problems in early pregnancy

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Problems in Early

Pregnancy

Exceptional healthcare, personally delivered



Am I going to miscarry?No – not necessarily. Many women experience bleeding and/orpain in pregnancy and carry on to have a normal pregnancy.Some of these women have a number of bleeding episodes in

the pregnancy.

Is there something wrong with the pregnancy?

Again not necessarily. The bleeding may be coming from theneck of the womb due to an area of inflammation (ectropion)common in pregnancy; An infection can cause bleeding;Sometimes some bleeding occurs around the pregnancy sac.

This is common, often resolves and does not mean thepregnancy itself will be affected. Although we do see this a lot,we do not actually know why it occurs.

Having bleeding in pregnancy remains an anxious time formany women, and we do appreciate that, and are here tosupport you as much as we can.

Can I still have intercourse?Sexual intercourse is perfectly safe in pregnancy. Howeverif you have experienced bleeding or spotting, wait until thiscompletely settles, or any discharge stops, before resuming sex.

Should I rest in bed?

There is no reason to rest in bed – you may carry on normalactivities, just be sensible, and rest when you are tired.

Should I go to work?

If you have a strenuous job you may wish to remain off workuntil the bleeding settles off. Do see the GP if you need to besigned off. However, as above, you are able to carry on withnormal activities.

Can I use Tampons?You should not use tampons as you are at risk of infection.Sanitary pads are safer, and better. Do ensure that you changepads or liners regularly.

3Problems in Early Pregnancy



4 Problems in Early Pregnancy

Can I have a bath?Personal Hygiene is obviously important. Showers are morehygienic if you are bleeding, but it is ok to have a bath.

If you need any further information, do contact your GP or midwife.

Pain in pregnancy

Why do I have pain?If you experience unexpected abdominal and pelvic pain duringpregnancy it is easy to worry. But whilst some pain may needmedical attention, often instances of pain are relatively harmless.

We do not always find a cause for pain; but we are aware thatepisodes of discomfort in the abdominal area are commonduring early pregnancy.

Will the pain affect the pregnancy?In the majority of cases the baby will be absolutely fine, and thepain will not harm the pregnancy in the future

Most common reasons for pain in pregnancyOne of the first times when you may experience pain is aroundthe time of your first missed period. For a day or two, somewomen have a pain that is low down in the abdomen and feelsa bit like a dull period pain, as if a period is about to start. It isthought that the embryo is beginning to implant itself in thesoft lining of your uterus at this time.

At any time during pregnancy, constipation, bloating and wind can

cause aches, pains and abdominal discomfort. Constipation isoften caused by the pressure of the growing pregnancy yourgrowing bump on your rectum, as well as hormones which canslow down the movement of food through your digestive system.These factors are also involved in bloating and wind too, as yourwomb grows it presses on your intestines and causes wind.

During the third or fourth month of pregnancy, women frequently

get a sharp stabbing pain in their groin or to one side. It may comeon at sudden intervals, might be worse if you suddenly get up,stretch or move and it might disappear then reappear a few dayslater. It can be really worrying to suddenly get pains like this. The



Other causes include:

n Appendicitis - this is rare in pregnancy.

n Gallstones (which can enlarge during pregnancy and may

present for the first time) - again rare in pregnancy.

What will happen to work out why I have pain?many women who have mild pain and are well, with a normalscan may be discharged back to the GP. Other women, who arefeeling less well, or have a lot of pain may need to be seen by anurse or doctor.

What does this include?n Asking you about your symptoms: pain history; other

problems, e.g. vaginal bleeding, urinary symptoms.

n Obstetric history and contraception used.

n Last period date, and what your periods are usually like.

n How many weeks pregnant you are; previous pregnancies.

n Getting pregnant e.g. was the pregnancy planned.

n Was it straightforward getting pregnant (or was additionaltreatment/help needed to assist you getting pregnant).

n Previous operations or medical problems.

Examination

n General examination - to see how you are feeling look forsigns of infection. This may include blood pressure, urinedipstick temperature.

n Abdominal examination - to see where you are tender, andalso to assess the pregnancy and uterus.

n Possibly, vaginal and / or rectal examination.

n

If a miscarriage is suspected, the neck of the womb can beexamined and bleeding assessed. If very bad constipation is noted

then a rectal examination may be needed. (performed rarely)




Other possible investigations

n MSU. (urine testing) to look for a water infection.

n Swabs - to look for infection.

n

Full blood count to look for infection.

Management (how we look after you)

We look after you by trying to find the cause of the pain andtreating you once we are sure we know what the problem is.If we have taken any blood tests or swabs or water samples,we will let you know the results. Often swabs and watersamples take 1 - 2 days to come back. Some specialist swabscan take longer.

n Management is based on identifying and treating thecause. Use of antibiotics without a clear diagnosis is not ourusual practice.

n It is not usual to refer you elsewhere but if needed we mayrefer you to a different specialist.

n Basic painkillers are used to control pain.

Summary

There are many reasons for pain in pregnancy, but the majorityof women we see have nothing seriously wrong, and thereason for pain falls into one of the ‘most common reasons forpain’ at the beginning of this information. Please be reassured.

The main aim of assessing you is to exclude any worrying causefor pain, and to ensure the pregnancy itself is doing well. Formany women if we have excluded any serious cause for painand the baby is fine, no treatment is needed, and basicpainkillers are advised. This is usually paracetamol.

If over the course of the next week pain worsens, ordoes not go away, it is sensible to consult your GP.




Contacts for support

Early Pregnancy Clinic8.30 am - 2.30 pm Mon - Thurs

8.30 am - 12 noon Friday0117 323 2365

Cotswold Ward0117 323 513324 hours





NHS Constitution. Information on your rights and responsibilities.Available at www.nhs.uk/aboutnhs/constitution[Last Accessed March 2010]



How to contact us:

Early Pregnancy ClinicCotswold CentreSouthmead HospitalBristol BS10 5NB

EPC0117 323 23658.30 am - 2.30 pm Mon - Thurs

8.30 am - 12 noon Friday

Cotswold Ward0117 323 513324 hours

www.nbt.nhs.uk/epac

If you or the individual you are caring for need support readingthis leaflet please ask a member of staff for advice.

© North Bristol NHS Trust First Published February 2004 This second edition July 2011 NBT002073

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