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Pregnancy SOS
Know the difference between a false alarm and a red alert
By Martine Gallie
Pregnancy is full of worries and doubts. Know the difference between a false alarm and a red alert with our guide to the top six signs that something’s wrong.
About 15 per cent of pregnancies have some bleeding in the first trimester. Usually, if the foetal heart can be seen, and bleeding does not get worse, the pregnancy and foetus will be fine.
Lots of mums-to-be get headaches in the early weeks of pregnancy.
Try not to worry, as the stress this causes isn’t good for you. |
Health worries like itchy skin, cramps and headaches can be a nuisance when you’re pregnant. But they can also be a sign of something more serious. Here’s how to tell the difference…
SPOTTING AND BLEEDING
Vaginal spotting and bleeding are common in the first trimester. Most women who have some bleeding go on to have healthy pregnancies, but it’s important to get it checked out, as bleeding can signal more serious pregnancy complications, like a miscarriage or an ectopic pregnancy.
According to Mother & Baby expert Dr Christopher Chong, a consultant obstetrician, gynaecologist and urogynaecologist at Gleneagles Hospital, about 15 per cent of pregnant women experience some bleeding in the first trimester. Usually, if the foetal heart can be seen, and the bleeding does not get worse, the pregnancy and foetus will be fine. Everything is fine in nine out of 10 cases.
However, bleeding can indicate a more serious problem, as Andrea Soh, 33, mum to Sean, 17 weeks, found out. “Whenever I sat down, I’d get this dull pain low down on my right side and I was getting brown spotting,” she says. “I had been using an intrauterine contraceptive device and thought I might have an infection so I saw my GP, who sent me to KKH. I was shocked to hear that I had an ectopic pregnancy, and would have to have a fallopian tube removed. I was worried when I got pregnant with Sean, but luckily, I had no problems at all.”
Later in pregnancy, spotting and bleeding are more likely to be signs of placenta problems. “If a woman comes to us with bleeding after 20 weeks, the first things we rule out are placental abruption (if there is abdominal pain), where the placenta comes away from the womb, and placenta praevia (if it’s painless), where the placenta is blocking the cervix,” says Bruce Ramsay, a consultant obstetrician and gynaecologist.
“Sometimes women bleed after sex and that needs checking in case there’s an underlying problem, such as a low-lying placenta,” he adds. “However, by far the majority of bleeding episodes fall into the category of ‘just one of those things’.”
ABDOMINAL PAIN
“If you feel a bit crampy when you’re first pregnant, infection is a common cause,” Dr Chong says. “But if you get a pain that takes your breath away, coupled with heart palpitations, which leaves you feeling faint, or if it’s persistent or getting stronger, phone your gynae straight away. It could be a sign of a miscarriage or an ectopic pregnancy, especially if you’re bleeding as well.”
Later in pregnancy, cramps can be caused by Braxton Hicks (practice contractions) or by overstretched ligaments under your bump. However, it can also signal more serious problems, such as HELLP syndrome, a life-threatening complication of the serious pregnancy condition, pre-eclampsia.
“When I was at 30 weeks I got an unusual pain just under my ribcage,” says Anita Subramaniam, 27. “Tests showed I didn’t have any protein in my urine and my blood pressure was normal, so I just put it down to heartburn.”
After three days in pain, Anita went to hospital, where blood tests showed she had HELLP syndrome. “My baby was delivered the same day,” says Anita, mum to Samy, 2. “I’m now 34 weeks pregnant with our second child, and I’m being watched closely.”
Mother & Baby Help For You
- Details on pre-eclampsia here.
- Details on miscarriages here.
- More on ectopic pregnancy here.
- If you need medical attention at odd hours of the day, you can go to KK Women’s and Children’s Hospital’s Women’s 24-Hour Clinic at Basement 1, where a specialist is always on duty.
- For non-medical assistance, call Pregnancy Crisis Service at 6339-9770, or the national pregnancy hotline at 1800-686-8623. |
LEAKING FROM YOUR VAGINA
A gush of amniotic fluid at 37 weeks or after is the first sign of labour for some women. Before 37 weeks, it can be a sign of premature labour. “You can tell the difference between a urine leak and an amniotic fluid leak because you can control a urine leak by tightening your pelvic floor muscles,” says M&B expert and midwife Helen O’Dell.
She adds, “If you get a leak before 37 weeks, call your gynae immediately. If you’re less than 35 weeks, he’d want you to get there straight away and if you are more than 35 weeks and don’t have any signs of infection, your gynae will probably tell you to take your time coming in to hospital, especially if the foetus is presenting by the head (which is the normal delivery position).”
However, Dr Chong cautions that if the foetus is transverse (lying across your tummy) or if baby is in a breech position, there’s about a 10 per cent chance that the umbilical cord will slip through the opening cervix and down into the birth canal. In this case, there’s a risk that the baby will die if it is not delivered immediately.
ITCHING
Itchy skin is very common in pregnancy but severe itching in the later stages, on the palms of your hands and soles of your feet, must be checked by your gynae because it can be a sign of a serious pregnancy-related liver condition called obstetric cholestasis.
Chan Si Si, 27, is mum to Min Xing, 13 weeks, Min Hui, 2, and Min Ming, 4. She says, “When I was 36 weeks pregnant with Min Hui, my hands and the soles of my feet got really itchy and my urine was a funny dark colour. I was lying awake scratching my hands and feet, thinking ‘This isn’t normal.’ I saw my gynae first thing the next morning. Blood tests showed I had obstetric cholestasis. I was induced the next day and, thankfully, Min Hui was fine.”
SWELLING
Swelling in the hands, feet and ankles is very common in later pregnancy. “But if you also have headaches or your blood pressure is raised, get it checked out,” says O’Dell.
Dr Ramsay agrees, “Facial oedema (swelling) in particular can indicate pre-eclampsia, so if people start saying you that look like a hamster, get your blood pressure and urine checked.”
HEADACHES
Lots of mums-to-be get headaches in the early weeks of pregnancy. Paracetamol, taken in the right dosage, should help ease these, but headaches later in pregnancy can signal danger. “They can be a sign of pre-eclampsia, particularly if they are accompanied by visual disturbances,” Dr Ramsay advises.
“If they persist despite taking paracetamol, contact your gynae.”
AND FINALLY ...
When you’re pregnant, it’s not unusual to feel you’re the World’s Worst Worrier. In most cases, your concerns are usually minor, not an emergency, so put your mind at rest.
Don’t worry…
These symptoms may sound scary; but they need to be put into perspective. Mother & Baby expert Helen O’Dell reassures, “Very few of these signs ever happen and, if they do, they’re very minor.” Read on for her advice.
• Less than 1 per cent of bleeds are serious.
• Try not to worry, as the stress this causes isn’t good for you.
• Swelling could be caused simply because you’ve been standing too long or you’re hot, so don’t assume the worst.
• If you’re in doubt over anything, call KK Women’s and Children’s Hospital’s Ask-A-Nurse Service at 1900-KK-Nurse (1900-556-8773), from 8am to midnight daily (including public holidays) for advice and reassurance. It costs 80 cents a minute.
• The best thing to do is not overdo it! Have lots of rest - pregnancy is the perfect excuse to put your feet up.
If you have any comments or practical suggestions, write to us at editor@family.sg
- Mother & Baby
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