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Pregnancy and birth can sometimes present life-threatening health problems for a mother and her baby. These problems are called Serious problems that can happen during pregnancy include: – the loss of a baby before 20 weeks gestation. A miscarriage cannot be stopped once it has started.

Treatment may be needed for infection, or to remove remaining tissue. – where the fertilised egg implants in one of the fallopian tubes (between the ovary, where the eggs are stored and the womb) rather than in the uterus (womb).

The pregnancy cannot continue and treatment usually means the loss of the tube

If the pregnancy causes a split in the tube, this can result in pain and serious bleeding. Loss of, or damage to, the tube may affect the ability to become pregnant in the future. – where the placenta (afterbirth) breaks away from the uterus before birth, causing bleeding, pain and contractions.

– where the placenta attaches to the lower part of the uterus and partly or completely blocks the neck of the womb. Bleeding can occur at any time during the pregnancy. and eclampsia – preeclampsia causes high blood pressure, often with severe swelling caused by water retention.

It can lead to kidney and liver failure

If it progresses to eclampsia (convulsions or fitting), as it can lead to serious health complications, including death, for the mother, the baby, or both. – where the bag of water (amniotic fluid) breaks before labour begins. This is more serious if the waters break before 37 weeks, known as Preterm pre-labour rupture of membranes (PPROM).

This increases the risk of premature birth and infection. – where the placenta is implanted too deeply in the uterine wall and cannot come out after the baby is born. This is usually discovered by a scan before labour.

Birth is usually by and a plan made to make sure the mother is safe. Depending on how deeply embedded the placenta, the womb may need removed to save the mother ( Serious problems that can happen during labour include:

  • – where the baby’s shoulders wedge in the pelvis after the baby’s head is born. If this happens
  • your carers must act quickly to release the baby’s shoulder
  • allow it to be born

– where the umbilical cord falls down into the vagina before the baby is born. This can happen before or during labour when the bag of water breaks and the baby is not deep enough in the pelvis.

When this happens, the cord gets squeezed between the baby’s head and the bones in the pelvis and stops oxygen going to the baby.

To survive, the baby must be born quickly, usually by caesarean. – where a weak spot in the uterus tears. This is more common in those who have had an operation on their womb before the pregnancy (such as a previous caesarean or surgery for – where the uterus is partly or fully turned inside-out and may be seen in the vagina.

This can happen during the removal of the afterbirth if it has not come away from the wall of the womb properly. Very rarely, it can happen by itself after the baby is born. – where fluid moves from the amniotic sac (bag of waters) through blood vessels in the womb and ends up in the mother’s blood.

This creates a severe allergic reaction affecting all systems in the body.

Although this is very rare, it causes serious complications including death

That happen in early pregnancy may happen because the afterbirth has not formed properly.

Often the reason for the miscarriage is unknown

A miscarriage may occur many weeks into a seemingly healthy pregnancy. Other serious problems can be caused by several reasons, such as trauma or for genetic reasons. Sometimes a woman’s experience in earlier pregnancies can help the doctor identify possible complications and prepare for them.

Most symptoms of pregnancy are nothing to worry about but there are some symptoms that need immediate medical attention.

If you experience any of the following symptoms, call your doctor, midwife or hospital immediately. Don’t wait until your next prenatal visit.

– could be a sign of ectopic pregnancy

– could be a sign of preeclampsia

– could be a sign of preeclampsia

Rapid increase in blood pressure, possibly signalled by nose bleeds, headache or dizziness – could be a sign of preeclampsia.

– could be a sign of preeclampsia

– could be a sign of preeclampsia

– could be a sign of an infection

Call an ambulance (000) for anyone who fits and for anyone who faints or blacks out and has not recovered in a few minutes. Obstetric emergencies during pregnancy are treated as follows: – there is no treatment, other than ensuring the mother is not at risk of excessive bleeding or infection. Sometimes a procedure may be necessary to treat infection or remove pregnancy tissue.

If the fallopian tube has burst or been damaged, further surgery is needed. – bed rest may prevent further separation of the placenta and stop the bleeding.

If the bleeding is very heavy or cannot be stopped, the baby may need to be born immediately. Some women and babies may need a blood transfusion. – most babies will be born by caesarean section before their due date, however this will depend on how low the placenta is.

– birth of the baby and delivery of the placenta is the only known cure for the condition. Medication may be used to control blood pressure and prevent convulsions. A woman near full term who has been diagnosed with mild preeclampsia may be advised to have her labour induced.

If the baby is under 28 weeks, the mother may be admitted to hospital and given steroids to build the lungs of the baby, in case it needs to be born early.

