Pregnancy: early signs, trimesters and prenatal care

Pregnancy brings many physical and emotional changes. Some women notice symptoms before their period is due, while others experience almost no early signs. Every pregnancy is different, and symptoms alone cannot confirm whether you are pregnant.

A home pregnancy test can provide an initial answer. Once pregnancy is confirmed, it is advisable to arrange an appointment with a gynaecologist and start prenatal care early. Regular examinations help monitor the health of both the pregnant woman and the developing baby.

At Republikas laukuma klīnika in central Riga, you can receive a gynaecologist’s consultation, pregnancy ultrasound examinations and individual recommendations for prenatal care.

Pregnancy due date calculator

Calculating the due date is one of the first steps in planning the coming months. A pregnancy calculator is a simple digital tool that helps determine the approximate date of delivery and calculate the current week of pregnancy. It is the first assistant women usually use upon learning of their pregnancy to navigate their new timeline.

How does a pregnancy calculator work?

Most calculators are based on Naegele’s rule. The calculation is based on the assumption that pregnancy lasts 280 days or 40 weeks, counting from the first day of the woman’s last menstrual period. To get a result, follow these steps:

• Identify the first day of your last period. You need to know this date; even if the bleeding was light that day, use the very beginning for the calculation.
• Select the date: In the pregnancy calculator window, click the calendar icon and select the relevant date.
• Press “Calculate”: After pressing the button, the screen will display the date corresponding to the 40th week of pregnancy.

Early signs of pregnancy

Early pregnancy symptoms commonly begin at around four to six weeks of pregnancy, although they may appear earlier or later. Some women have only one or two symptoms, while others experience several.

A missed period

For women with a regular menstrual cycle, a missed period is often the first noticeable sign of pregnancy. However, delayed menstruation may also be caused by stress, illness, hormonal changes, intensive physical activity or changes in body weight.

A pregnancy test is therefore required to determine whether pregnancy is the likely cause.

Nausea and vomiting

Pregnancy-related nausea is commonly known as morning sickness, but it can occur at any time of the day or night. It often begins between weeks four and seven and usually improves during the second trimester.

If vomiting is frequent and you cannot keep fluids down, medical advice is necessary. Severe and persistent vomiting may indicate hyperemesis gravidarum, which can lead to dehydration and may require treatment.

Breast tenderness

Hormonal changes may cause the breasts to feel swollen, heavy or tender. The nipples and the surrounding area may become darker. Similar breast changes can also occur before menstruation, so this symptom alone does not confirm pregnancy.

Fatigue

Feeling unusually tired is common during the first trimester. Hormonal changes, particularly rising progesterone levels, contribute to fatigue. The body is also adapting to increased blood volume and the development of the placenta.

More frequent urination

You may need to urinate more frequently than usual. This can begin early in pregnancy as blood flow through the kidneys increases.

Pain, burning or discomfort during urination is not considered a normal pregnancy symptom and may indicate a urinary tract infection.

Changes in smell, taste and appetite

Some women become more sensitive to certain smells or notice a metallic taste in the mouth. Food preferences may change, and previously enjoyed foods can suddenly become unappealing.

Light bleeding or spotting

Light spotting can occur in early pregnancy, including around the time a period would normally be expected. However, bleeding during pregnancy should not automatically be assumed to be harmless.

Contact a healthcare professional if you experience bleeding, particularly when it is heavy, persistent or accompanied by abdominal pain, shoulder pain, weakness or dizziness.

When should you take a pregnancy test?

Most home pregnancy tests can be used from the first day of a missed period. If you do not know when your period is due, follow the instructions provided with the test.

A negative result may be unreliable if the test is performed too early. If your period has not started, repeat the test after a few days or consult a healthcare professional.

A positive home test is usually reliable when the instructions have been followed correctly. A gynaecologist can confirm the pregnancy and advise you about the next steps.

