Report These Symptoms Right Away
Possible cause: Preeclampsia
If you are experiencing any of these symptoms, you may be developing preeclampsia. This condition affects about 5 percent of pregnant women. It can progress to eclampsia, which may result in convulsions and possibly, coma. Throughout your pregnancy, your doctor will be monitoring you for preeclampsia. The condition is monitored by checking blood pressure and testing a urine sample for protein.
William Brunner, MD, an Ob/Gyn with more than 25 years of experience, says that it is usually first pregnancies that are affected by preeclampsia.
"Typically it is in the very young teenagers or elderly primigravidas greater than 35 years of age, but can occur in any pregnancy or at any age," Dr Brunner says.
Dr Brunner says treatment of mild preeclampsia can be accomplished by observation and bed rest. It's also recommended to drink lots of water and avoid salty foods, to keep water retention to a minimum. However, if the preeclampsia is severe, medication such as magnesium sulfate is typically used to help prevent seizures. This medication is administered by IV during and after delivery.
If antihypertensive medication is administered to lower blood pressure, a cesarean delivery may be necessary.
"When antihypertensive meds are needed, it is generally best to accomplish delivery either by induction of labor or cesarean section," Dr Brunner says, "Most of the time, this occurs close to term, and the patient can therefore be delivered in short order."
Sandra T., from Fresno, California, had preeclampsia with her first pregnancy. "When the doctor diagnosed me in my second trimester, I was nervous about how the rest of the pregnancy would go. Toward the 38th week, my blood pressure went up and they had to do an emergency c-section. Luckily, my little girl and I pulled through it OK," Sandra says.
Emergency c-sections are rare for those with preeclampsia, but it's best to be prepared.
Possible cause: Molar pregnancy, placenta previa, implantation bleeding or miscarriage
Vaginal bleeding may occur for several reasons, and any bleeding should be reported to your healthcare provider to determine if it is serious or not.
Molar pregnancy is the abnormal growth of placental tissue, instead of an embryo. In addition to vaginal bleeding, women may also experience excessive nausea and vomiting. An ultrasound is used to determine if the pregnancy is normal. If not, a dilation and curettage (D&C) is done as soon as possible. This procedure removes the abnormal placental tissue.
Bleeding may also be caused by placenta previa. This condition involves the placenta being near the cervix or covering the cervix. It is a serious complication because it can result in heavy bleeding during labor.
Dr Brunner says placenta previa is treated mainly by observation. "Any significant bleeding needs to be evaluated, especially past the first trimester. If the patient is known to have a previa, she should report to the hospital immediately after new bleeding occurs," Dr Brunner says. "Depending upon location of bleeding, there may be significant retained blood behind the placenta necessitating immediate delivery."
Another cause of bleeding may be miscarriage. While molar pregnancy and placenta previa are treatable, Dr Brunner says there isn't a way to avoid a miscarriage.
"If there is bleeding and cramping occurring, she has a 50 percent chance of pregnancy loss," Dr Brunner says. "Bed rest only helps to decrease the bleeding, not necessarily improve the outcome of the pregnancy. Of course, any bleeding needs to be reported to her doctor."
Katie M., of New Paltz, New York, experienced vaginal bleeding during the first trimester. "I think it was the sixth week of pregnancy or so, when I started bleeding. I called my doctor right away and he told me to get off my feet and take it easy until the bleeding subsided," Katie says. "I was convinced that I was miscarrying, but the doctor said sometimes there is some implantation bleeding."
Possible cause: Urine, normal secretions, labor
During the third trimester, an increase in vaginal discharge or urine leakage is not unusual. Pregnancy normally brings about an increase in vaginal secretions, called leukorrhea.
Urine leakage is also quite common. As the baby grows, the weight of the uterus causes small amounts of urine to escape. However, if you notice a gush of liquid, followed by small amounts of fluid, your water may have broken. Amniotic fluid is usually clear or watery but may appear bloody.
If this gush of fluid occurs before the 38th week, premature, or preterm, labor may be in progress. A premature birth can result in babies born with immature lungs, low birth weight, among other problems. It is possible to stop premature labor by administering beta-adrenergic agents, which cause the uterus to relax and decrease contractions. Bed rest may also be recommended.
Susan W., of Harrisburg, Pennsylvania, had no warning that her water was about to break, almost three weeks before her due date.
"I had just gotten home from my baby shower at church and started to show my husband the shower gifts. As I stood up, I felt a small gush of fluid. I experienced several small gushes of fluid, about every three to four minutes. I wasn't experiencing contractions," Susan says.
Within an hour, Susan and her husband were at the hospital and she was two centimeters dilated. Her contractions started within two hours. As she looked back, she realized that while she didn't experience contractions before her water broke, she felt ready to have the baby about a week earlier.
"My baby had dropped significantly in the pelvis, and I just felt that it was time. I was tired, irritable, and had trouble walking," she says.
Possible cause: baby is in distress
Many pregnant women notice their babies' first movements by 22 weeks. Those first movements may feel like a gentle flutter. As the baby matures, some women notice the baby has a routine, such as being quiet during the day, then kicking and stretching at night. While the night-time movement may interrupt sleep, it is reassuring to feel the baby moving. A baby's movements will also vary from woman to woman, according to Glade B. Curtis, MD, Ob/Gyn and author of Your Pregnancy Week by Week.
"It isn't unusual for a baby to have quiet times when there is not as much activity," writes Dr Curtis. If you don't feel any movement after several hours, even after eating and resting, Dr Curtis advises that women can always visit their caregiver to hear the baby's heartbeat.
The bottom line
While many of these symptoms can easily be treated by a doctor's visit, there are a few that Dr Brunner advises women take seriously and head directly to the closest hospital.
"Warning signs that warrant an ER appearance include active bleeding at any gestational age, especially if accompanied by cramping and or clotting, persistent headache at any gestational age if it is severe and unrelieved by Tylenol (especially near term), severe abdominal pain (especially if it is in the upper abdomen) or sudden excessive swelling in hands face and feet are other signs," Dr Brunner advises.
As you progress with your pregnancy, you will learn what's normal and not normal. If you have any of the symptoms on this list, do not hesitate to contact your health care provider. Your baby is depending on you!