It contributes greatly to a successful pregnancy, but not all moms-to-be receive prenatal care. Those who do sometimes overlook common warning signs during pregnancy. Dr. Wayne Farley is Medical Director of the Advanced Maternal and Newborn Institute at Medical City in Dallas. In a Health Checkup, Dr. Farley described some of those.
Dr. Farley: Number one on my list would be vaginal spotting and bleeding, a very common problem that can occur throughout the pregnancy. Early in the pregnancy some vaginal spotting and bleeding can be an indication of a miscarriage. In most cases it is not.
That problem later in the pregnancy can indicate the patient is going into labor. It can be an indication that there’s a problem with the placenta. So those kind of issues need to be addressed.
Baker: So when that occurs that involves a call to your –
Dr. Farley: Provider.
Baker: Not a move to the emergency room?
Dr. Farley: That’s exactly right. The patient’s perception of heavy bleeding is much different than the physician’s interpretation of heavy bleeding. So it’s important to talk to the provider first and see, “Is this something I need to be concerned about?”
Baker: Other signs on the list?
Dr. Farley: Headaches unfortunately are very common in pregnancy and more common in pregnancy. It’s part of the vascular changes that occur in pregnancy and also the hormonal events that occur during pregnancy as well. But if you have a persistent headache, a headache that’s not relieved with hydration, drinking more fluids; Tylenol, which is perfectly safe to use during pregnancy; and rest – especially if the patient describes it as “the worst headache I’ve ever experienced in my life,” that’s a headache that needs to be evaluated.
Baker: Other signs?
Dr. Farley: Pain in one or both legs. Cramping is normal, leg cramps are very common in pregnancy. But if it’s persistent and severe pain, especially if its occurring more in one leg than the other … pregnancy is what we call a hypercoaguable state, which means the patient is more inclined to blood clots. In fact, it increases your risk of a blood clot about seven times your normal state. That’s why we encourage pregnancy patients to exercise frequently and stay very active during pregnancy because the more sedentary a patient is, the even greater risk of a blood clot.
Baker: At the same time, it’s easy to see why some of these signs could be easily misdiagnosed or dismissed. They seem common to people every day.
Dr. Farley: Pregnancy is a state of aches and pains. If you talk to a lot of patients, they get a little bit frustrated because they talk to a nurse at the physician’s office, or the physicians themselves. And the response is, it’s because you’re pregnant. But you just can’t ignore these things.
For later in the pregnancy something people often don’t pay attention to is decreased fetal movements -- “My baby isn’t moving as much as it’s used to.” But there is s a myth out there that baby’s movements decrease as the pregnancy progresses. And in fact that’s not true, your baby should move throughout the pregnancy. It should move at 25 weeks as much as it did at 20 weeks, and it should move at 35 weeks as much as it was moving at 25 weeks.
Baker: It’s certainly not for lack of emphasis on the need for prenatal care – that’s certainly been in place for God knows how long – so how is it that you’re still running into problems of women not knowing to maybe be more aware of signs of what’s going on in their bodies and if they need to go to the doctor to check that out?
Dr. Farley: There’s a percentage of the population that has difficulty with transport, with the funding, the ability to pay for prenatal care, access to prenatal care, so we see a larger portion of the people in lower socioeconomic class not having access to prenatal care.
There are public and county clinics available, but not enough to handle the demand. And so as a result the more complications of pregnancy occur in the lower socioeconomic class. And that does not exclude those who have access to prenatal care; they certainly have their problems as well. But simply having the access to prenatal care allows them to receive a higher level of care and avoid more of those problems and complications that occur later in the pregnancy, and compromise the outcome of the pregnancy.
Baker: And in terms of this problem of missing signs, do you tend to find this more in women who are pregnant for the first time?
Dr. Farley: I think it’s the opposite actually. The first-time moms are so dedicated to knowing everything, buying every book on the shelf to learn about their pregnancy, reading everything and tend to overanalyze somewhat, and then the moms that have had two or three babies –
Baker: They get a little too comfortable?
Dr. Farley: “Oh that happened in my first pregnancy, and everything was fine, and I know now that’s no big deal.” So I think the older, more experienced, are actually more prone to overlook these common signs and symptoms than the younger ones are.
Tag: Dr. Wayne Farley is Medical Director of the Advanced Maternal and Newborn Institute at Medical City in Dallas.
Dr. Wayne Farley’s list of warning signs during pregnancy:
Fetal movement – Contrary to popular belief, it should remain consistent throughout the pregnancy
Headaches – though headaches are more common during pregnancy, severe headaches can be a sign of toxemia. Toxemia causes high blood pressure and affects the kidneys
Vaginal spotting/bleeding – though it is common during pregnancy, it can also be a sign of a problem, and should always be checked out by your physician
Swelling – though some swelling is normal, extreme swelling and swelling that extends up to the knees can be a sign of trouble
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