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When to call your gynae...(and when not to)

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Some niggles are little more serious than heartburn while others definitely need your gynae's help...

Article: Tina Otte

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Symptom:
Bleeding in the first trimester, pink or brownish spotting usually 5-12 days after ovulation, but much lighter than your normal period.

Cause:
This is known as implantation bleeding and occurs when the fertilised egg attaches to the endometrium and "eats" into the lining.

Panic level:
LOW: This is not serious at all, in fact 25% of all women experience this form of bleeding. It is only a cause of concern if you feel any form for pain or the spotting gets worse (same as or heavier than a period).

Symptom:
Heavy bleeding in the first trimester, sometimes accompanied by period-like cramps.

Cause:
Miscarriages occur in 15-20% of pregnancies, most before the woman even realises she is pregnant. Miscarriages usually occur within the first 12 weeks.

Panic level:
HIGH: Unfortunately, most miscarriages cannot be prevented, and in many cases there is no reason pinpointed for the miscarriage. These are often the body's way of dealing with a pregnancy that isn't viable.

Symptom:
Fainting, light-headedness or dizziness, unusual bleeding, sharp, stabbing pains in your abdomen, shoulder pain, bladder or bowel pain.

Cause:
An ectopic pregnancy is less common than a miscarriage and is when the fertilised egg implants itself somewhere other than in the uterine lining, usually in the fallopian tube.

Panic level:
HIGH: The levels of hCG (human chorionic gonadotrophin) don't rise as quickly as they would in a regular pregnancy. Unfortunately, this form of pregnancy is not viable, and will need to be removed.

Symptom:
Intermittent, brownish discharge, accompanied by severe nausea or vomiting. No foetal movement or heartbeat.

Cause:
This is rare, and is known as a molar pregnancy. It is the growth of abnormal tissue instead of an embryo and occurs when chromosomal abnormalities prevent the pregnancy from developing normally.

Panic level:
HIGH: Unfortunately, this is usually only diagnosed at your check-up when a scan is done. It is usually picked up within the first 8-10 weeks of pregnancy and the pregnancy usually ends spontaneously.

Symptom:
Bleeding in the last trimester, accompanied by abdominal pain or tenderness, nausea, excessive thirst, fainting, decrease in baby's movement, severe cramping.

Cause:
Placenta abruption is when the placenta detaches from the uterine wall.

Panic level:
HIGH: This is a rare complication and cannot be stopped or re-attached. Treatment depends on the mother’s health and the viability of the baby.

If the abruption is mild, the mother will probably be kept on bedrest and monitored. If the baby isn't distressed the pregnancy will be allowed to progress to full term and your labour induced. If severe, a caesarean section will be performed.

Symptom:
Third trimester bleeding accompanied by premature contractions. Your baby may be lying in a breech or transverse position and your uterus may measure larger than it should according to your dates.

Cause:
Placenta praevia occurs in about one in every 250 pregnancies. This is when the placenta covers part or all of the cervix and is also known as a low lying placenta.

Panic level:
HIGH: If this is diagnosed after 20 weeks, and you are not bleeding, you may be asked to take things easy and have bedrest.

Early placenta praevia can resolve itself. If you are bleeding, you may be hospitalised. The goal is to keep the pregnancy going until 36 weeks, at which point the baby will be delivered via caesarean section.

Symptom:
Brief, sharp, stabbing pain, or a longer-lasting, dull ache that is felt on one or both sides of your lower abdomen or deep in your groin, usually in your second trimester.

Cause:
Round ligament pain.

Panic level:
LOW: Your ligaments are stretching and thickening to accommodate and support your growing uterus. Your round ligament is stretching as your uterus grows.

These ligaments can cause great discomfort. Deep breathing and folding in toward the pain will alleviate the problem immediately.

Symptom:
Abdominal discomfort, small pellet-like stools.

Cause:
Constipation.

Panic level:
LOW: Your pregnancy hormones are slowing the movement of food through your digestive tract. Added discomfort is caused by the pressure of your growing uterus on your rectum. Sip water frequently.

Symptom:
Pain, discomfort or burning when weeing, lower abdominal pain, uncontrollable urge to wee, cloudy or strong-smelling urine.

Cause:
Urinary tract infections are very common during pregnancy.

Panic level:
MEDIUM TO HIGH: Call your caregiver if you are experiencing any of these symptoms as an untreated bladder infection can lead to a kidney infection or premature labour.

Signs that this has spread to the kidneys include: a high fever, pain in your lower back or just under your ribs, blood in your urine.

Symptom:
Burning sensation that feels a bit like a fire in your chest.

Cause:
Heartburn.

Panic level:
LOW: This will easily be rectified with an antacid such as Rennies or Gaviscon. There are homeopathic remedies that are excellent.

Symptom:
High blood pressure and protein in your urine accompanied by swelling of your face, hands, feet and ankles.

You may also experience tenderness in your upper abdomen, a severe headache, blurred vision, nausea and vomiting.

Cause:
Pre-eclampsia is a pregnancy condition that causes spasms and other changes in your blood vessels. This can affect a number of organs, including your liver, kidneys, brain and placenta.

Panic level:
HIGH: Call your caregiver immediately. This condition is life-threatening and you may need to be hospitalised.

Symptom:
Battling to breathe, from mid-pregnancy onwards.

Cause:
Breathlessness.

Panic level:
LOW: Your body has to work harder to meet your body's increased oxygen needs. To take in more air, your ribs flare out and your lung capacity increases dramatically, which can make you feel breathless.

In the last three months, your enlarged uterus pushes up against the base of your lungs.

Symptom:
A tightening of your uterus. Felt from mid-pregnancy, usually infrequent and essentially painless.

Cause:
Braxton-Hicks contractions, also known as workout contractions.

Panic level:
MEDIUM: This is your body's way of preparing for labour. The contractions usually ease off if you change position or walk around.

If these contractions are accompanied by lower back pain, are coming at regular intervals or if you feel more than four contractions an hour, you could be in premature labour and need to call your caregiver immediately as the panic level has just risen to high.

Symptom:
Blood streaked mucus, accompanied by period-like cramps, a few weeks prior to, or on, your due date. The pain starts at the back and radiates to the front, increasing in intensity. It does not ease off if you move position or walk around.

Cause:
May be the start of labour.

Panic level:
LOW to MEDIUM: This may be it – the start of your labour, your baby is ready to come! Check with the hospital!

- Your Pregnancy magazine

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