Pregnancy Warning Signs: A Guide for Emergency and Primary Care Staff

Many health care providers outside obstetrics help prevent maternal deaths: emergency department staff, EMTs, paramedics, urgent care staff, primary care providers, mental health professionals and others. Asking about pregnancy and recognizing warning signs can save lives.

Did you know?

• One in three pregnancy-related deaths happens in the year after pregnancy.
• The risk of complications lasts a full year after a pregnancy ends — so identifying patients who are pregnant, or were in the past year, is critical.

Always ask: pregnant now, or in the past year?

• Patients may not say: pregnancy or postpartum status may not occur to a patient or their support person to mention, especially in an emergency — but it can make the difference in an accurate, timely diagnosis.
• Symptoms overlap: normal pregnancy changes can mimic cardiovascular disease — shortness of breath, swelling, lightheadedness, dizziness and heart murmurs — making heart disease harder to diagnose. Keep these changes in mind.
• Blood pressure: in a pregnant or postpartum woman, a reading over 140/90 may need evaluation and immediate treatment for preeclampsia. See ACOG's Practice Bulletin on Pregnancy and Heart Disease.

Recognize urgent maternal warning signs

These may signal a life-threatening problem, and a pregnant or recently pregnant woman who has one needs care immediately. If your patient has one, consult an OB-GYN or another specialist.

• headache that won't go away or gets worse;
• dizziness or fainting;
• changes in vision;
• fever of 100.4°F or higher;
• extreme swelling of the hands or face;
• thoughts of harming herself or her baby;
• trouble breathing;
• chest pain or a fast-beating heart;
• severe nausea and vomiting;
• severe belly pain that doesn't go away;
• the baby's movement stopping or slowing during pregnancy;
• vaginal bleeding or fluid leaking during pregnancy;
• heavy vaginal bleeding or discharge after pregnancy;
• severe swelling, redness or pain in a leg or arm;
• overwhelming tiredness.

More: urgent maternal warning signs · campaign resources for health care professionals · clinical resources and tools.

Sources

Based on "Other Health Care Professionals," Hear Her, Centers for Disease Control and Prevention, citing the American College of Obstetricians and Gynecologists; a work of the United States government in the public domain. A stock photograph is left out.