You’re pregnant and everything seems like an emergency! Is your headache a sign of pre-eclampsia? What was that twinge? Was it a contraction? Should you call the doctor or drive straight to the emergency room? Maybe you should just stay put. Of course, it’s always better to be, as they say, safe than sorry. But don’t be surprised if your doctor seems a bit condescending. After all, obstetricians have to deal with hormonally-challenged women every day!
It’s not uncommon for spotting to occur, particularly early in the pregnancy. However, any bleeding that’s significantly more than that should be reported to your doctor.
Types of and possible causes of bleeding:
- Implantation bleeding. This can occur when the egg attaches itself to the uterus.
- Cervicitis. When cervical cells are irritated during sex or due to an infection, some bleeding can occur. However, it’s important that you don’t self-diagnose. While it might be cervicitis, it’s important that your obstetrician makes that determination.
- Ectopic pregnancy. When a fertilized egg implants itself in the fallopian tubes, an ectopic pregnancy occurs and immediate medical intervention is necessary. In the case of an ectopic pregnancy, the embryo is not viable and there is serious risk to the mother’s life. Urgent medical care must be sought if you experience heavy bleeding accompanied by severe pain. Having a sonogram early in the pregnancy can reassure you that your baby is securely resting within your womb.
- Molar pregnancy. This is a rare disorder caused by a chromosomal defect in the sperm which causes an abnormal mass to develop instead of a normal fetus. Bleeding will only occur in the first trimester, and again, having an ultrasound performed can confirm a normal pregnancy.
- Preterm labor. Bleeding in the second and third trimesters often is a sign of preterm labor. Pick up the phone and call your doctor immediately if you experience vaginal bleeding, a watery mucus-like discharge, pain and/or cramping.
- Placental abruption. In the third trimester the placenta can begin to separate from the uterus before labor has begun. Occasionally, placental abruption will occur without any bleeding.
- Placenta previa. Another potentially serious condition where the placenta partially or completely blocks the cervical opening. This is potentially life-threatening as hemorrhaging can occur either before or during delivery; a caesarean section will have to be done to avoid the excessive loss of blood.
Vaginal hemorrhaging involves bright red blood and signals an urgent need to get to the hospital immediately! Don’t worry about your chipped nail polish or partially cooked roast. Turn off the oven and get someone to drive you to the ER! Miscarriages can occur prior to the 20th week of pregnancy, so if you start to bleed in your second trimester and the bleeding is accompanied by cramping, a miscarriage is likely to happen. Uterine cramping at any time can be a sign that labor has begun. Don’t ignore the symptoms. Call your obstetrician or make a trip to the Emergency Room if any bleeding occurs, other than the initial spotting that some women experience. That said, put your feet up and relax. All these things are exceptions and not the norm.
Other Areas for Concern
Not that I want to be the bearer of bad news, but bleeding isn’t the only cause for concern during pregnancy. Serious complications can occur if you don’t call your doctor when you experience any number of symptoms, from something as seemingly harmless as a headache to cramping and other indications of pre-term labor. While you may not want to think about any of this, you really need to know the other causes for concern and medical intervention:
Headaches
When I bring up headaches as a concern, I’m not referring to the standard excuse you may use with your hubby at bedtime. Everyone gets an occasional headache, but if yours doesn’t seem to go away after you’ve tried the usual remedies, pick up the phone. Headaches can be an indication of pre-eclampsia, a serious condition that relates to spikes in blood pressure.
Warning: Unless you want to run the risk of hemorrhaging during your pregnancy, don’t take aspirin! Aspirin interferes with the clotting ability of the blood, which leads to a higher likelihood of hemorrhaging during pregnancy. Also, fetal development problems have been linked to the use of aspirin. If those reasons aren’t enough to stop you from reaching for the aspirins, consider this: taking too much aspirin can result in…gasp...prolonged labor! But you might not want to grab the acetaminophen either, as it’s been linked with liver damage. The best thing, as always, is to discuss your options with your obstetrician.
Of course, you can always opt for simply enduring the pain. It would be good practice as you prepare for the terrible twos!
Weight Loss
If you’ve been struggling to lose weight for most of your life, now is not the time to do it! Weight loss during pregnancy is not healthy for the fetus and can be an indication of a potential problem.
Call your doctor if the scale is heading in the wrong direction!
Prolonged vomiting and dehydration
If five or more hours pass with you spending most of your time kneeling over the toilet bowl, unable to keep anything down, including fluids, call your doctor. This is especially important if the vomiting is accompanied by chills and severe pain in your abdomen or shoulder. Also, you must seek immediate medical attention if you find that you’re not able to urinate or if urination is painful.
Blurred Vision and/or Dizziness
Pregnant women can tend to be a bit ditsy (I think it’s from the baby sucking up those brain cells)! But ‘ditsyness’ should not be confused with dizziness. When your equilibrium seems out of balance, talk to your doctor. While it may be natural for you to be a bit dizzy when you first stand up, dizziness at other times is a sign that something could be wrong. Also, call the doctor if your vision becomes blurred or you’re unable to focus your eyes.
Other reasons to call your doctor:
Your feet, ankles, face and/or hands may suddenly swell when pre-eclampsia occurs. Call your doctor immediately if you experience sudden swelling.
A lack of movement of your fetus can indicate a problem, so seek your physician’s advice if this happens. It’s possible your baby may have found a snug spot to take a nap, but don’t make that assumption if movement has stopped for a prolonged period.
Another cause of concern is cord prolapse where the umbilical cord pushes out of the vagina. This is a very serious condition that is life-threatening to your baby, as the blood supply may quickly be cut off to the fetus, and requires immediate medical intervention!
Pre-term Labor
The signs of pre-term labor include:
- Sharp abdominal pain
- Vaginal discharge that is thick and mucus-like
- Lower back pain
- Cramping
- Passage of tissue or clumps in large amounts
- A feeling of bearing down
- Rhythmic uterine contractions
- Bleeding
Additionally, it goes without saying that if your water breaks, get to the hospital or clinic right away. Babies don’t have timelines. They’re born when they want to be born, with no consideration of your schedule or desires. So, if your little one decides to make an early entrance, make sure you’re in the place where he or she will receive the best care.
The bottom line, which I mentioned in Part 1, is a bit clichéd, but it is better to be safe than to be sorry! If you have any of these symptoms during your pregnancy, contact your obstetrician or get to an emergency room. Keep in mind that the earlier a problem is diagnosed and treated, the better the chances are that you’ll deliver a beautiful, healthy newborn.
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