Expert: Catherine Beier MS CBE - 7/26/2008

Question
My daughter is in her second pregnancy, approx 32 weeks. About 2 months ago she began experiencing shortness of breath with or without exertion. There was also extreme fatigue. I urged her to ask the dr to do a hematocrit and Hgb to rule out anemia.  Sure enough, she was low.  With almost 2 months of iron supplements she is feeling better, but the SOB continues, and what bothers me is she says she has tightening of the abdomen, similar to early contractions each time she becomes SOB.  If she climbs stairs she is SOB and has tightening of the abdomen.  I do not like this cluster of symptoms and feel the dr should not just "brush it off", as it could potentially lead to early or pre-term labor. Other than this she is very healthy and has not gained too much wt, although her ankles are very swollen, even early in the morning.  There is no pitting edema, though.  Could you advise me on how she should get her dr to take these symptoms seriously?  Or, am I being a hysterical mother?  Thanks in advance.

Answer
Patricia,

While I don't think that anything is seriously wrong, I also don't think that you're being a "hysterical mother".  


It does sound like she is experiencing Braxton-Hicks contractions, which would be completely normal at this point and could be accompanied by shortness of breath.


What I don't like is that she has shortness of breath without exertion.  That would be more atypical of a concern.  Coupled with swelling, it would be something I wanted checked out as well.


Now, if she has to make her doctor take her seriously, then perhaps she needs a different doctor.


You should never have to "convince" your doctor of the symptoms you're experiencing.  If your doctor isn't listening now, then he isn't likely to start listening later.


Some ways to broach the topic are to keep a daily diary of the symptoms (when they occur, what happened, for how long).  This can convey your concern to the doctor in that if he sees that you've gone to the trouble of record keeping, then he can truly it's an issue of concern to you.


He should not be opposed to some routine bloodwork or urinalysis to rule out infection, check hormone and thyroid levels, etc.


At the very least it can give you (and your daughter) peace-of--mind or reveal if there truly is a problem.


Best,
Catherine