Specialist: Dr Ida Lilywaty Md Latar

Specialty: Obstetrics & Gynaecology

Hospital: Pantai Hospital Cheras (PHC)

You’re pregnant! Congratulations! The next 9 months are going to filled with lots of happy moments as you prepare for your little bundle of joy. Among the happy moments, you might also encounter a few challenges and lots of changes – not just physically but emotionally as well. Here, Dr Ida Lilywaty summarised what you’ll be going throughout the 3 trimesters of pregnancy and have included some helpful tips to keep in mind throughout each trimester.

 

First Trimester (1-3 months)

Weight Gain:

1 to 1.5 kg in total

 

Physical Changes:

Fatigue, headache, lightheadedness, nausea, vomiting, dyspepsia, bloatedness, frequent urination, increased vaginal secretion

 

Emotional Changes:

Fatigue, easily stressed, morning sickness

 

Critical Nutrients:

Folate, vitamin B12, zinc

Sources:

Dark leafy vegetables, eggs, meat, asparagus, pumpkin seeds.

 

Appetite and Healthy Tips:

Usually less/poor appetite due to nausea and sometimes vomiting. Avoid gas containing food, spicy and oily foods as it may upset your stomach. Ginger may reduce symptoms of nausea and vomiting (not in high amount).

 

Check-Ups:

• Ultrasound by 10 weeks to confirm date of delivery
• Another ultrasound at 11-14 weeks for nuchal translucency (estimating risks for Down Syndrome)
• Offer antenatal screening (triple test)

 

Tips:

• Limit high fat foods, sugar and caffeine intake.
• Stop smoking & avoid alcohol

---

 

Second Trimester (4-6 months)

Weight Gain:

1.5 to 2 kg each month until you give birth.

 

Physical Changes:

Breast tender and swollen, skin gets darker, rosy and shiny, growing belly, thin and whitish discharge, quickening (first fetal movement felt), swollen legs, stretch marks, dental caries and sometimes gingivitis.

 

Emotional Changes:
Forgetfulness, body image issues (face may look more puff

 

Critical Nutrients:

Iron, Calcium, Vitamin D, protein, DHA

Sources:

Lean beef, beans, chicken, fish, nuts. peanut butter, milk, yogurt, cheese, cabbage, tofu, eggs dark green, leafy vegetable, citrus fruits, enriched breads or cerealsNote: Iron supplement given is best taken with vitamin C containing food to optimize its absorption and best avoided taken together with egg and milk.

**300 extra calories daily needed to maintain healthy pregnancy (FDA recommendation)

 

Appetite and Healthy Tips:

Appetite improves but needs to follow dietary guidance properly or else there will be tendency of excessive weight gain. Sugar intake should be in moderation.

 

Beauty Tips:

Adequate sleep. Avoid dehydration. Moisturizing cream may help as skin may get drier due to hormonal effect.

 

Check-Ups:

• Ultrasound at 16 weeks and discuss on result of antenatal screening done.
• Ultrasound at 18 to 24 weeks to look for fetal anomalies. Gender can also be determined by now.
• For each visit onwards till delivery, blood pressure and urine will be taken to check for protein and sugar.
• For those at risk of diabetes in pregnancy, a screening with oral glucose test (OGTT) will be done.

 

Tips:

• Limit high fat foods, sugar and caffeine intake.
• Stop smoking & avoid alcohol.

---

 

Third Trimester (7–9 months)

Weight Gain:

1.5 to 2 kg each month until you give birth.

 

Physical Changes:

Slightly short of breath and easily tired, dyspepsia, frequency, fetal movement felt, more swollen legs and sometimes visible veins, constipation, urinary frequency, lower back and pubic pain, Braxton-Hicks contraction.

 

Emotional Changes:
Anxiety especially for first time mothers, sometimes fear and weepiness, ‘nesting instinct’.

 

Critical Nutrients:

Iron, Calcium, Vitamin D, protein, DHA

Sources:

Lean beef, beans, chicken, fish, nuts. peanut butter, milk, yogurt, cheese, cabbage, tofu, eggs dark green, leafy vegetable, citrus fruits, enriched breads or cereals.

 

Appetite and Healthy Tips:

• Appetite usually improves and able to take more usual food as in prepregnancy.
• Avoid food binging at this period as it may cause bloatedness and severe dyspepsia.

 

Check-ups:

• Ultrasound at 28, 31, 34, 36, 38, 40 and 41 weeks for fetal surveillance and growth monitoring.
• Also to estimate fetal weight near delivery and presentation of the fetus (cephalic or breech)