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By: Ikedi Ani-okoye

Pregnancy: Coping with antenatal emergericies

Situations sometimes arise in pregnancy that call for immediate action. These include bleeding, severe abdominal pain, headache, continuous vomiting, breaking of the waters, and lack of fetal movements. The first priority is to call for the emergency services and explain what has happened so they can warn the hospital. While waiting for specialist help, keep the mother calm and reassure her that Help is on the way and that the baby will be fine. You should be prepared to monitor her condition and take appropriate action if it changes.

Problems in pregnancy may occur that require getting to hospital quickly, and occasionally rapid action is needed prior to reaching hospital. You should familiarize yourself with what constitutes an antenatal emergency, but always seek medical advice if you are in any doubt at all about a pregnant woman's symptoms.

Collapse in pregnancy

Any woman of fertile age who suddenly collapses should be considered possibly to be pregnant. The main concern is that the collapse may be due to a tubal pregnancy, also known as an ectopic pregnancy.

A heavily pregnant woman should not be laid on her back if she collapses. Keep her on her left side and perform CPR at a 30-degree angle. The pregnant uterus lies on the vessels that feed blood back to the heart, so resuscitation and cardiac compressions will only be effective if the woman is turned slightly on to her left side, in order that these vessels are not constrained in anyway.

Bleeding in early pregnancy

Any bleeding during the first eight weeks of pregnancy could be due to an ectopic pregnancy, in which the baby develops in one of the Fallopian tubes. There is often, but not always, low pelvic pains before the bleeding starts. In this case, the pregnant woman should see her doctor urgently, even if the bleeding is very light. |early signs of pregnancy. If there is any abdominal pain with the bleeding, or if the woman feels unwell, particularly if she is pale, dizzy or prone to faintings it is important to seek a doctor's advice urgently.

Miscarriage

Another possible cause of bleeding in early pregnancy (up to 23 weeks) is miscarriage, and the woman should see her doctor urgently or go to hospital depending on the severity of symptoms. Sometimes there is only a very small amount of blood and very little abdominal pain. This is usually called a threatened miscarriage, and Bed rest and avoidance of sex may be the only advice from the doctor.

In other cases, the bleeding from a miscarriage may be extremely heavy and accompanied by cramp-like pains in the the lower abdomen. There may even be signs and symptoms of shock when the miscarriage has become inevitable, and there may also be visible parts of the placenta and fetus in the Blood. Such severe symptoms require admission to hospital, where it is likely that an operation will be performed under anaesthetic to ensure that the entire contents of the uterus are removed.

Bleeding in late pregnancy

Any bleeding after 23 weeks should be taken very seriously, and the woman should be taken to a doctor immediately. lt only be a harmless "mucous plug", which sits in the cervix until near the end of pregnancy. However, it may also be a sign that the placenta is bleeding, or has started to rupture away from the wall of the uterus. These placental conditions are known as placenta previa (in which there is painless bleeding) and placental abruption (in which there is severe pain). Both conditions can threaten the baby's life.

Breaking of the waters

The membranes surrounding she baby in uterus normally rupture at the onset of labour. This may release a release of amniotic fluid or a more gentle leakage. Sometimes, however, the waters can break before the baby is ready to be born and the woman will have to be admitted to hospital to protect the baby from infection.