Warning Signs During Pregnancy

By Jeffrey Boyle, MD Jun 03, 2016


Your body goes through many changes in pregnancy. It is difficult to know what signs and symptoms you experience are normal and what could be an indication of a problem. Below is a list of normal changes that you don’t typically have to worry about and a list of which symptoms you should contact your doctor about.

Normal symptoms during pregnancy

  • Nausea and vomiting in the first trimester
  • Heartburn
  • Restless legs syndrome
  • Sciatica—nerve pain that shoots down from buttocks to legs
  • Carpal tunnel syndrome—pain and numbness in thumb and fingers
  • Hemorrhoids
  • Constipation
  • Frequent urinating or incontinence
  • Round ligament pain—sharp groin pains, on the sides of uterus, with movement
  • Light headedness/dizziness—with standing
  • Back pain
  • Swelling of legs
  • Mild shortness of breath
  • Fatigue
  • Nasal stuffiness
  • Nose and gum bleeds
  • Darkening of the skin on abdomen and face
  • Small red rashes on face, neck and chest
  • Redness of the palms

Symptoms you should not ignore

Vaginal bleeding after 12 weeks gestation—light spotting is normal before 8 weeks as the embryo is implanting. Some spotting can also occur after sex or with a cervical infection. Bleeding with pelvic pain can mean an ectopic pregnancy. Bleeding after 12 weeks can also mean the cervix is shortening or dilating which can lead to preterm birth or miscarriage. Contact your doctor to be evaluated if you have bleeding after 12 weeks.

Contractions—contractions are common in pregnancy and can occur from the second trimester until term. The Braxton Hicks contractions are normal and do not typically change the cervix or indicate labor. They are usually painless, feel like tightening or hardening of the uterus and occur irregularly. If your contractions are painful, regular or accompanied by any bleeding or spotting, you should be evaluated by your doctor.

Decreased fetal movements—you should feel your baby’s movements by 18 weeks gestation. At first, the movements will feel like a fluttering but will get stronger as you get farther along. Fetal movements after 28 weeks are usually more regular and more common at night than during the day. Regular monitoring of fetal movements is a good idea for all pregnant women. Starting at 28 weeks gestation, count how long it takes to feel 10 movements. This should be done daily and in the evening (6 to 9 p.m.). If you don’t feel 10 movements in two hours, you should contract your doctor to be seen.

Leg swelling and pain—the changes of pregnancy place women at an increased risk for blood clots. If you experience swelling and pain in one leg (calf), you should call your doctor or be seen in the hospital to find out if you have a deep vein thrombosis (DVT) or pulmonary embolism (PE). These are blood clots that are dangerous and require immediate treatment.

Severe swelling, headache, blurred vision, high blood pressure—swelling of the lower legs is common in pregnancy. However, swelling accompanied by a severe headache, blurred vision, spots in your eyes, or abdominal pain can be a sign of high blood pressure in pregnancy called preeclampsia. If you experience these symptoms, have your blood pressure checked. Call your doctor if you have blood pressure of 140/90 or higher with these symptoms.

Pelvic pressure—as the baby grows, you will experience pelvic pressure and uterine stretching pains. You will also have a small amount of vaginal discharge during the pregnancy. However, if the pressure turns into pain and the discharge becomes bloody or increased in amount, you should be evaluated for possible cervical dilation and preterm labor.

Pain with urinating or one-sided lower back (kidney) pain—frequent urinating is common in pregnancy but you should not feel pain when urinating or have back pain on one side. These could be signs of a bladder or kidney infection. Bacteria in the bladder or kidney can result in a serious blood infection and preterm labor. Contact your doctor for urine and blood tests if you have pain with urinating or one-sided lower back pain.

Headaches—normal hormone changes in pregnancy cause the blood vessels to dilate. This can result in women experiencing headaches. A lack of sleep and discontinuing caffeine can also bring on more headaches. These common headaches of pregnancy should be relieved with Tylenol in most cases. If you experience severe headaches, especially occurring in the front or back of your head, you should contact your doctor. Severe headaches can be a sign of preeclampsia that may require additional testing or treatment.

Other symptoms you should be evaluated for include:

  • Blurry or impaired vision—this can be a sign of preeclampsia which is high blood pressure and protein in the urine
  • Severe or persistent abdominal pain or tenderness—this can be preeclampsia, gallbladder disease or appendicitis
  • Excessive vomiting and diarrhea—if you are losing weight, can’t keep any fluids or food down, feel weak
  • Fever over 101 degrees F or chills
  • Increase in vaginal discharge or a change in type of discharge
  • Trauma to the abdomen—abdominal trauma from a car accident, fall or hit
  • Fainting, frequent dizziness, rapid heartbeat
  • Chest pain
  • Coughing up blood
  • Severe itching of your abdomen, palms, soles of your feet
  • Exposure to someone with known flu or if you have flu symptoms—symptoms of the flu include fever, sore throat, cough, runny or stuffy nose, fatigue, body aches and chills
  • Exposure to someone with chicken pox if you are not immune