlarges and puts pressure on your bladder.

You may notice changes in your breasts. Tingling or soreness in the breasts or nipples is common. You may also see a darkening of the areola or an elevation of the glands around the nipple.

Another early symptom of pregnancy is tiring easily. This very common symptom may continue through pregnancy. Be sure to take your prenatal vitamins and any other medications prescribed by your doctor, and get enough rest.

How Your Actions Affect Your Baby's Development

When Should You Visit the Doctor?

One of the first questions you may ask yourself when you suspect you're pregnant is, ôWhen should I see a doctor?ö

Good prenatal care is necessary to deliver a healthy baby from a healthy mother. Make an appointment to see your physician as soon as you are reasonably sure you're pregnant. This could be as early as a few days after a missed period. For the health of your baby, as well as your own health and well-being, seek care early.

Getting Pregnant While Using Birth Control

If you have been using some type of birth control, it's important to tell your doctor. No method is 100% effective. Occasionally a method fails, even oral contraceptives. If you are sure you're pregnant, stop taking the pill and see your doctor as soon as possible. Don't become overly alarmed if this happens to you; talk to your doctor about it.

Pregnancy can also occur with an IUD (intrauterine device) in place. If this happens, it's important to see your doctor immediately. Discuss whether you should remove the IUD or leave it in place. In most cases, an attempt is made to remove the IUD. If left in place, the risk of miscarriage increases slightly.

Spermicides used alone, or with a condom, sponge or diaphragm, are frequently in use when pregnancy occurs. They have not been shown to be harmful to a developing baby.

You Should also Know

Ectopic Pregnancy

As described in Weeks 1&2, fertilization occurs in the Fallopian tube. The fertilized egg travels through the tube to the uterus, where it implants on the cavity wall. An ectopic pregnancy occurs when implantation occurs outside the uterine cavity, usually in the tube itself. Ninety-five percent of all ectopic pregnancies occur in the tube (hence the term ôtubal pregnancyö). Other possible sites of implantation are the ovary, cervix or other places in the abdomen. The illustration on page 57 shows some possible locations of an ectopic pregnancy.

Ectopic pregnancy occurs in 1 out of every 100 pregnancies. Chances of an ectopic pregnancy occurring increase with damage to the Fallopian tubes from pelvic inflammatory disease (PID), from other infections, such as a ruptured appendix, or from abdominal surgery. If you have had a previous ectopic pregnancy, there is a 12% chance of recurrence. Use of an intrauterine device (IUD) also increases the chance of ectopic pregnancy.

Symptoms of an Ectopic Pregnancy

Symptoms include vaginal bleeding, pain in the abdomen and other signs, such as tender breasts or nausea. However, it may be difficult for your doctor to diagnose an ectopic pregnancy because many of these symptoms can be present in a normal pregnancy.

Diagnosing Ectopic Pregnancy

To test for an ectopic pregnancy, human chorionic gonadotropin (HCG), a hormone produced during pregnancy, is measured. The test is called a quantitative HCG. The level of HCG increases very rapidly in a normal pregnancy and doubles in value about every 2 days. If HCG levels do not increase as they should, an abnormal pregnancy is suspected. In the case of an ectopic pregnancy, the woman may have a high HCG level with no sign of a pregnancy inside the uterus.

Ultrasound testing is also helpful in diagnosing an ectopic pregnancy. (Ultrasound is discussed in detail in Week 11.) A tubal pregnancy may be seen in the tube during ultrasound examination. Doctors may see blood in the abdomen from rupture and bleeding or a mass in the area of the Fallopian tube or the ovary.

Our ability to diagnose an ectopic pregnancy has improved with use of laparoscopy. Very small incisions are made in the area of the bellybutton and in the lower-abdominal area. Doctors view the inside of the abdomen and the pelvic organs with a small instrument (called a laparascope). They can see an ectopic pregnancy if one is present.

An attempt is made to diagnose a tubal pregnancy before it ruptures and damages the tube, which could make it necessary to remove the entire tube. Early diagnosis also attempts to avoid the risk of internal bleeding from a ruptured, bleeding tube.

