Danger Signals—When to Notify the Doctor

The attainment of superior medical care is a bilateral undertaking between doctor and patient. If a doctor lacks competence or fails in diligence, ideal care cannot result, no matter how cooperative the patient. On the other hand, no doctor, no matter how expert and conscientious, can render even adequate care unless his patient cooperates. Part of patient cooperation in pregnancy requires that she inform him promptly of any deviation from normal health, unless it be of an obviously minimal variety such as a cold or a minor stomach upset. A list of the main danger signals follows. 1. Vaginal bleeding at any time during pregnancy. If it is just staining (less than normal menstrual flow) in the first half of pregnancy the news will keep till morning, but in the second half notify the doctor day or night, irrespective of the amount of bleeding. This does not include pink, mucoid discharge at term (show). 2. Puffiness of the face, eyes, or fingers, particularly significant if very sudden. Swelling of the legs and ankles when the face and hands are uninvolved is usually not significant, especially in hot weather. 3. Severe, unremitting headache, especially in the second half of pregnancy. 4. Dimness or blurring of vision, especially in the second half of pregnancy. 5. Severe abdominal pain, particularly if constant, no matter in what area of the abdomen or in what week of pregnancy. 6. Vomiting several times within a few hours. 7. Fever over 100 degrees Fahrenheit, particularly when associated with a chill. 8. Rupture of the membranes, resulting in the escape of watery fluid from the vagina. The nearer you are to your term date, the less the significance. 9. Absence of fetal movements for twenty-four hours, from the thirtieth week on.