ODOBGYNDECODED

← All presentations

Dyspnoea in pregnancy

Bleeding in pregnancyAbdominal pain in pregnancyReduced fetal movementsHeadache + high BP in pregnancy/postpartumFever in pregnancy/postpartumDyspnoea in pregnancyVaginal discharge / cervicitisAcute pelvic pain (non-pregnant)Postmenopausal bleedingInfertility evaluation
Immediate red flags:
  • SpO2 <95%
  • Collapse/chest pain
  • Unilateral leg swelling (PE)
  • Fine crepitations (pulmonary oedema PET)
Urgent workup:
  • ABG/SpO2, ECG, CXR (safe)
  • Echo if unclear
  • CTPA/V-Q per pathway

Structured differential — act in priority order

PriorityConditionKey featuresAction
CANNOT MISS
Pulmonary embolism
Pleuritic pain+risk factors
VTE module →
CANNOT MISS
Pulmonary oedema of severe PE/fluids
Hypertension+crepitations
Sit up, stop fluids, frusemide
COMMON
Asthma exacerbation
Wheeze history
Full asthma treatment (undertreatment harms fetus)
COMMON
Physiological dyspnoea
Gradual, normal investigations
Diagnosis of exclusion
CONSIDER
Anemia severe
Pallor, Hb <7
Anaemia module →
CANNOT MISS
Amniotic fluid embolism
Peripartum collapse+DIC
AFE protocol →

First moves

  1. Left-lateral tilt + O2 immediately when distressed