First Trimester Pregnancy Care — Weeks 1 to 12
The first trimester spans conception to 12 completed weeks and represents the most critical period of fetal organogenesis. Early, structured medical care during this window establishes the foundation for the entire pregnancy. At Balaji Horizon Women’s Hospital, we recommend your first antenatal visit before 10 weeks of gestation.
Your First Visit — What to Expect
At your first visit, we confirm the intrauterine location of the pregnancy via transvaginal ultrasound, assess cardiac activity, calculate the accurate expected date of delivery (EDD) using crown-rump length (CRL), and rule out early complications including threatened abortion, missed abortion, ectopic pregnancy, and gestational trophoblastic disease. A detailed medical and obstetric history is taken and a formal risk stratification is completed.
Nuchal Translucency Scan (11–13+6 Weeks)
The NT scan, performed between 11 weeks 0 days and 13 weeks 6 days, measures the fluid-filled space at the back of the fetal neck (nuchal translucency) and combines it with serum biochemistry (PAPP-A and free β-hCG) to generate a risk estimate for chromosomal anomalies including Trisomy 21 (Down syndrome), Trisomy 18, and Trisomy 13. An increased NT may also indicate cardiac defects or other structural anomalies. Our Fetal Medicine Unit performs all NT scans to FMF-accredited standards with trained specialists.
First Trimester Investigations
Routine investigations arranged in the first trimester include: blood group and Rh typing, complete blood count, haemoglobin electrophoresis (for sickle cell and thalassaemia carrier status — important in Gujarat), urine culture and sensitivity, blood glucose (fasting and 2-hour postprandial), thyroid function (TSH), HIV, HBsAg, VDRL/RPR, Rubella IgG serology, and urine protein/creatinine ratio for pre-eclampsia risk profiling. High-risk patients also receive renal function tests and autoimmune workup.
Aspirin Prophylaxis for Pre-Eclampsia
Women identified as high risk for pre-eclampsia based on first-trimester combined screening (uterine artery Doppler, mean arterial pressure, PAPP-A, history) are offered low-dose aspirin (150 mg at bedtime) from 11–14 weeks as per FIGO 2019 guidelines. Early identification and initiation before 16 weeks has been shown to reduce preterm pre-eclampsia by 62% (ASPRE trial). We follow this protocol at Balaji Horizon.
Folic Acid and Supplementation
All women are counselled on folic acid supplementation — ideally started pre-conception and continued through the first trimester to reduce the risk of neural tube defects. Women with prior NTD-affected pregnancy, epilepsy, or diabetes receive 5 mg daily; all others receive 0.4–1 mg daily. Iron supplementation is initiated based on haemoglobin levels at booking.
When to Seek Urgent Care in the First Trimester
Contact us immediately if you experience: heavy vaginal bleeding, passage of tissue, severe lower abdominal pain, one-sided shoulder-tip pain (possible ectopic), persistent vomiting preventing fluid intake (hyperemesis gravidarum), fever, or urinary burning and frequency. Our emergency obstetric team is available 24/7.
Schedule your first trimester visit: Call +91 +91 97234 31544 | Balaji Horizon Women’s Hospital, Science City Road, Ahmedabad.