Types of Pregnancy: A Comprehensive Guide for Expecting Parents

Every pregnancy is unique, and the experience of being pregnant differs for each person. This is because everyone is different and has different health problems. While most pregnancies follow a smooth path, some people have special circumstances that need extra care. It's good to know the different types of pregnancy so you can prepare yourself for what to expect and feel more confident.

What are the common types of pregnancy?

Pregnancies can be classified into several common types based on where the baby develops and whether you're carrying one or more babies. Each type has its own characteristics and care requirements.

Intrauterine pregnancy

An intrauterine pregnancy is the most common pregnancy type and occurs when the fertilised egg successfully implants within the uterine cavity. This pregnancy type is the most optimal, as the uterus provides ideal conditions for foetal growth, including proper blood supply, adequate space for development, and natural protection through the amniotic fluid and sac.

The vast majority of intrauterine pregnancies result in healthy, full-term deliveries, making this the most reassuring diagnosis you can receive when pregnancy is confirmed.

Singleton pregnancy

A singleton pregnancy involves carrying one baby and is the most common pregnancy type alongside intrauterine pregnancy.

Carrying a single baby offers the most straightforward prenatal experience with lower risks of complications such as preterm birth or low birth weight as compared to multiple pregnancies like carrying twins or triplets.

Your body is able to concentrate most of its nutrients on one baby, typically resulting in a more predictable pregnancy journey. Standard prenatal care includes regular check-ups, routine ultrasounds, and blood tests, with most singleton pregnancies progressing smoothly to full-term delivery between 37and 42 weeks.

Multiple pregnancy

Multiple pregnancy refers to the situation where you're carrying two or more babies simultaneously. These pregnancies can be either fraternal, where two separate eggs are fertilised by two different sperm, or identical (monozygotic), where a single fertilised egg splits into two or more embryos, giving rise to identical twins. Multiple pregnancies usually carry increased risks such as preterm birth, gestational diabetes, and preeclampsia. Your healthcare team may recommend specialist care from a maternal-foetal medicine doctor.

What are high-risk pregnancies?

A pregnancy where there's an increased risk and possibility of complications for the mother, baby, or both. This can stem from pre-existing medical conditions, pregnancy-related complications, maternal age, lifestyle factors, or pregnancy type (such as multiple pregnancy).

Being classified as a high-risk pregnancy doesn't mean that problems will occur. It just indicates that closer monitoring and specialised care are needed to ensure the best possible outcomes.

High-risk pregnancies often require more appointments, additional testing, and consultation with maternal-foetal medicine specialists. With proper medical management and monitoring, many women with high-risk pregnancies go on to have successful deliveries.

Molar pregnancy

Molar pregnancy is a type of gestational trophoblastic disease. Molar pregnancy is characterised by abnormal tissue developing in the uterus instead of the embryo. This happens when there's an error during fertilisation, resulting in abnormal chromosome patterns that cause the placental tissue to grow excessively despite no viable foetus developing. 

There are two main types of molar pregnancy:

• Complete molar pregnancies:

  • No normal foetal tissue forms

• Partial molar pregnancies:

  • Some normal foetal tissue may be present alongside abnormal tissue

Common signs of molar pregnancy include heavy vaginal bleeding, unusually rapid uterine growth, severe morning sickness, high blood pressure, and elevated hCG hormone levels despite the absence of a foetal heartbeat on ultrasound.

Early diagnosis through ultrasound and blood tests is crucial, as molar pregnancy requires immediate medical treatment through a procedure called dilation and curettage (D&C) to remove the abnormal tissue.

Ectopic pregnancy

An ectopic pregnancy occurs when a fertilised egg implants and develops outside the uterus. In ectopic pregnancy, the fertilised egg typically embeds itself in the fallopian tube, ovary, cervix, or abdominal cavity. This condition usually arises due to damaged or blocked fallopian tubes from previous infections, surgery, or endometriosis.

Early symptoms include severe, sharp abdominal or pelvic pain (particularly on one side), shoulder pain caused by internal bleeding irritating the diaphragm, vaginal bleeding, dizziness, and nausea.

As the pregnancy progresses, the growing embryo can cause the fallopian tube to rupture, leading to life-threatening internal bleeding. Diagnosis typically involves blood tests to monitor hCG levels, pelvic examinations, and ultrasound scans to locate the pregnancy. Treatment options depend on the stage and location but may include medication to stop cell growth or surgery to remove the pregnancy tissue.

Tubal pregnancy

A tubal pregnancy is the most common form of ectopic pregnancy and is characterised by when the embryo implants within the fallopian tube itself. The confined space of the fallopian tubes makes this particularly dangerous, as the growing baby will eventually stretch the fallopian tube beyond its capacity, ultimately leading to a rupture. When rupture occurs, it can cause severe internal bleeding into the abdominal cavity, resulting in shock and requiring immediate surgical intervention.

