Red Flags in Pregnancy

Throughout your pregnancy, you will experience many new sensations as your body changes to support your growing baby.  While most of these are normal, it is vital to know which symptoms require immediate medical attention. As your obstetrician, I want you to feel empowered to trust your instincts.

If you experience any of the following "red flags," please do not wait for your next appointment. Contact my rooms or the hospital maternity unit immediately.

1. Changes in Baby’s Movements

From around 20 to 24 weeks, you will begin to feel your baby move. By the third trimester, these movements should follow a regular pattern.

• The Red Flag: Any significant decrease or sudden change in the strength or frequency of your baby’s movements.

• The Action: Do not wait until the next day. A change in movement is the most important way your baby communicates that they may be in distress.

2. Vaginal Bleeding

While light spotting can occur in early pregnancy, bleeding at any stage should be evaluated.

• The Red Flag: Bright red bleeding (like a period), passing clots, or bleeding accompanied by abdominal pain.

• The Action: In later pregnancy, this can indicate issues with the placenta (such as placenta praevia or abruption) and requires urgent assessment.

3. Severe Abdominal or Pelvic Pain

It is normal to feel "stretching" or mild cramping (Braxton Hicks), but severe pain is a cause for concern.

• The Red Flag: Sharp, constant, or severe pain in the abdomen or pelvis that does not resolve with rest.

• The Action: This can be a sign of early labour, placental issues, or non-pregnancy related issues like appendicitis.

4. Symptoms of Pre-eclampsia (High Blood Pressure)

Pre-eclampsia is a serious condition that can develop quickly after 20 weeks.

The Red Flags:

• A severe headache that won't go away with paracetamol.

• Sudden swelling in your face, hands, or feet.

• Visual disturbances (flashing lights, blurring, or spots).

• Pain just below the ribs, especially on the right side.

Mild swelling in the feet and ankles is very common, especially at the end of the day or in hot weather. However, if the swelling is sudden, affects your face or hands, or is accompanied by a headache, you must seek medical advice immediately.

5. Rupture of Membranes (Waters Breaking)

• The Red Flag: A sudden gush or a persistent trickle of clear or straw-colored fluid from the vagina.

• The Action: If your "waters break" before 37 weeks, it is considered premature. Even at full term, we need to monitor you for infection risk once the membranes have ruptured.