Your pregnancy: Symptoms you should never ignore

MANY women complain of an odd mix of pregnancy symptoms — acute morning sickness, weird cravings, or developing new habits and lifestyle practices. And while most of these pregnancies will go full term and turn out healthy babies, obstetrician-gynaecologist at ICON Medical Centre, Dr Keisha Buchanan, says that some pregnancy symptoms warrant investigation.

“Most pregnancy symptoms are normal and do not herald a sign of any possible danger in the pregnancy. Many pregnancy symptoms may be similar to those seen in medical conditions, and when assessed may be normal and not a sign that anything is wrong. At times, [however], these may be a signal that a medical complication is developing; this may be unrelated to pregnancy — such as a heart attack — or may be a sign of complications that can arise due to pregnancy, such as high blood pressure.”

Dr Buchanan warns pregnant women to seek medical attention in order to safeguard both themselves and their unborn babies.

Below she shares a list of symptoms that pregnant women should never ignore.

1. Vaginal bleeding

“This may be a sign of a threatened or actual miscarriage if it occurs early in the pregnancy, or antepartum haemorrhage if it occurs later in the pregnancy, such as due to the placenta prematurely separating (placental abruption) or a low-lying placenta (placenta previa).” Dr Buchanan further explained that the latter two can cause sudden severe bleeding in pregnancy, and are associated with foetal and maternal morbidity or foetal mortality.

2. Vomiting

This is common, especially in the first trimester (first three months) and early second trimester (second three months). “Most vomiting resolves by the second trimester; however, vomiting that is severe, associated with blood in the vomit, moderate to severe stomach pains, dehydration causing weakness and lethargy must not be ignored, and medical attention should be sought,” Dr Buchanan advised. Severe vomiting may be caused by hyperemesis gravidarum, but other causes such as gastroenteritis (running belly), acute appendicitis and acute cholecystitis (inflamed gallbladder) need to be ruled out. “Vomiting arising in the late second or third trimester is also unusual and may be due to non-pregnancy-related causes such as gastroenteritis, or more serious but rarer conditions like a liver disease,” Dr Buchanan said.

3. Shortness of breath

“Shortness of breath is common as the womb grows and presses up against the diaphragm (located at the base of the lung), and is often experienced on lying down,” Dr Buchanan said. She notes that if experienced it should be transient – for a few seconds; however, if it persists or is associated with dizziness, chest pain, fainting and coughing, a medical evaluation is required.

4. Vaginal discharge with odour or bloody discharge

This may be a sign of infection. “Most vaginal infections are not serious, but some STDs such as trichomoniasis or gonorrhoea, or non-STIs such as bacterial vaginosis can cause premature rupture of membranes and can cause premature delivery and infections in the womb,” Dr Buchanan cautioned. She explained that prematurity is associated with higher risk of the complications in the baby such as respiratory problems, bleeding in the brain, and long-term complications. She advised that any offensive vaginal discharge must be investigated immediately, and safe sex with a condom to protect against STIs is always recommended.

5. Sudden onset of persistent pelvic pressure

“If this occurs early in the second trimester, especially between 13 to 22 weeks, it should be assessed. This may preclude premature cervical dilation (cervical insufficiency),” Dr Buchanan advised. She said one factor that may predispose a woman to this is a prior surgery on the cervix (the neck of the womb); however, many times there are no predisposing factors.

6. A headache, sudden swelling of the feet, blurred vision or spots in front of the eyes

“If any of these are experienced, especially in the late second and third trimester, this may be a sign of a high blood pressure condition in pregnancy called preeclampsia,” Dr Buchanan pointed out. She said this requires urgent assessment by the doctor, as this can progress to further complications such as seizures.

7. An onset of regular abdominal pain

“If a woman experiences these pains every 10 minutes, and if they get progressively stronger, these are usually labour symptoms. These pains usually last for a minute or less, and it’s best to go to the hospital when they start,” Dr Buchanan said. She explained that if the pregnancy is less than 34 weeks, urgent medical attention should be sought even for pains that are regular and coming at a frequency more than 10 minutes, as in many cases treatment to prevent premature delivery will be required.

8. Decreased foetal movements

“This needs urgent medical assessment, especially in the context of conditions such as high blood pressure and diabetes in the pregnancy,” Dr Buchanan advised. She said further foetal assessment such as through an ultrasound or foetal heart testing such as a non-stress testing may be needed to make sure the foetus is viable.

“Pregnancy should be an uneventful condition. However, that’s not always the case, and so it’s always best to use your sixth sense, as most women know when something isn’t right. Get assessed,” Dr Buchanan urged.