The narrow diameter of the fallopian tube also means that symptoms often develop more quickly and severely compared to other ectopic locations, making early detection and treatment critical for preserving the affected tube and future fertility.

Intra-abdominal pregnancy

Intra-abdominal pregnancy is an extremely rare form of ectopic pregnancy where the embryo implants elsewhere within the abdominal cavity (e.g., on the bowel, liver, or other organs). This condition might lead to severe internal bleeding, damage to surrounding organs, and death.

The embryo may survive longer as compared to tubal pregnancies due to there being more space for growth. However, the lack of proper uterine support makes complications unavoidable. Diagnosis is challenging and often delayed, requiring advanced imaging techniques, whilst treatment typically involves complex surgical removal.

Chemical pregnancy

A chemical pregnancy refers to an early pregnancy loss that occurs shortly after implantation, typically within the first few weeks before a clinical pregnancy can be confirmed by ultrasound. This type of miscarriage happens in approximately 10-20% of all pregnancies, often before women even realise they're pregnant.

Signs include a brief positive pregnancy test followed by a negative result, slight bleeding around the time of an expected period, and mild cramping. While emotionally difficult for those trying to conceive, chemical pregnancies are usually caused by chromosomal abnormalities and don't typically indicate underlying fertility problems.

Lupus pregnancy

Pregnancy in women with lupus requires specialised high-risk obstetric care due to increased risks for both the mother and baby. Lupus can increase the likelihood of pregnancy complications, including preterm birth, preeclampsia, blood clots, kidney problems, and lupus flares triggered by hormonal changes during pregnancy.

Additionally, some women may experience neonatal lupus in their babies, which can affect the heart, skin, or blood counts. Successful lupus pregnancies require careful pre-conception planning, medication adjustments to pregnancy-safe options, frequent monitoring by both rheumatologists and maternal-foetal medicine specialists, and close observation for signs of lupus activity or pregnancy complications throughout all trimesters.

Breech pregnancy

A breech pregnancy occurs when the baby is positioned with their feet, buttocks, or both presenting first instead of the typical head-down position. The three types of breech presentations are:

• Frank breech: Buttocks first with hips flexed

• Complete breech: Buttocks and feet first

• Incomplete breech: One or both feet first

While many breech babies can be delivered vaginally by experienced practitioners, this presentation increases the risk of delivery complications, cord prolapse, and birth injuries.

Depending on the situation, your healthcare provider may attempt techniques to encourage the baby to turn head-down or may recommend a planned caesarean section.

Have concerns about your pregnancy? Our obstetricians and gynecologists can provide you with comprehensive care for high-risk pregnancies. Request an appointment to discuss your individual care needs with our team.

Symptoms of pregnancy

Pregnancy symptoms often differ widely among women and can even vary for the same woman across different pregnancies. Each person's physiological makeup is unique, leading to distinct experiences.

Physical changes arise as your body adapts to support your growing baby, leading to common symptoms of pregnancy like morning sickness and more. These changes are often driven by hormonal shifts and the increasing demands of pregnancy. Knowing what symptoms to expect can help you recognise early pregnancy signs and help you prepare yourself for what is to come as your pregnancy progresses.

It's important to remember that not every woman experiences all symptoms, and the intensity and timing of such symptoms can differ greatly.

Early symptoms 

• Missed period:

  • Often the first sign of pregnancy, especially if you have regular menstrual cycles.

  • However, some women may experience light bleeding or spotting during early pregnancy.

• Morning sickness:

  • Nausea or vomiting affects up to 80% of pregnant women.

  • Morning sickness typically begins around 6 weeks and often improves by 12-14 weeks. Despite the name, it can occur at any time of day.

• Breast tenderness: 

  • Your breasts may feel swollen, sensitive, or sore due to hormonal changes. You might also notice darkening of the areolas.

• Fatigue: 

  • Fatigue is common in early pregnancy due to rising progesterone levels and your body's increased energy demands for supporting the developing baby.

• Increased urination: 

  • Frequent trips to the bathroom occur as your kidneys process additional fluids and your growing uterus puts pressure on your bladder.

Late symptoms

• Weight gain

  • Expect gradual weight increase as your baby grows, with most weight gained in the second and third trimesters.

• Back pain: 

  • Lower back discomfort becomes more common as your centre of gravity shifts and pregnancy hormones relax your ligaments and joints.

• Swelling of ankles or hands:

  • Mild swelling (oedema) is normal, especially in the later months.

  • This is due to increased fluid retention and pressure from your growing uterus.

