Major or Key Symptoms in Pregnancy

Vaginal bleeding
Vaginal bleeding, or antepartum haemorrhage as it is called if it occurs after the 24th week of pregnancy up to delivery of the child, should always be investigated promptly, particularly to exclude the possibility of a placental abruption (usually associated with pain) or placenta praevia. If the mother is Rhesus negative, Anti - D should be administered, to minimise the risk of Rhesus iso-immunisation. New evidence suggests that universal prophylaxis against Rhesus iso-immunisation for all women can further reduce the risks of iso-immunisation.

Abdominal Pain
In pregnancy, abdominal pain is a common presenting symptom of a urinary tract infection (see common obstetric complications). Constipation, musculoskeletal strain, uterine contractions or indeed labour, placental abruption, are but some of the possible causes. In most cases, a good history and examination will identify the probable source of the pain, allowing appropriate action to be taken.

Rupture of membranes
Premature rupture of the membranes, presenting as leakage of fluid from the genital tract, is another key symptom in pregnancy. If this occurs before 20 weeks gestation, the risk of premature delivery, lung hypoplasia (failure to develop) and limb deformity, are very high. (Continued next page)