Pregnancy warning signs

WE have all been conditioned to believe that pregnancy is as smooth a sail as it is to venture to Lime Cay from Morgan’s Harbour on a still and calm day. However, just as the Caribbean Sea can be very rough on this short trip to an island 20 minutes away, so can pregnancy. To ensure a smooth sail for mother and baby, be sure to look out for the following signs, and if they occur, scream at your captain, Dr ObGyn, for help.

Nausea and vomiting

Because of the rising hormones in pregnancy, women can present with excessive vomiting. At times the vomiting can be so severe that a woman can become moderately to severely dehydrated resulting in the need for admission to the hospital for IV fluids and medication. Severe dehydration can have a negative outcome on pregnancy resulting in poor growth of the foetus, miscarriage, or even death of the mother and foetus.

Vaginal bleeding

A loss of pregnancy before 24 weeks is defined as a miscarriage. The causes range from medical disorders and infection to unknown causes. Miscarriages usually present with bleeding from the vagina with or without abdominal pain. When bleeding occurs after 24 weeks, other causes may be due to the placenta (afterbirth) such as placenta previa (when the placenta is low in the uterus) or placenta abruption (when the placenta starts to separate from the uterus which normally happens after birth and not before). All bleeding in pregnancy needs to be evaluated.

Premature labour

Most women deliver after 37 weeks. Occasionally a baby may choose to make his/her début at an earlier date. Labour occurs when there are regular uterine contractions increasing in intensity and decreasing in time. The main cause of premature labour is an infection such as a bladder infection. If you think premature labour is occurring, head to your doctor immediately.

Preeclampsia

The main cause for pregnant mothers to die in Jamaica is secondary to high blood pressure. Preeclampsia is one such condition in pregnancy. Women will have high blood pressure, complain of headaches, upper abdominal pain and blurred vision. The only way to treat this condition is to lower the blood pressure and to deliver the baby. Women with this condition can deteriorate very rapidly.

Diabetes

The circulating hormones of pregnancy can predispose a mother to developing diabetes and once the baby has been delivered, diabetes usually resolves. Classically, there may be no signs or symptoms of the disease, but if present, women may be excessively thirsty and pass urine frequently. Diabetic mothers are at an increased risk for having stillbirths, large babies, and Caesarean sections. Most ObGyns screen for diabetes in pregnancy, so it is usually picked up early and treatable.

Zik V

Still a lot is not known about Zik V, but if a pregnant woman develops a rash, intermittent fever and muscle pain, she should be tested. If positive, this patient should have ultrasounds every four weeks by a foetal maternal specialist, and once the baby is born, a thorough evaluation by a paediatrician should be conducted.

Pulmonary embolism

Hormones of pregnancy as well as the actual pregnancy itself, may slow down blood flow and predispose to blood clot formation particularly in the leg. If this clot breaks off and travels to the lung it can result in sudden death — called a pulmonary embolism. Women will present with difficulty breathing and shortness of breath. The window for treatment here is very short, so once confirmed women should be attended to quickly.

This condition can also occur after pregnancy, especially within the six weeks following pregnancy.

So ladies, let’s sail smoothly!

Dr Daryl Daley is a medical officer in ObGyn at the May Pen Hospital and consultant ObGyn at Gynae Associates, 23 Tangerine Place, Kingston 10 and Shops 46-50, Portmore Town Centre, Portmore. He can be contacted at 929-5038/9, 939-2859 or drdaryldaley@gmail.com