Common Pregnancy Conditions & When to Call Your Doctor
Recognizing symptoms early makes all the difference. Here's what to watch for.
🚨 Emergency symptoms — call 911 or go to the ER immediately:
Severe abdominal pain · Heavy vaginal bleeding · Chest pain or difficulty breathing · Signs of stroke (face drooping, arm weakness, speech difficulty) · Reduced or absent fetal movement after 28 weeks · Seizure · Loss of consciousness
Gestational Diabetes (GDM)
What Is It?
Gestational diabetes develops when pregnancy hormones interfere with insulin function, causing elevated blood sugar. It affects 2–10% of pregnancies and typically develops in the second half. GDM usually resolves after delivery but increases lifelong risk of Type 2 diabetes for both mother and child.
Symptoms
Most women with GDM have no symptoms — it's detected by routine screening. Occasionally: increased thirst, frequent urination beyond normal pregnancy, unusual fatigue, or blurred vision. This is why the glucose screening at 24–28 weeks is universal.
Management
- Blood sugar monitoring (4–6× daily)
- Modified diet: complex carbs, lower glycemic index foods, balanced meals and snacks
- Regular moderate exercise (walking after meals lowers post-meal glucose)
- Insulin or oral medication (metformin) if diet/exercise not sufficient — 15–30% of GDM cases require medication
- Increased monitoring: NSTs at 32+ weeks, growth ultrasounds, more frequent OB visits
📞 Call your provider if: Blood sugars are consistently above target (fasting > 95 mg/dL, 1-hr post-meal > 140 mg/dL), symptoms of low blood sugar (shakiness, sweating, confusion), or reduced fetal movement.
Preeclampsia
What Is It?
Preeclampsia is a serious pregnancy complication characterized by high blood pressure (≥ 140/90 mmHg) plus signs of organ damage, occurring after 20 weeks. It affects 5–8% of pregnancies and is the leading cause of maternal and fetal complications worldwide. The only cure is delivery.
⚠️ Warning signs of preeclampsia — call your OB or go to L&D immediately:
Severe headache not relieved by acetaminophen · Visual disturbances (flashing lights, blurry vision, blind spots) · Severe upper-right abdominal pain (just under ribs) · Sudden rapid swelling of face, hands, or feet · Shortness of breath · Nausea/vomiting in second half of pregnancy
Risk Factors
- First pregnancy (3× higher risk)
- Prior preeclampsia, family history
- Chronic hypertension, kidney disease, diabetes
- BMI ≥ 30
- Multiple gestation (twins/triplets)
- Age over 35 or under 20
- IVF conception
Prevention
Low-dose aspirin (81 mg/day), started at 12–28 weeks, reduces preeclampsia risk by 10–24% in high-risk women. Ask your OB if you qualify — ACOG recommends it for women with ≥ 1 high-risk factor or ≥ 2 moderate-risk factors.
Hyperemesis Gravidarum (HG)
What Is It?
Severe, persistent nausea and vomiting beyond normal morning sickness that causes weight loss (> 5% of pre-pregnancy weight), dehydration, and nutritional deficiencies. Affects 0.5–3% of pregnancies. Unlike morning sickness, HG often requires medical treatment and may persist all pregnancy.
When to Seek Care
- Unable to keep any food or liquid down for 24+ hours
- Signs of dehydration: dark urine, dizziness, no urination for 8+ hours
- Weight loss of 5+ pounds
- Vomiting blood
- Extreme weakness or confusion
Treatment Options
- First line: Vitamin B6 (pyridoxine) + doxylamine (Unisom) — safe, effective, often tried first
- Prescription antiemetics: Zofran (ondansetron), Phenergan, Reglan — prescribed when B6/doxylamine insufficient
- IV fluids: When oral intake fails; may require hospitalization
- Thiamine (B1) supplementation: Critical to prevent Wernicke's encephalopathy in severe HG
- Home IV therapy: PICC line for severe, prolonged cases
Placenta Previa
What Is It?
The placenta covers part or all of the cervix, blocking the birth canal. Affects about 1 in 200 pregnancies at term (more common earlier — many cases resolve as the uterus grows). Complete previa at term always requires C-section delivery.
Symptoms
- Painless bright red vaginal bleeding (hallmark symptom)
- Bleeding often begins in the second or third trimester
- Soft, non-tender uterus (distinguishes from placental abruption)
- Often discovered incidentally on anatomy scan
⚠️ Any vaginal bleeding in pregnancy requires immediate evaluation. Do not wait — call your OB or go to L&D. Pelvic exams and sex are contraindicated with known placenta previa.
Placental Abruption
What Is It?
The placenta separates from the uterine wall before delivery, potentially cutting off oxygen and nutrients to the baby. A serious emergency — often requires immediate delivery. Occurs in about 1% of pregnancies; most common in the third trimester.
⚠️ Signs of placental abruption — call 911 or go to the ER:
Sudden severe abdominal or back pain · Uterus that feels rigid/board-like and painful · Vaginal bleeding (may be absent in concealed abruption) · Decreased fetal movement · Rapid contractions
Preterm Labor
What Is It?
Labor beginning before 37 weeks. Approximately 10% of births in the US are preterm. Causes range from cervical insufficiency, infection, placental problems, and multiple gestation to largely unknown. Survival and outcomes improve dramatically with each week closer to term.
Warning Signs (Call Your Provider Immediately)
- Regular contractions (6+ per hour) before 37 weeks, even if painless
- Menstrual-like cramps, low backache
- Pelvic pressure or feeling that baby is "pushing down"
- Change in vaginal discharge — watery, mucousy, or bloody
- Fluid leaking or gushing (may indicate ruptured membranes)
Intrahepatic Cholestasis of Pregnancy (ICP)
What Is It?
A liver condition where bile flow is impaired, causing bile salts to build up in the bloodstream. Affects 0.3–5% of pregnancies (more common in women of South Asian and South American descent and those carrying multiples). Associated with increased stillbirth risk — typically managed with early delivery at 37–38 weeks.
Hallmark Symptom
Intense itching — especially palms and soles, worse at night, without rash. If you have unexplained intense itching in the second or third trimester, call your OB. Diagnosed with elevated bile acid blood test (not standard liver enzymes, which may be normal).