Most ectopic pregnancies are detected around 6 to 8 weeks of pregnancy. The key in early diagnosis involves communication between you and your doctor about symptoms and their severity.

Treatment for Ectopic Pregnancy

With an ectopic pregnancy, the doctor's goal is to remove the pregnancy while preserving fertility. Surgical treatment requires general anesthesia and laparoscopy or laparotomy (a larger incision and no scope), and recovery from surgery. In many instances, it is necessary to remove the Fallopian tube, which affects future fertility.

A new, nonsurgical treatment of an unruptured ectopic pregnancy involves the use of a cancer drug, methotrexate. Methotrexate is given through an I.V. in the hospital or outpatient clinic. Methotrexate is cytotoxic; it terminates the pregnancy. HCG levels should decrease after this treatment, which indicates the pregnancy has been terminated. Symptoms should improve.

What Sex Will Your Baby Be?

You can guess the sex of your child as well as your doctorùoften better! As I've mentioned, the sex of your baby is determined when the egg is fertilized by the baby's father's sperm.

Many couples ask for ways to ôget a boyö or ôget a girlö before they try to get pregnant. In a few cases, sperm separation is used. Male and female sperm are separated, and artificial insemination deposits the selected sperm in the woman. It's not a foolproof method, and it is expensive. This procedure may be done when there is a sex-specific problem, such as a family history of hemophilia.

Artificial Sweetener Use during Pregnancy

Many women use artificial sweeteners. Aspartame and saccharin are the two most common artificial sweeteners added to foods and beverages. Are they safe to use during pregnancy?

Aspartame (sold under the brand names Nutrasweet« and Equal«) may be the most popular, widely used artificial sweetener. It is used in many ôlow-calorieö foods and beverages to help reduce calorie content. Aspartame is a combination of phenylalanine and aspartic acid, two amino acids.

Recently, there has been controversy as to the safety of aspartame. I advise you to substitute foods that do not contain the sweetener. At this point we are unsure about aspartame's safety for pregnant women and their developing babies. Also, pregnant women who suffer from phenylketonuria must follow a low-phenylalanine diet or their babies may be adversely affected. The phenylalanine in aspartame contributes to phenyl-alanine in the diet.

Saccharin is another artificial sweetener used in many foods and beverages. Although it is not used as much today as in the past, it still appears in many foods, beverages and other substances. The Center for Science in the Public Interest reports testing of saccharin does not indicate that it is safe to use during pregnancy. It would probably be better to avoid using this product while you're pregnant.

Don't use artificial sweeteners or food additives during pregnancy if you can avoid them. I recommend eliminating any substance you don't really need from the foods you eat and the beverages you drink. Do it for the good of your baby.

One of my patients, Joy, was a little upset when I advised her to watch her artificial sweetener intake. She had told me she regularly drank a 2-liter bottle of diet soda every day. I told her she didn't have to give up the soda completelyùshe could have one can a day. I suggested she substitute unsweetened fruit juice and water flavored with lemon or other citrus juice for the rest of the day.

Weight Gain during Pregnancy

The amount of weight women gain during pregnancy varies greatly. It may actually range from weight loss to a total gain of 50 pounds or more.

We know complications arise at the extremes of these weight changes. Because of this, it's difficult to set one figure as an ôidealö weight gain during pregnancy. How much weight you gain is affected by your weight before you became pregnant. Many quote a weight-gain figure of 2/3 of a pound (10 ounces) a week until 20 weeks, then 1 pound a week from 20 to 40 weeks.

Other researchers have suggested weight-gain amounts acceptable for underweight, normal weight and overweight women. See the chart on page 61.

If you have any questions about your weight gain during pregnancy, discuss them with your physician. He or she will advise you and guide you about how much weight you should gain during pregnancy.

Dieting during pregnancy is not a wise idea, but that doesn't mean not watching your caloric intake. You should! It's important for your baby to get proper nutrition from the foods you eat. Choose your foods for the nutrition they provide for you and your growing baby.

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