Problem Pregnancy

When to Worry

A woman's body goes through so many changes during pregnancy that it is sometimes hard for her to know when to worry. Many changes such as heartburn, gradual weight gain, and fatigue are just part of being pregnant; however, some problems are not a routine part of pregnancy and should prompt an urgent call or visit to your doctor or midwife. The following are not normal and require medical evaluation:

Miscarriage

Bleeding in the early months of pregnancy signals the possibility of a miscarriage. As many as 20 percent of pregnancies end in miscarriage. Sometimes this occurs so early in pregnancy a woman may not even know she was pregnant. Bleeding, clots, and cramping are the usual signs of miscarriage. Surgery (D&C) may be required to completely empty the uterus.

Ectopic Pregnancy

Sometimes a woman is pregnant, but the fertilized egg does not make it all the way into proper position in the uterus. As the embryo begins to grow in its abnormal location, it stretches and may tear delicate structures and blood vessels. The symptoms of an ectopic pregnancy are bleeding, low back pain, nausea, lower abdominal pain or cramping, and the usual signs of pregnancy. This can turn quickly into an emergency and requires surgery to remove the malpositioned, nonviable embryo.

Premature Labor

Premature labor and delivery are common problems of pregnancy. About 11 percent of all pregnancies in 1995 ended in delivery before 37 completed weeks of gestation. The seriousness of the problem depends on how prematurely a woman goes into labor. A change in vaginal discharge, leakage of fluid from the vagina, menstrual-like cramps, dull backache or abdominal cramping for more than one hour, or a feeling of having to push, all may indicate premature labor. The consequences of early delivery can be serious for your baby. Seek care and advice immediately.