Vaginal bleeding

If the bleeding is heavy (heavier than a period), you should seek advice straight away unless you have been advised otherwise. If you are less than 20 weeks contact Dr Arrage/Jenkins directly. If you are, more than 20 weeks contact labour ward. Lighter amounts of bleeding if not accompanied by abdominal pain should be reviewed on the next working day. If there is pain, contact either Dr Arrage/Jenkins or labour ward as above.

Thrush

Vaginal thrush or Candida is a common pregnancy problem. It causes a vaginal/vulval itch and sometimes a white/yellowish discharge. It is safe to treat it with any of the over the counter preparations available from your pharmacy. Either vaginal cream or pessaries are satisfactory. If you are using a vaginal cream it needs to be used with the applicator otherwise the treatment will be ineffective.

Heartburn or Indigestion

This can be safely and effectively treated with any of the over the counter preparations. Follow the manufacturer instructions regarding dose and frequency.

Constipation

If untreated, is likely to lead to abdominal discomfort and hemorrhoids. Dietary measures are the best first steps ie. increase fluid intake and dietary fibre (fruit, vegetables, cereals). If this is ineffective, a bulk laxative such as Metamucil or Fybogel will usually work. Other laxatives such as Normacol, Senokot, Coloxyl are also perfectly safe if required. Suppositories and enemas can also be used if necessary.

Haemorrhoids

These are enlarged veins at the entrance of the anus. They occur commonly in late pregnancy and improve dramatically afterwards. Sometimes they cause no problems at all; occasionally they are uncomfortable or even exquisitely painful. Constipation should be avoided. Any of the over the counter haemorrhoid preparations (e.g. Proctosedyl or Rectinol) are perfectly safe to use in pregnancy and will usually assist with the discomfort. If severe pain occurs, an ice pack will often help.

Fetal Movements (FM)

Movements vary greatly from pregnancy to pregnancy. In a first pregnancy, FM will often be first noticed between 18 and 22 weeks. In general, FM are usually felt earlier in second and subsequent pregnancies compared with first. From approximately 26 weeks, you should notice your baby move every day. If you do not feel any movements on a given day or if you feel that the FM are less than usual, sit down somewhere quiet for 20 minutes so that you can notice your baby moving. You will probably feel the baby move during this time. If you do not, or if the FM continue to feel reduced, you should contact the Birth Unit at your hospital and speak to a midwife who will advise you to attend the hospital to have the baby's wellbeing assessed. There will usually be no cause for concern, but very occasionally it can indicate that there is something important happening that we need to know about. It is something which should always be checked and should never be left till tomorrow.

Head cold

These common respiratory infections do not pose any significant concerns for the wellbeing of your pregnancy. If you have a fever, you should treat it with paracetamol, 2 tablets every four hours (maximum 8 per day) and drink plenty of fluids. If fever persists more than 48 hours, seek advice from your GP. Otherwise, symptom relief is all that may be required. Safe options are included on the safe medications list.