If the life of the mother or baby is at risk, the baby is delivered immediately, usually by caesarean. – treatment depends on the number of weeks of pregnancy at which this happens.

If PROM occurs before 37 weeks, intravenous antibiotics are recommended.

Induction of labour is not always needed if contractions start within 24 hours of rupture (unless the mother has had a test during the pregnancy that is positive for a bug called GBS that can make babies very unwell).

Obstetric emergencies during labour are treated as follows: – the mother sits or lies with her knees to her chest, to free the child’s shoulder. An episiotomy is also performed to widen the vaginal opening. Different manoeuvres (external and internal) can be tried to free the baby.

– if the cord has come out the vaginal opening an immediate delivery by caesarean section is usually needed. – the placenta is usually surgically removed after the baby is born. Other treatments and medications may be used to try to save the uterus but most commonly, a hysterectomy is needed.

The mother may need a blood transfusion

If you are unsure whether your situation is an emergency, you can call your doctor, midwife or hospital and explain what is happening.

Or just call 000. but then changed your mind.

You always have the right to be admitted to a public hospital for care

You can make the decision to go to the nearest maternity hospital at any point during your pregnancy or labour, right up to the actual birth.

Your midwife may recommend you transfer to a hospital if things are not going as expected or you need more expert care. The midwife might call an ambulance or agree that you can travel to hospital in a car (not driving yourself). At hospital, your midwife will stay with you as much as possible, but the hospital midwives and doctors will take over your care.

If you are admitted to hospital with serious pregnancy or labour problems, a specialist will take your medical history and perform a pelvic and general physical examination. (to look for infection), and you will have your heart rate and blood pressure monitored (if preeclampsia is suspected).

Your baby’s heartbeat will also be monitored. It can also provide information on your baby’s size, movements and heart rate, and the amount of fluid around your baby. A hospital is the safest place for dealing with any emergency.

About pregnancy and birth related emergencies obstetric emergencies Obstetric emergencies during pregnancy Miscarriage Ectopic pregnancy Placental abruption Placenta praevia Preeclampsia Premature rupture of membranes (PROM) Placenta accreta caesarean hysterectomy Obstetric emergencies during labour Shoulder dystocia Prolapsed umbilical cord Rupture of the uterus fibroids Inversion of the uterus Amniotic fluid embolism Why things may go wrong during pregnancy Miscarriages What to look for – signs of an emergency during pregnancy Any bleeding during pregnancy is not normal – be sure to call your doctor or midwife Heavy bleeding with severe stomach pain in the first 3 months of pregnancy – could be a sign of ectopic pregnancy Heavy bleeding with cramping in the first 3 to 4 months of pregnancy – could be a sign of miscarriage Bleeding with abdominal pain in the last 3 months of pregnancy – could be a sign of placental abruption Stomach cramps in early pregnancy Dizziness Severe vomiting or sickness Severe stomach pain Lower back pain Blurry vision and headaches Sudden and significant swelling of hands, face and feet Fever A decrease in your baby’s normal daily movements Regular, increasingly intense contractions before 37 weeks of pregnancy – might be a sign of premature labour If your waters break before labour begins Blackouts Treatment of emergencies during pregnancy Miscarriage Ectopic pregnancy Placental abruption Placenta praevia Preeclampsia and eclampsia Premature rupture of membranes (PROM) Treatment of emergencies during labour Shoulder dystocia Prolapsed umbilical cord Placenta accreta Rupture of the uterus Inversion of the uterus Amniotic fluid embolism What to do in an emergency If you are having an obstetric emergency, call Triple Zero (000) When to call an ambulance during a home birth You may have arranged a home birth.

In addition to the obstetric emergencies mentioned above, a hospital birth epidural pain relief (which must be administered by an anaesthetist) control of any bleeding that the midwife cannot stop assistance with the birth of your baby because you cannot push your baby out yourself help with the labour assistance because the placenta is stuck (retained placenta) repair of a serious tear Obstetric emergencies – what happens at hospital You may have blood and urine tests A scan (abdominal ultrasound ) may help identify whether the placenta is out of position ( placenta praevia or placental abruption Where to get help In an emergency, call Triple Zero (000) for an ambulance Your midwife or obstetrician Your GP (doctor) Your hospital’s Emergency unit or maternity unit.

Key Points

  • Treatment may be needed for infection, or to remove remaining tissue
  • pregnancy cannot continue and treatment usually means the loss of the tube
  • If the pregnancy causes a split in the tube, this can result in pain and serious bleeding
  • and eclampsia – preeclampsia causes high blood pressure, often with severe swelling caused by water retention
  • This increases the risk of premature birth and infection