每位伴侣应了解的5个妊娠红旗

突然的严重头痛——尤其是感觉与她以前经历过的任何头痛不同——结合视力变化（模糊视力、看到斑点或闪光、暂时失去视力）是子痫前期的标志性警告信号，这是一种潜在的危及生命的妊娠并发症。

子痫前期影响5-8%的妊娠，涉及危险的高血压，可能损害肝脏、肾脏和大脑。它通常在20周后发展，并可能迅速加重。其他迹象包括面部和手部的突然肿胀（不仅仅是妊娠期间正常的脚踝肿胀）、上腹部疼痛（尤其是在右肋下——这表明肝脏受累）、妊娠后期突然出现的恶心或呕吐，以及因液体潴留而导致的突然体重增加。

伴侣需要知道这一点：子痫前期可能在数小时内进展为子痫（癫痫发作）或HELLP综合征（危及生命的肝脏和血液凝固障碍）。孕妇可能会轻描淡写症状，因为头痛和肿胀在妊娠中是“正常”的。如果她描述的是她一生中最严重的头痛，无法正常视物，或在肋骨下有疼痛——不要等待医生办公室的回电。请前往急诊室。子痫前期是全球母亲死亡的第二大原因，早期干预可以挽救生命。

妊娠期间的任何大量阴道出血都是紧急情况。虽然轻微的点滴出血可能是正常的（尤其是在第一孕期），但大量出血——定义为在一小时内浸透一片卫生巾——在妊娠的任何阶段都需要立即进行医学评估。

在第一孕期，大量出血可能表明流产或异位妊娠（受精卵在子宫外着床，如果破裂可能危及生命）。在第二和第三孕期，大量出血可能是前置胎盘（胎盘覆盖宫颈）或胎盘早剥（胎盘从子宫壁脱落）的信号，这两种情况都威胁到母亲和婴儿的生命。

伴侣应采取的措施：不要等待出血是否停止。让她侧卧在左侧，记录出血开始的时间以及她浸透卫生巾的速度，保存任何通过的组织或血块（放在干净的容器中——医院可能需要检查它们），并前往急诊室。如果她感到头晕、苍白或心跳加速，请拨打911。

不要给与任何相关疼痛的阿司匹林或布洛芬——对妊娠期间唯一安全的非处方止痛药是对乙酰氨基酚（Tylenol）。

在大约28周后，大多数医生建议关注胎动模式。每个宝宝都有自己的节奏——有些是体操运动员，有些是温和的移动者——但关键是要保持一致。从宝宝正常的运动模式中明显减少是需要联系医生的理由。

经典的指导是“踢数”：选择宝宝通常活跃的时间，侧卧，计算感觉到10次运动（踢、翻滚、戳都算）。大多数宝宝在2小时内达到10次。如果需要更长时间，或者孕妇说“今天宝宝动得不多”，请认真对待。

伴侣应采取的措施：鼓励她喝一些冷的甜饮料，侧卧在左侧，专注于运动一个小时。如果在2小时内少于10次运动——或者如果她只是觉得有什么不对——请联系医生或前往分娩监测。不要等到明天。

胎动减少可能表明宝宝因脐带问题、胎盘功能不全或其他并发症而处于窘迫状态。在许多情况下，宝宝只是睡觉，一切正常。但在某些情况下不检查真正出问题的后果远远超过额外医院就诊的不便。相信她的直觉——母亲对减少运动的感知是许多死胎预防案例中最早的警告信号。

妊娠期间体温超过100.4°F（38°C）的发热需要及时的医学关注。发热本身可能对发育中的宝宝有害——特别是在第一孕期，持续的高体温与神经管缺陷相关。在妊娠后期，发热可能是感染的迹象，可能引发早产。

妊娠期间发热的常见原因包括尿路感染（非常常见，可能迅速发展为肾脏感染）、流感或COVID-19、李斯特菌病或其他食源性疾病、羊膜炎（羊水感染——一种严重的紧急情况）以及其他病毒或细菌感染。

伴侣应采取的措施：用真正的温度计测量她的体温（而不是用手放在额头上）。如果超过100.4°F，请拨打妇产科医生办公室或前往急救中心。给她服用对乙酰氨基酚（Tylenol）以退烧——在妊娠期间是安全的。请勿给布洛芬（Advil/Motrin）或阿司匹林，这些在妊娠期间不推荐使用。保持她的水分摄入，注意其他红旗：寒战、背痛（可能表明肾脏感染）、阴道分泌物异味或宫缩。

ACOG特别建议在妊娠期间接种流感和COVID疫苗，因为这些感染在妊娠期间的风险更高。如果她还没有接种疫苗，值得与她的医生讨论。

Perinatal mood disorders — including depression and anxiety during pregnancy, not just after birth — affect up to 1 in 5 pregnant women. Suicidal ideation is more common than most people realize: suicide is a leading cause of maternal death in the first year after pregnancy, and the risk can begin during pregnancy itself.

Warning signs that partners should watch for include withdrawing from activities she used to enjoy, persistent sadness or hopelessness lasting more than two weeks, expressing feelings of worthlessness or being a burden, talking about death, not wanting to be alive, or wishing she could "go to sleep and not wake up," giving away possessions, dramatic mood swings beyond normal pregnancy hormones, inability to sleep even when exhausted (or sleeping excessively), loss of interest in the pregnancy or the baby, and increased substance use.

What partners should do: if she expresses any thoughts of self-harm or suicide, take it seriously every single time. Don't minimize it ("it's just hormones") and don't panic. Stay calm, listen without judgment, and take action. Call a suicide and crisis line for immediate guidance — findahelpline.com lists them by country. Postpartum Support International also supports people during pregnancy, and has volunteers in many countries. Contact her OB or midwife to report what's happening.

Perinatal depression is highly treatable. Therapy, medication (several antidepressants are safe in pregnancy), and support groups can make an enormous difference. Your role as a partner is to be the bridge between her and professional help.

Being prepared turns panic into action. Every partner should have these things ready by the third trimester — but ideally earlier.

On your phone: your OB/midwife's office number AND after-hours emergency line, the hospital's labor and delivery direct number (not the main switchboard), the address of the hospital where you're delivering (programmed into your GPS — you don't want to be typing it in an emergency), your local emergency number, a crisis line from findahelpline.com, and your local poison control centre.

In the car or by the door: the hospital bag (packed by 36 weeks), her insurance card and ID, a phone charger, and a printed copy of her birth plan and medication list.

Knowledge in your head: her blood type (especially if Rh-negative), any pregnancy complications or risk factors, her current medications and allergies, the name of her OB/midwife, and the five red flags from this article — severe headache with vision changes, heavy bleeding, decreased fetal movement, high fever, and thoughts of self-harm.

The most important thing a partner can bring to any emergency is calm, confident action. She may be scared, in pain, or unable to advocate for herself. You are her voice. Knowing what to watch for and how to respond is one of the most meaningful ways you can show up during pregnancy.