• Foetal movements: 

  • You'll typically feel your baby's first movements (quickening) between 16-25 weeks, becoming stronger and more frequent as pregnancy progresses.

• Braxton Hicks contractions:

  • Practice contractions that prepare your uterus for labour, usually beginning in the second trimester and becoming more noticeable in the third trimester.

When to seek immediate care?

Knowing when to contact your healthcare provider immediately can be crucial for both your safety and your baby's wellbeing. Below is a list of the following circumstances where you should immediately contact your doctor and head to the nearest emergency room.

• Heavy vaginal bleeding

• Severe abdominal pain

• Sudden swelling of face/hands

• High fever

• Severe headache with vision changes

• Signs of ectopic pregnancy (shoulder pain, dizziness, fainting)

How are pregnancy types diagnosed?

Ultrasound scans are the primary method for confirming pregnancy location, determining whether you're carrying one baby or multiples, checking foetal development, and identifying potential complications like ectopic or molar pregnancies. 

Blood tests play a crucial role by measuring human chorionic gonadotropin (hCG) levels, which can indicate pregnancy viability and help detect abnormalities. For example, unusually high or low hCG levels may suggest molar pregnancy or ectopic pregnancy, respectively. 

Physical examinations allow your doctor to assess uterine size and position, check for signs of complications, and monitor your overall health. 

For complex or rare cases, specialised imaging techniques such as MRI scans, 3D ultrasounds, or additional blood work may be necessary to provide a comprehensive picture of your pregnancy and guide appropriate treatment plans.

How to support yourselves during pregnancy?

Taking an active role in your pregnancy care significantly contributes to positive outcomes for both you and your baby. 

• Attend all scheduled prenatal appointments. Regular monitoring allows for the early detection and management of any potential complications.

• Maintain a well-balanced diet rich in essential nutrients like folic acid, iron and calcium.

• Stay adequately hydrated by drinking plenty of water throughout the day

• Gentle exercises like walking or prenatal yoga can improve circulation, reduce discomfort, and prepare your body for labour. 

• Don't underestimate the importance of emotional support: connect with your partner, family, friends, or pregnancy support groups to share experiences and concerns. 

• Manage stress through relaxation techniques such as deep breathing, meditation, or prenatal massage, as chronic stress can impact both maternal and foetal health.

Understanding the different types of pregnancy empowers you to make informed decisions about your care and know what to expect throughout your journey to motherhood. Whether you're experiencing a straightforward singleton pregnancy or managing a high-risk condition, having the right medical support makes all the difference in ensuring the health and wellbeing of both you and your baby. Every pregnancy is unique, and with proper care, monitoring, and support, you can navigate this incredible journey with confidence.

You are not alone in your pregnancy journey, our obstetricians and gynecologists will be there with you every step of the way. Want to learn more? Request an appointment with our team.

FAQ

How do I know what type of pregnancy I have?

Your healthcare provider will determine your pregnancy type through ultrasound scans and physical examinations. An early ultrasound (typically between 6-12 weeks) confirms the location of your pregnancy, determines if you're carrying multiples, and checks for abnormalities. Blood tests measuring hCG levels provide additional information, while your medical history and age help classify your pregnancy type.

What types are considered high risk?

High-risk pregnancies include multiple pregnancies (twins, triplets), ectopic pregnancies, molar pregnancies, and pregnancies in women with lupus or other chronic conditions. Pregnancies in those with diabetes, high blood pressure, heart disease, or previous pregnancy complications are also classified as high-risk.

Can my pregnancy type change during pregnancy?

Yes, certain aspects can change during pregnancy. A baby in breech position may turn head-down naturally or through medical intervention before delivery. Your risk level can also change if you develop conditions like gestational diabetes or preeclampsia during pregnancy. However, fundamental aspects like carrying multiples or singleton pregnancy won't change.

What are three signs of an ectopic pregnancy?

The three key warning signs are severe, sharp abdominal or pelvic pain (often on one side), abnormal vaginal bleeding different from a normal period, and shoulder tip pain caused by internal bleeding. Additional symptoms may include dizziness, fainting, and nausea.

Can a 47-year-old woman become pregnant?

Yes, pregnancy is possible at 47, though fertility declines significantly and risks increase substantially. Women in their late 40s face higher chances of chromosomal abnormalities, miscarriage, gestational diabetes mellitus, and other complications. The likelihood of natural conception decreases dramatically after 40, often requiring fertility treatments and enhanced prenatal care.

Which pregnancy is most difficult?

Difficulty varies by individual circumstances, but multiple pregnancies, high-risk pregnancies with chronic medical conditions, and those complicated by severe preeclampsia or placental problems typically require more intensive care. Ectopic and molar pregnancies require immediate medical intervention. Any pregnancy can become challenging, making appropriate medical support essential for your specific situation.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.