$Unique_ID{PAR00422} $Pretitle{} $Title{Pregnancy: The Fifth Month: Ask the Doctor} $Subtitle{} $Author{ Editors of Consumer Guide Ellis, Jeffrey W Ellis, Maria} $Subject{Fifth Month Ask Doctor pregnancy Complication Complications prenatal care Vaginal Bleeding Spotting ectopic placenta previa Cramping Abdominal Pain Burning Urination Bacterial infection infections bladder kidney kidneys Fever Chills amniotic sac fluid Rupture rupturing Leak Leakage Swell Swells Swelling Puffiness Face Hand Hands foot Feet preeclampsia toxemia high blood pressure urine protein edema seizure seizures stroke headache headaches dizzy dizziness Blurred vision vomit vomits vomiting Decreased Movement Soreness Redness Legs blood clot clots Visit Visits} $Log{ Placenta Previa*0042201.tif} Miracle of Birth The Fifth Month: Ask the Doctor How Will I Know if Something is Wrong? It is the hope and dream of all parents to experience a normal pregnancy and bring home a healthy baby. Although the majority of pregnancies are uneventful, some involve complications that may range from minor to life-threatening--for the mother, the baby, or both. Complications of pregnancy may develop gradually or suddenly and without warning. One objective of prenatal care, therefore, is to promptly diagnose and treat these complications. In this section, we will describe the "warning signs" of pregnancy--signs that may indicate that a complication is developing. If you ever experience any of these warning signs, notify your doctor immediately. Any Vaginal Bleeding or Spotting Normally, after your last menstrual period you should have no more vaginal bleeding until the delivery of your baby. If you do experience bleeding or spotting at any time during your pregnancy, contact your doctor or hospital immediately. Bleeding that occurs during the first trimester may indicate that a miscarriage is occurring or that the pregnancy may be located outside the uterus--for example, in the fallopian tube (called an ectopic pregnancy). Bleeding or spotting that occurs in the second or third trimester may indicate a problem with the placenta. In some cases, the placenta may begin to separate from the wall of the uterus and cause bleeding. This condition is called placental abruption. In other cases, the placenta--which should normally be located high up in the uterus--may grow down too low and cover the opening of the cervix (called placenta previa). Bleeding may then occur from exposed blood vessels over the canal of the cervix. These problems are usually diagnosed with the aid of ultrasound. Severe Cramping or Sharp Abdominal Pain This is another sign that may indicate that the placenta has begun to separate from the wall of the uterus. If you experience such cramping or pain, call your doctor immediately. Pain or Burning During Urination Bacterial infection of the bladder and kidneys is more common during pregnancy. Severe infection is not only painful, but it may also cause you to go into labor prematurely. Therefore, it is extremely important to call your doctor if you experience either pain or a burning sensation when you urinate. Do not attempt to treat yourself with home remedies. Fever or Chills If you develop a fever of over 100 degrees or experience chills, this maybe a sign of infection. Even though most fevers are caused by a "cold" or the flu, your doctor will need to explore the possibility of pneumonia or kidney infection. If your amniotic sac has broken, fever and chills may indicate an infection of the amniotic fluid--a serious condition that will require antibiotics and delivery of the baby. Rupture of the Amniotic Sac or Leakage of Fluid When the amniotic sac breaks, some women have a sudden gush of fluid from the vagina while others may have only a slight leak. In the majority of pregnancies, labor begins within 24 hours of the rupture of the amniotic sac. Sometimes, however, the amniotic sac may rupture prematurely. When the amniotic sac breaks, the protective seal around the baby is broken and bacteria from your vagina may enter the amniotic fluid. This can cause a serious infection in the baby and placenta within a few hours. Therefore, you should call your doctor immediately--whether or not you are near your estimated delivery date--if you ever suspect that the sac has broken or is leaking. Swelling or Puffiness of the Face, Hands, and Feet This may be a sign that you are developing a condition called preeclampsia, also called toxemia. This complication of pregnancy is associated with abnormally high blood pressure, protein in the urine, and swelling (edema) of the face, hands, and feet. If toxemia is left untreated and becomes severe, seizures, stroke, and even death can occur. Other warning signs that may indicate preeclampsia include: - Continuous or severe headache - Unexplained dizziness - Blurred vision - Continuous, severe, or recurrent vomiting - Decrease in the amount of your urine Decreased Movement of the Baby In cases where an abnormality of the placenta may be developing, the baby's movements may slow down considerably or even stop. If you ever suspect that your baby is moving less than usual during the third trimester, call your doctor immediately. Soreness or Redness in One or Both Legs Because of certain changes in the blood during pregnancy, blood clots, especially in the calves of the legs, become much more common. This is a serious condition, since these clots can break away and travel through the mother's bloodstream to the lungs, heart, or brain. Even if you think it is only a simple muscle strain, report any unusual leg soreness, as well as any redness, to your doctor immediately This Month's Visit During this month's office visit, your doctor will probably: - Check your weight. By now, you will have gained about ten to 12 pounds; if you have not gained this amount, your doctor will probably advise you to increase the number of calories you consume each day. - Check your blood pressure. Your blood pressure may be slightly lower than it was before pregnancy. - Check your urine for sugar and protein. You should normally have neither in your urine. - Ask about symptoms of pregnancy. You may now be experiencing leg cramps, bleeding gums, sinus congestion, and changes in your sense of taste. - Ask you how you are feeling. - Ask about the baby's movements. By now, you should feel the baby moving and kicking. - Check the growth of your uterus by feeling your lower abdomen and measuring the distance from your pubic bone to the top of the uterus with a tape measure. By now, the top of your uterus should be at about the level of your navel. - Listen for the baby's heartbeat with a doppler instrument or with a stethoscope. The baby's heart will beat about 140 to 160 times a minute. - Perform a blood test to check your blood sugar level.