Pregnancy trimesters

Pregnancy is divided into three trimesters. Each trimester is associated with different stages of fetal development and changes in the pregnant woman’s body.

First trimester: weeks 1–12

During the first trimester, the baby’s major organs and body systems begin to develop. Common symptoms include:

• nausea or vomiting;
• breast tenderness;
• fatigue;
• frequent urination;
• changes in appetite;
• increased vaginal discharge;
• mild abdominal discomfort;
• mood changes.

The first prenatal consultation is an opportunity to discuss previous pregnancies, chronic conditions, medications, allergies and lifestyle factors. Your doctor will explain which tests and ultrasound examinations are recommended.

Do not stop prescribed medication without consulting the doctor who manages your treatment.

Second trimester: weeks 13–27

Many women find the second trimester more comfortable because nausea and fatigue may improve. The abdomen becomes more visible as the uterus grows.

Changes during this trimester may include:

• feeling the baby move;
• continued breast growth;
• back or pelvic discomfort;
• ligament pain in the lower abdomen or groin;
• skin pigmentation changes;
• heartburn or constipation.

Fetal movements are commonly first noticed between approximately 16 and 24 weeks, although the timing varies between pregnancies.

Third trimester: from week 28 until birth

During the third trimester, the baby continues to grow and gain weight. The enlarging uterus places increasing pressure on surrounding organs.

Common symptoms may include:

• back and pelvic discomfort;
• shortness of breath during physical activity;
• heartburn;
• sleeping difficulties;
• frequent urination;
• swelling of the feet and ankles;
• irregular Braxton Hicks contractions.

Mild swelling can occur during pregnancy. Sudden swelling of the face, hands or feet, particularly with a severe headache or visual disturbance, requires urgent medical assessment.

Common health problems during pregnancy

Most pregnancies progress without serious complications. Nevertheless, regular prenatal examinations are important because some conditions may initially cause few noticeable symptoms.

Gestational diabetes

Gestational diabetes is high blood glucose first diagnosed during pregnancy. It develops when the body cannot produce enough insulin to meet the increased demands of pregnancy.

Screening is performed at the appropriate stage of pregnancy and may be recommended earlier when additional risk factors are present. Treatment can include dietary changes, physical activity, blood glucose monitoring and medication when necessary.

Pre-eclampsia

Pre-eclampsia is a pregnancy-related condition associated with high blood pressure and other signs of organ involvement. It most commonly develops after 20 weeks, although it may also occur after delivery.

Warning signs can include:

• a severe or persistent headache;
• blurred vision or flashing lights;
• pain below the ribs;
• sudden swelling of the face, hands or feet;
• vomiting or feeling very unwell.

Blood pressure and urine examinations during prenatal appointments help detect possible pre-eclampsia, including cases without obvious symptoms. Suspected pre-eclampsia requires specialist assessment and closer monitoring. Treatment depends on the gestational age and severity of the condition.

Iron deficiency anaemia

The body needs more iron during pregnancy. Insufficient iron may lead to anaemia, which can cause fatigue, weakness, dizziness, palpitations or shortness of breath.

A blood test can assess haemoglobin and iron-related indicators. Iron supplements should be taken according to a healthcare professional’s recommendation.

Constipation

Hormonal changes can slow bowel movement during pregnancy. Reduced physical activity, changes in diet and iron supplements may also contribute to constipation.

Drinking enough water, eating fibre-rich foods and remaining physically active can help. Ask your doctor or pharmacist before using medication for constipation during pregnancy.

Infections

Some infections can affect pregnancy or fetal development. Prenatal care includes appropriate screening based on national recommendations, medical history and individual risk factors.

Seek medical advice if you develop fever, painful urination, an unusual vaginal discharge, persistent vomiting or diarrhoea, or if you have been exposed to an infection that may be relevant during pregnancy.

What should be avoided during pregnancy?

