DANGER SIGNS IN PREGNANCY (PART 2)

DANGER SIGNS IN PREGNANCY (PART 2)

Last week we discussed about the danger signs in pregnancy, this week we will be continuing with symptoms you should not ignore in pregnancy.

SWOLLEN HANDS OR FACE: In pregnancy, most body part may seem to be getting bigger and a little bit of swelling might be expected, close attention must be paid to the hands and face. Puffiness in the face and anything more than a little swelling of the hands could be a sign of pre-eclampsia, also known as pregnancy-induced hypertension (PIH) or toxemia. Severe, sudden swelling in the ankles and feet must also be noted. Early detection and close monitoring with regular blood pressure check and specialist management is required in Pre-eclampsia.

Symptoms of Pre-eclampsia include:
• Headaches
• Swelling of your feet, ankles, face, or hands
• Pain in your upper abdomen
• Blurred vision
• Protein in the urine diagnosed during routine ANC check by urinalysis test.

Pre-eclampsia not treated will get severe, and can cause brain, liver, kidney, heart or eye damage and sometimes seizures.
Delivery of the baby may be the best treatment for preeclampsia, however if baby has not developed enough, bed rest at home or in the hospital until blood pressure is controlled or the baby is ready for delivery is needed depending on the appropriate option of treatment by the physician that is managing the patient.

RAPID WEIGHT GAIN: There should be no stress about gaining weight as that is expected in pregnancy, but if more than is added in a week, that could be another sign of pre-eclampsia, in which case specialist evaluation will be required.

ITCHING: The skin could be itchy simply because it is dry or over stretched or due to the presence of a rash called PUPPP, an itchy rash that appears in stretch marks of the stomach in late pregnancy, which is aggravating but not harmful at all. But if you have all over itchy, or your itchiness is more severe than normal, special test need to be done to rule out cholestasis in pregnancy, a liver disorder that can cause serious issues, such as preterm labor and stillbirth.

BACKPAIN: Women experiencing backpain are advised to seek specialist attention. Pain must be checked to make sure is just normal pregnancy pain and not a sign of bladder infection, cyst, miscarriage or preterm labor.

BLURRY VISION: Getting up too fast from the bed can result in some normal pregnancy dizziness. Blurry vision that is persistent or comes along with other symptoms, such as headache or rapid weight could be a sign of preeclampsia or gestational diabetes, both of which require urgent medical management.

FEVER: Most pregnant women are vulnerable to cold and flu germs, so a fever is likely to happen sometime during the nine months period. There are a number of viruses and conditions that can cause fever. A temperature that is over 100F (37.8C) could be a sign of infection or illness. If it lasts longer than 24 to 36 hours then the need for treatment arises, as a high temperature or infection can lead to preterm labor. The infection may need to be treated with antibiotics or other medications.

BABY MOVEMENT: Babies start to move early in pregnancy. Most women start to feel the movements at about 18-20 weeks or halfway through the pregnancy. Each baby has its own pattern of movement. Every woman needs to know the pattern of their baby’s movements, keep track and know when to tell the doctor about possible irregularities noted.

PREMATURE RUPTURE OF MEMBRANES (PROM): Rupture of membranes is a normal part of giving birth. It’s the medical term for saying your “water has broken’. It means that the amniotic sac (water sac) that surrounds the baby was broken, allowing the fluid to flow out. While it is normal for the sac to break during labor, if it happens too early, it can cause serious complications. This is called preterm/ premature rupture of membranes (PROM).

The cause of PROM is not always clear, but sometime genetic factor and infection of the amniotic membranes can be a cause. Treatment of PROM varies. Women are often hospitalized and given antibiotics, steroids and drugs to stop labor. When PROM occurs at 34 weeks or more, some doctors might recommend delivering the baby. At that time the risk of prematurity are less than the infection risks. If there are signs of infection, labor must be induced to avoid serious complications. Occasionally, a woman with PROM experiences resealing of the membranes. In this case a woman with pregnancy can continue her pregnancy to near term, although still under close observation.

The risks associated with prematurity decrease significantly as the fetus nears term. If PROM occurs in the 32-to 34- week range and the remaining amniotic fluid shows that the fetus’ lungs have matured enough, the doctor may discuss delivering the baby in some cases. Availability of improved intensive care nursery services, many preterm infants born in the third trimester (after 28 weeks) usually survive.

ABDOMINAL PAIN: In the third trimester, causes of abdominal discomfort can include gas, constipation, and Braxton-Hicks contractions (false labour) and they should not cause excessive amounts of pain. It is important to see your physician if you experience severe abdominal pain.

CONCLUSION

Knowledge of the danger signs will help women to make the right decisions and take appropriate healthcare seeking action, which means receiving immediate and appropriate care, which reduces maternal mortality (death rate) and morbidity (incidence) associated with pregnancy.

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