Signs of danger in pregnancy

There are ten groups of symptoms which may occur during pregnancy that deserve serious attention. They do not indicate that disaster has occurred or is likely to occur, but they should be seriously considered and reported to the doctor either immediately or as soon as is reasonably possible.

The first five listed below should be reported immediately while the second five may be reported at the earliest convenience, which usually means within 24hours.

  • Vaginal bleeding.

When vaginal bleeding occurs in the first 28weeks of pregnancy it indicates that the pregnancy is unstable and that there is a threat of miscarriage or abortion. If the amount of bleeding is slight , immediate rest in bed is indicated and the doctor should be notified as soon as reasonably possible, but if the bleeding is heavy or associated with pain you should go to bed at once and notify the doctor immediately.

Any vaginal bleeding after the 28th week of pregnancy should be notified immediately to your doctor or the nearby hospital with an exception of the pink, mucous stain which occurs at the onset of labor, and is usually accompanied by uterine contraction of which you will be aware.

  • Severe continuous abdominal pain.

The onset of severe, incapacitating continuous abdominal pain should be notified to the doctor immediately. This kind of pain may be associated with some premature separation of the placenta or with any other acute abdominal emergency, but it is emphasized that this type of pain is continuous and not intermittent and usually occurs in the lower abdomen.

  • Breaking of the waters, or rupture of the membranes.

When this occurs the onset of labor usually follows fairly quickly. Some types of miscarriage or abortion are preceded by rupture of membranes and it is the first symptom to occur in approximately forty percent of premature labors. It is important, therefore, to notify your doctor or the hospital immediately so that arrangements can be made for your transfer to the hospital, but be certain that the membranes have in fact ruptured and that the watery loss is neither urine nor bath water which has found its way into the vagina and is being expelled either minutes or hours after the bath.

  • Mistiness , difficulty and blurring of vision.

In the second half of pregnancy this may be a symptom of pre-eclampsia or of raised blood pressure and if it occurs you should go to bed and notify your doctor at once.

  • Continuous severe headache.

Continuous severe headache which is not relieved by paracetamol, codeine or other simple headache remedies. Such a headache usually occurs either above or behind the eyes or over the back of the head. This kind of headaches is usually a symptom of severe pre-eclampsia or high blood pressure.

Symptoms not so urgent as the five above , but which warrant early notification to your doctor are :

  • frequency and pain on micturition .

This usually indicate the onset of a urinary tract infection and if they persist for several hours then treatment is indicated as soon as this can conveniently be arranged.

  • Temperature.

A rise in temperature to 101ºF(38.5ºC) should be reported to the doctor. Even if its cause is obvious some form of treatment will usually be necessary.

  • Swelling of the hands, face and ankles.

This is known as edema, and may occur at any stage of pregnancy and is frequently associated with a raised blood pressure or excessive weight gain. A certain amount of swelling of the ankles is common in pregnancy, especially during hot weather, but excessive swelling of the ankles such that shoes cannot fit is a warning sign.

  • Absence of fetal movements.

It cannot be overemphasized that babies frequently stop moving for quite long periods during pregnancy. It is fairly common for babies to stop moving at about the 20th or 22nd week for several hours and frequently for up to 24 hours during the latter part of pregnancy. However , if your baby does not move for longer than 48hours tell your doctor as soon as it is convenient to do so.

  • Excessive vomiting.

A certain amount of sickness or vomiting is very common in the first 14 weeks of pregnancy. If however, vomiting becomes so severe that no food or fluid can be retained then help should be sought. Sickness usually ceases after the 14th week, although occasional bouts of vomiting may occur. During the last three months of pregnancy , most women vomit occasionally, but repeated, recurrent and severe vomiting is unusual and should be reported to your doctor as soon as possible.