Recommendations should be adapted to your health and pregnancy, but general precautions include:

• avoiding alcohol;
• avoiding smoking, vaping and recreational drugs;
• avoiding raw or undercooked meat and seafood;
• avoiding unpasteurised milk and products made from it;
• washing fruit and vegetables thoroughly;
• limiting caffeine;
• avoiding overheating and dehydration;
• checking all medicines and supplements with a healthcare professional;
• using gloves when gardening or handling cat litter to reduce exposure to toxoplasmosis.

Do not begin herbal remedies or dietary supplements simply because they are described as natural. Some products are not suitable during pregnancy.

When should you seek urgent medical help?

Seek urgent medical assessment if you experience:

• heavy vaginal bleeding;
• severe or one-sided abdominal pain;
• shoulder-tip pain with bleeding or dizziness;
• fainting or marked weakness;
• a severe headache or visual disturbance;
• sudden swelling of the face or hands;
• chest pain or severe difficulty breathing;
• fever or signs of a serious infection;
• persistent vomiting and inability to drink;
• leaking fluid from the vagina;
• regular painful contractions before term;
• a noticeable reduction in your baby’s movements after movements have become established.

For a medical emergency in Latvia, call 113.

When should you see a gynaecologist?

Arrange a consultation after a positive pregnancy test or when pregnancy is suspected. Starting prenatal care early allows the doctor to:

• confirm and assess the pregnancy;
• estimate gestational age and the due date;
• review your medical and obstetric history;
• evaluate medications and chronic conditions;
• recommend appropriate blood and urine tests;
• plan ultrasound examinations;
• discuss nutrition, supplements and physical activity;
• create an individual pregnancy care plan.

An earlier consultation may be needed if you have pain, bleeding, a previous ectopic pregnancy, recurrent pregnancy loss, a chronic medical condition or concerns about medication use.

Prenatal care in central Riga

At Republikas laukuma klīnika, our gynaecologists provide consultations and pregnancy-related examinations in a calm, supportive environment.

The clinic is located at Republikas laukums 3–18, Riga, on the first floor of Centra nams, with the entrance from the side of the Ministry of Agriculture.

To arrange a consultation, use the online booking system or call +37128 002 363.

Frequently asked questions

What are the earliest signs of pregnancy?

A missed period is often the first noticeable sign in women with regular cycles. Other possible symptoms include nausea, breast tenderness, fatigue, frequent urination and changes in smell or taste. Symptoms vary, and a pregnancy test is needed for confirmation.

When should I take a pregnancy test?

Most home tests can be used from the first day of a missed period. If the result is negative but menstruation has not started, repeat the test after a few days.

How is the due date calculated?

The estimated due date is commonly calculated as 40 weeks from the first day of the last menstrual period. An ultrasound examination may provide a more accurate estimate, particularly when the menstrual cycle is irregular.

When should the first pregnancy appointment take place?

Contact a gynaecologist after receiving a positive pregnancy test. Early prenatal care is particularly important if you have a chronic condition, take regular medication or experience pain or bleeding.

Is light bleeding normal in early pregnancy?

Light spotting can occur, but bleeding should not automatically be considered normal. Contact a healthcare professional, especially if bleeding is heavy, persistent or accompanied by pain, dizziness or weakness.

Is abdominal pain normal during pregnancy?

Mild, temporary discomfort can occur as the body changes. Severe, persistent or one-sided pain, particularly with bleeding, shoulder pain or faintness, requires urgent medical assessment.

Can I exercise during pregnancy?

Physical activity is generally beneficial in an uncomplicated pregnancy, but the type and intensity should be appropriate for your health and previous activity level. Ask your gynaecologist for individual advice.

When can an ultrasound confirm pregnancy?

The timing depends on the purpose of the examination and the individual situation. A very early ultrasound may not yet show all expected structures, so the gynaecologist will recommend the appropriate time and explain whether a repeat examination is necessary.