Dear Dr. Murage,
I am a mother-to-be and I keep hearing and reading about red signals during pregnancy. How do I know the difference between common pregnancy niggles and when there is truly something wrong? Martha
Dear Martha,
Majority of women will go through trouble-free pregnancies, all the way from conception to delivery. But a few will experience complicated pregnancies, where there can be real risks either for the mother or the unborn baby, or for both.
The main aim of antenatal care is to detect and appropriately manage any unexpected complications that can occur. Monitoring during pregnancy is a shared responsibility between the pregnant woman and her healthcare team.
There are many symptoms in pregnancy, ranging from unusual pains to the occasional infective episodes. Most symptoms are just a nuisance, and do not impact on pregnancy progression. All that is required is reassurance and simple measures to help address the symptoms. But you need to be aware of what constitutes serious symptoms, and how to react when such symptoms appear.
In the first three months, a degree of nausea and mild vomiting are common. So is some pelvic discomfort. However, any protracted nausea and vomiting can lead to poor food and fluids intake, quickly tipping you over to dehydration.
Hospital review and rehydration is usually warranted to avert additional complications. Any disproportionate pain, or bleeding should be triggers for an early scan to exclude potential for an early miscarriage or ectopic pregnancy.
As pregnancy advances, there are more symptoms to look out for. Any bleeding should always be considered abnormal. So is any suspicion of leakage of waters. Both should trigger contact with your midwife or obstetrician, or a trip for assessment in the labour ward.
Mild uterine cramping is common as pregnancy advances. But severe cramping, or premature labor-like pains could be something else and a review is usually warranted. Mild headaches are also common, but severe headaches, especially if associated with visual disturbances could be an indication of a rise in your blood pressure. Get it checked out if it happens. If the baby appears inactive, you must also get this checked out.
The list of what to look out for cannot be exhaustive. If you cannot easily explain unusual symptoms, or they don’t get relieved with simple remedies, the default should always be a call to your healthcare team.
Always make arrangements to get reviewed at the earliest opportunity. This gives you the best chance of having appropriate remedial measures instituted, with consequential good outcomes for you and your baby.
Ideally, you should plan to conceive when in the best of health. This minimizes potential for pregnancy-related complications. Once you conceive, aim to commence antenatal care between 11 to 13 weeks. Subsequent antenatal visits will be guided by your own individual characteristics.
Don’t miss any recommended antenatal appointments. Make sure you understand all the instructions given during your pregnancy. Keep a copy of the symptoms to watch out for, or track events with a pregnancy app. You must always be the key decision maker in matters related to your pregnancy.