Antenatal care entails monthly visits to the clinic till 28 weeks gestation, then two weekly visits till 36 weeks then followed by weekly visits till delivery for those progressing well. Sometimes there is a variation from this schedule depending on the needs of the expectant mother

However, there are certain situations when it becomes necessary to get in touch with your gynecologist at times on an urgent basis before the next visit when certain complications develop.

Complications during pregnancy and childbirth are common. In fact, approximately 40 percent of pregnant women experience some complications during pregnancy, childbirth and the postpartum period and about 15 percent develop life-threatening complications. Most complications cannot be predicted and can happen at any point during the antenatal period or during delivery or thereafter. Therefore all pregnant women should be prepared to respond appropriately when complications arise by contacting their caregivers immediately.

There are certain symptoms if present denotes that they could be serious complications hence need to act immediately. These symptoms are referred to as danger signs. Knowledge of danger signs of pregnancy emergencies and appreciation of the need for a rapid and appropriate response when they occur is important to avert fatal outcomes. At times getting medical help early makes the difference between survival and death. 

The Danger signs in pregnancy are vaginal bleeding, severe headache, severe vomiting, swelling of hands and face, difficulty in breathing, fits, fever, reduction or absent fetal movement, a gush of fluid (liquor), intense abdominal pain and contractions before 37 weeks. Danger signs indicate a woman needs immediate care and therefore should seek help soonest possible.

Bleeding is a very serious complication. It causes most of the maternal and fetal deaths in our country. Any bleeding in pregnancy irrespective of the amount is abnormal. When bleeding is present during pregnancy it may indicate that the placenta position is on the lower aspect of the womb (placenta praevia). Bleeding may also occur when there is premature separation of the placenta. 

Premature separation cuts of delivery of oxygen and other nutrients to the baby and this can cause the death of the baby. Other causes of bleeding in pregnancy include rupture of the uterus and rarely bleeding from the baby. Heavy bleeding after delivery may arise from different causes such as relaxation of the uterus (atony), injuries in the birth canal, an incomplete expulsion of the placenta and sometimes bleeding disorders.

A severe headache, swelling of hands and face, blurred vision, fits and difficulty in breathing indicate high blood pressure and need for urgent attention. This complication is referred to as severe pre-eclampsia and when fits are present it’s called eclampsia. This disease is also deadly and delivery is the way out regardless of whether the baby is mature or not. Seeking immediate care from your gynecologist is important.

The hotness of the body with or without vomiting may indicate the presence of serious infection or malaria. Prompt treatment does save a life.

When waters break, it's an emergency. There is a possibility that the baby’s cord can come out and get compressed by the baby’s head stopping the blood supply to the baby which can cause the death of the baby. It's very easy for infection in the uterus to set in once the waters break. This infection is life-threatening. Urgent care is crucial.

Fetal movements (kicks) are usually present from the 5th month of pregnancy. Any decrease in the baby’s movement may indicate that the baby’s life is in danger hence should be reported to your gynecologist as soon as possible.

Intense abdominal pains require urgent evaluation by your doctor. Causes of severe abdominal pain include ectopic pregnancy; rupture of the uterus, premature separation, infection of the kidney. At time’s abdominal pain may be due to surgical diseases such as appendicitis, intestinal obstruction, etc.

Contractions that occur before 37 weeks indicate premature labor. Babies born at this time usually develop breathing difficulties which at times is very serious and can be fatal. It's advisable for expectant women to seek assistance when they start getting regular uterine contractions especially if there are more frequently than 10 minutes apart.

In conclusion knowledge of danger signs is important because it improves complication recognition and ensures timely decision to seek care hence handling complications in good time and consequently saving lives and avoiding serious disabilities.


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