Pregnancy, recent pregnancy and infection

Pregnant people and those who have recently been pregnant can become seriously unwell from infection and may need rapid assessment via maternity, urgent care or emergency services. Recent pregnancy includes the period after birth, miscarriage or termination.

Reception staff must not assume that fever, pain, bleeding, breathlessness or a general sense of being very unwell is normal in pregnancy or after pregnancy loss. If infection symptoms suggest deterioration, follow the local urgent route immediately.

Listen or look for

• Fever, shivering or feeling very unwell in pregnancy or recent pregnancy.
• Severe abdominal pain, pelvic pain or wound pain, particularly when accompanied by signs of infection.
• Breathlessness, chest pain, collapse, confusion or severe weakness.
• Heavy bleeding, offensive discharge or leaking fluid.
• Severe headache, visual disturbance, seizure or sudden swelling.
• The patient saying something is seriously wrong after birth, miscarriage or termination.

Use maternity and urgent routes promptly

Local pathways include maternity triage, early pregnancy services, the duty clinician, NHS 111 and emergency services. Staff should know which route to use and what to do if a patient contacts the practice instead of the maternity service.

Do not let uncertainty about the correct pathway delay escalation. If the route is unclear, escalate to a clinician, manager or agreed senior contact without delay.

Country and pathway variation

Pregnancy or recent pregnancy can change the urgency of infection symptoms - follow the agreed pathway rather than routine booking.