When “Normal” Pregnancy Symptoms are “Abnormal”

Pregnancy Symptoms

We all know that the most common symptoms of pregnancy are a missed period, nausea and vomiting, urinary frequency, and fatigue. But how do you know when these symptoms might mean that something is amiss? Here’s a guide to knowing when to call in the health care professionals (HCP):

Missed Period
You thought you were pregnant but your urine test keeps coming up negative. There are lots of reasons besides pregnancy that you might have missed a period.

When to call the HCP: if it is at least 14 days since your last episode of sexual intercourse and your urine pregnancy test is negative. Your HCP may order a blood (serum) test, which provides a more sensitive and accurate reading of your hormone levels. If it remains negative, you’ll want to explore other reasons why you may not be bleeding.

Nausea and Vomiting
Nausea and vomiting are not uncommon early in pregnancy; in fact they occur in 50% to 90% of pregnancies to varying degrees. Nausea and vomiting caused by pregnancy usually begins within the first 6 weeks, peaks at 9 weeks and is gone by 18 weeks’ gestation.[1]

When to call the HCP: if you are having trouble keeping any food and fluids down and you are losing weight. Hyperemesis gravidarum is the term for severe nausea and vomiting of pregnancy. Your HCP want to watch you for weight loss and dehydration, check your liver and thyroid function via blood tests, and do an ultrasound to check the status of the baby.

Gestational trophoblastic disease (molar pregnancy) and multiple gestation (twins, triplets, etc.) can be the cause of increased nausea and vomiting.

If nausea and vomiting begin after 10 weeks’ gestation you should report it to your HCP, especially if it is accompanied by pain, fever, dizziness, diarrhea, or headache. There may be something unrelated to the pregnancy that is causing your symptoms.

Urinary frequency
Having to urinate more frequently is one of the more common complaints of pregnant women. The increased frequency is caused by changes in the structure and function of the kidneys and bladder that result in an increased production of urine, especially at night.

When to call the HCP: if the frequency has suddenly increased and is accompanied by pain during urination, blood or pus in the urine, fever, chills, or back pain. Urinary tract infections (UTIs) occur more frequently in pregnant women than in non-pregnant women. UTIs that are not treated can progress to kidney infections (pyelonephritis) which can cause pregnancy complications like preterm birth. It is best to prevent a UTI from progressing to a kidney infection, so if you have any symptoms, let your HCP know sooner rather than later.

Fatigue
Extreme tiredness is common in pregnancy, especially in the first trimester.

When to call the HCP: if your fatigue does not resolve in the second trimester, or recurs later in pregnancy. It could be a sign of anemia (low blood iron) or an infection.

Knowing what’s normal and abnormal can help you know when to call your health care provider. But don’t hesitate to call at any time – they are the experts at answering your questions and providing you with the care you and your baby need.

Reference:

  1. Refuerzo JS, Dmaith JA, Ramin AM. Clinical features and evaluation of nausea and vomiting of pregnancy. In: Lockwood CJ (Ed), UpToDate, UpToDate, Waltham, MA.
Kristine Shields
Dr. Kristine Shields is an Ob/Gyn Nurse Practitioner with a doctorate in Public Health. She is a women's health advocate dedicated to providing evidence-based information to pregnant and breastfeeding women and their health care providers so they can make informed treatment decisions.