Your Pregnancy - - Pregnancy Files -

IT’S HARD NOT TO WORRY about ev­ery new twinge, even when wellmean­ing friends and rel­a­tives tell you not to. It’s also hard to stay calm if your over-anx­ious part­ner keeps spot­ting a calamity ev­ery time you frown. Life is short, and preg­nancy is hard enough, so re­mem­ber just this gy­nae-vet­ted list of five sit­u­a­tions that need ur­gent ac­tion – and get on with liv­ing your best preg­nant life in the mean­time.


Some women re­port fewer to no headaches while they’re with child, oth­ers un­for­tu­nately keep get­ting them, or get headaches when they never used to. A mild headache is noth­ing to worry about, but if you sud­denly get a se­vere headache, this could be very se­ri­ous. Dr Yer­shini Mood­ley, a gy­nae­col­o­gist and ob­ste­tri­cian in pri­vate prac­tice in Jo­han­nes­burg, says, “Se­vere headache may be a symp­tom of im­mi­nent eclamp­sia.” A preg­nant woman with very high blood pres­sure can start fit­ting and even be­come co­matose and die. Dr Mood­ley says, “Pre-eclamp­sia is the lead­ing cause of ob­stet­ric mor­bid­ity and mor­tal­ity,” so it is vi­tal you mon­i­tor your­self. Other symp­toms are blurred vi­sion and dizzi­ness, as well as pain on the right side of your stom­ach.


Smal­lanyana pains, such as an ab­dom­i­nal mus­cle spasm or Brax­ton Hicks con­trac­tion, are not a cause for con­cern. “But se­vere ab­dom­i­nal pain is usu­ally a symp­tom of a se­ri­ous un­der­ly­ing pathol­ogy, which can be from a gy­nae­co­log­i­cal, ob­stet­ric, or other source,” ex­plains Dr Mood­ley. What does that mean? If it’s a gy­nae­co­log­i­cal is­sue, it could in­di­cate a mis­car­riage in progress, or a rup­tured ec­topic preg­nancy. Ec­topic preg­nan­cies (in which the foe­tus fails to move into the uterus) are not vi­able and in­evitably end in mis­car­riage. So those are the worstcase sce­nar­ios. An­other pos­si­bil­ity is a large, com­pli­cated ovar­ian cyst, says Dr Mood­ley, which may have to be sur­gi­cally re­moved if it is caus­ing pain. Se­vere ab­dom­i­nal pain could also have an ob­stet­ric cause, mean­ing it could in­di­cate preterm labour, or abrup­tio pla­cen­tae (bleed­ing be­hind the pla­centa). In each case, get­ting to a hos­pi­tal quickly is crit­i­cal so that labour can be stopped if pos­si­ble, or the baby be pre­pared for pre­ma­ture birth with life­sav­ing in­ter­ven­tions. In the case of pla­cen­tal abrup­tion, the pla­centa is threat­en­ing to come away from the walls of the uterus, and de­pend­ing on the spe­cific con­di­tions, bed rest and other med­i­cal in­ter­ven­tions may be needed to save the life of your baby. “Other causes of pain could be dis­or­ders in­volv­ing other or­gan sys­tems, e.g. ap­pen­dici­tis, chole­cys­ti­tis (in­flam­ma­tion of the gall­blad­der), pan­cre­ati­tis or a com­pli­cated pep­tic ul­cer,” says Dr Mood­ley. These con­di­tions are not med­i­cal emer­gen­cies but are com­pli­cated by your preg­nancy and need to be treated by a doc­tor.


If your mem­branes have rup­tured be­fore 37 weeks of preg­nancy, that is con­sid­ered pre­ma­ture, and ob­vi­ously, the ear­lier along in your preg­nancy this hap­pens, the more se­ri­ous the con­di­tion. “In­fec­tion of the pla­centa, chorion and am­nion can cause a se­vere in­flam­ma­tory re­sponse in the foe­tus, lead­ing to neu­ro­log­i­cal or car­diores­pi­ra­tory com­pli­ca­tions,” cau­tions Dr Mood­ley. You need to get to hos­pi­tal to check if your mem­branes have in­deed rup­tured. If they have, you will have to stay in hos­pi­tal to try to de­lay labour for as long as pos­si­ble, or go home on bed rest. In­fec­tion is now a risk and you will be treated with an­tibi­otics. Your baby will most likely be given steroids to pre­pare his lungs for a pos­si­ble pre­ma­ture birth. If this has hap­pened to you, you ob­vi­ously need to be ex­tra vig­i­lant for the rest of your preg­nancy.


An­other se­ri­ous symp­tom, vaginal bleed­ing early in preg­nancy can in­di­cate an ec­topic preg­nancy or a mis­car­riage, ac­cord­ing to Dr Mood­ley. Vaginal bleed­ing later than 20 weeks into your preg­nancy (the med­i­cal term for this is “an­tepar­tum haem­or­rhage”, says Dr Mood­ley) can have sev­eral causes, “the most com­mon be­ing pla­centa prae­via or pla­cen­tal abrup­tion. In the case of pla­centa prae­via, the pla­centa is ly­ing over the open­ing of the cervix. You’ll need to fol­low med­i­cal ad­vice, such as pos­si­bly avoid­ing ex­er­cise, sex or us­ing tam­pons, through­out your preg­nancy and may need to have a C-sec­tion.”


“Once the preg­nancy reaches vi­a­bil­ity at around 24 weeks, it is im­por­tant that you keep track of how of­ten your baby moves,” says Dr Mood­ley. “No move­ment may be a sign that your baby is in se­ri­ous trou­ble and you need to seek med­i­cal ad­vice im­me­di­ately.” Hav­ing said that, ba­bies do sleep, and do have days where there is some­what less move­ment. Try to gauge what is nor­mal for your baby, and if you are wor­ried, try a few things to “wake” him such as eat­ing or drink­ing some­thing su­gary or prod­ding your belly a lit­tle, be­fore you take fur­ther ac­tion.

Yes, most niggles are harm­less dis­com­forts, and you don’t want to spend your whole preg­nancy wor­ry­ing. But these symp­toms do need med­i­cal at­ten­tion, so be on the look­out for them, writes Mar­got Ber­tels­mann

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