Warning Signs That Need Immediate Medical Attention

Pregnancy, while a natural process, can sometimes develop complications that require urgent medical attention. Recognising warning signs early and responding promptly can prevent life-threatening situations for both the mother and the baby. Every expectant mother and her family should be educated about these signs as part of routine antenatal care.

In India, delays in seeking emergency obstetric care remain a significant contributor to maternal and neonatal complications. These delays are often due to lack of awareness about warning signs, distance from healthcare facilities, or hesitation in seeking help. Education about danger signs empowers families to act quickly when necessary.

This information is not intended to cause alarm but to prepare expectant mothers to respond appropriately when unusual symptoms occur. Most pregnancies progress normally, but knowing when to seek emergency care provides an important safety net.

Vaginal bleeding during pregnancy should always be reported to the doctor, but heavy bleeding at any stage constitutes an emergency. In the first trimester, heavy bleeding may indicate a miscarriage or ectopic pregnancy, both of which require immediate evaluation. Ectopic pregnancy, where the embryo implants outside the uterus, can be life-threatening if the fallopian tube ruptures.

In the second and third trimesters, bleeding may be caused by placenta previa, where the placenta covers the cervix, or placental abruption, where the placenta separates from the uterine wall before delivery. Both conditions can cause serious blood loss and require emergency management. Any bleeding accompanied by pain should be treated as urgent.

Light spotting, while often benign, should still be mentioned at the next prenatal visit. The doctor can determine the cause and advise on whether any further evaluation is needed. Keeping the doctor informed about all episodes of bleeding ensures appropriate surveillance.

While mild cramping can occur as the uterus grows, severe or persistent abdominal pain during pregnancy is a warning sign. In early pregnancy, sharp one-sided pain may suggest an ectopic pregnancy. Later in pregnancy, severe constant pain, especially with a rigid abdomen, could indicate placental abruption or uterine rupture.

Pain accompanied by bleeding, fever, or fainting is particularly concerning and warrants an immediate trip to the hospital. Even without these additional symptoms, any abdominal pain that is unusual in character, intensity, or duration should be evaluated by a healthcare provider without delay.

Distinguishing between normal discomfort and concerning pain can be difficult for expectant mothers, especially first-time mothers. As a general rule, pain that prevents normal activities, wakes the mother from sleep, or does not improve with rest and position changes should be reported to the doctor.

Preeclampsia is characterised by high blood pressure and protein in the urine, typically developing after 20 weeks of pregnancy. Warning signs include severe headaches that do not respond to paracetamol, visual disturbances such as blurred vision or seeing flashing lights, upper abdominal pain particularly under the right ribs, sudden swelling of the face or hands, and feeling generally unwell.

If left untreated, preeclampsia can progress to eclampsia, which involves seizures and can be fatal for both mother and baby. HELLP syndrome, a severe variant, involves breakdown of red blood cells, elevated liver enzymes, and low platelet count. Both conditions require immediate hospitalisation and may necessitate emergency delivery.

Regular blood pressure monitoring during antenatal visits helps detect preeclampsia early. However, it can develop rapidly between visits, which is why awareness of symptoms is essential. Any combination of the above symptoms should prompt immediate medical evaluation.

From around 28 weeks onwards, expectant mothers are usually aware of their baby's movement patterns. A noticeable reduction in fetal movement can be a sign that the baby is in distress and requires urgent evaluation. While babies have quiet periods, a significant decrease from the usual pattern should not be ignored.

Doctors often recommend kick counting, where the mother tracks the number of movements felt in a specified time period. If fewer than ten movements are felt in two hours during the baby's usual active time, or if movements have clearly reduced, the mother should contact her doctor or go to the hospital for a fetal assessment, which typically includes a non-stress test.

Leaking of amniotic fluid, recognised as a gush or continuous trickle of clear fluid from the vagina, is a sign that the membranes have ruptured. Before 37 weeks, this is considered preterm premature rupture of membranes and requires immediate hospitalisation. Even at term, the mother should contact her doctor promptly to receive appropriate guidance on when to come to the hospital.

High fever during pregnancy, persistent vomiting that prevents any fluid intake, difficulty breathing, and signs of urinary tract infection such as painful or bloody urination are additional symptoms that need medical attention. Keeping the doctor's emergency contact number readily available and knowing the route to the nearest hospital with obstetric services are practical steps that every expectant family in Visakhapatnam should take.