Maggie McKay (Host): Welcome to Vital Signs, Candid Conversations With Providers Who Care from Jackson Hospital. I'm your host, Maggie McKay. Today we're going to discuss the first trimester of pregnancy and why it's so important with OBGYN, Dr. Nisa Cubro. Thank you so much for joining us.

Hajrunisa Cubro, MD, MS: Hi, Ms. Maggie. Thank you for having me. Very excited to be with you.

Host: Let's start with what are typical early pregnancy questions that you hear from your patients during the first trimester, and how do you answer them?

Hajrunisa Cubro, MD, MS: A lot of my patients have a little bit of cramping and maybe some spotting early on in pregnancy and they come with questions about that. Is that normal? Should they be worried about it? And we kind of have to discuss what could be accepted as normal and what could be potential sign of miscarriage.

In general, when the symptom is very mild, not worsening, transient, in general that is a sign of normal pregnancy. However, on the opposite side, if there is a lot of pain, worsening bleeding, a very abnormal discharge; that all can be a sign of either miscarriage or some kind of infection that we would need to look more into.

Host: Tell me more about bleeding. What we need to know.

Hajrunisa Cubro, MD, MS: Some spotting in pregnancy is fairly common, because cervix of the uterus gets a lot of blood flow during pregnancy. Sometimes even light activity can trigger some of the bleeding or spotting. However, if the bleeding, is persistent or if it's accompanied with a lot of cramping, or if it's very heavy, those all can be a sign of miscarriage.

Also, if it's accompanied with a severe pain, can be a sign of ectopic pregnancy. In general, that should be evaluated. And we'll check, make sure that everything is okay.

Host: At what point should patients call you?

Hajrunisa Cubro, MD, MS: I tell them, if they're concerned with any question, they should go ahead and call. It's better to call and clarify what's going on than to wait, too long and be too late for treatment or evaluation. There are some things that are worrisome, such as very bad pain, excruciating pain, like all of a sudden, or a lot of bleeding. Those would be symptoms that definitely need immediate evaluation.

Host: And what else are patients asking you about that first trimester?

Hajrunisa Cubro, MD, MS: There are many complaints such as very frequent urination, then breast tenderness, nausea, vomiting, some patients feel dizzy. Some have some shortness of breath. So all fairly common symptoms, may be normal, but also may be signs of a problem.

Host: And what lifestyle changes do you suggest to your patients?

Hajrunisa Cubro, MD, MS: Oh, as far as lifestyle during pregnancy, that is very important topic that we discuss together. It all kind of circles back to a healthy lifestyle, meaning, avoiding any bad habits such as smoking, drinking, illicit substances, but also exercise, and healthy diet. As far as exercise, I tell my patients, to make it a goal to be physically active at least 30 minutes every day.

It really depends on, in what kind of shape they are before pregnancy. So, they can either be exercising regularly before pregnancy. So, I encourage them to continue whatever they're doing. Or, if the patient hasn't been really, living the healthy lifestyle, then I encourage them at least 30 minutes of brisk walking.

As far as the diet goes, I tell them to try to eat twice as healthy, not twice as much. So, turning to baked over fried, baked and cooked. Taking in more protein, avoiding simple carbohydrates, and turning more to complex carbohydrates such as oatmeal, potatoes, rice, and then also eating more fruits and vegetables.

And very importantly, also keeping themselves, well hydrated.

Host: Is there anything else you would recommend for early pregnancy that you think is important to know?

Hajrunisa Cubro, MD, MS: I recommend my patients, to trust their instincts. If they're concerned, to ask questions, and be evaluated, to learn more about what is normal in pregnancy. So to read either online or get some books. The more they know, the better their decisions are going to be, and I tell them to enjoy their pregnancy, it's going to go by very quickly.

Host: Good advice. Thank you so much for sharing this important information. We really appreciate you and knowing your expertise.

Hajrunisa Cubro, MD, MS: My pleasure, anytime.

Host: Again, that's Dr. Nisa Cubro. To find out more, please visit jacksonclinic.org. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. Thanks for listening to Vital Signs, Candid Conversations With Providers Who Care.