Breathlessness in pregnancy
Is breathlessness normal during pregnancy?
It’s normal to feel out of breath in pregnancy sometimes, especially as your baby grows bigger. This can also be called shortness of breath or breathlessness.
Shortness of breath starts gradually in early pregnancy or the second trimester. It should not be painful or come on suddenly. You shouldn’t have other symptoms, such as wheezing or a cough.
Shortness of breath can also be a sign of anaemia, or serious conditions called pulmonary embolism, pulmonary oedema or peripartum cardiomyopathy.
These conditions can sometimes be missed or misdiagnosed. This is because lots of the symptoms are like pregnancy symptoms.
When should I get help with breathlessness in pregnancy?
If you are feeling out of breath during pregnancy you should always mention it to your midwife or doctor next time you see them.
Contact your doctor or midwife straight away if you are feeling out of breath and you also have any of the symptoms below.
- Shortness of breath has only started, or has got a lot worse, in your third trimester.
- Shortness of breath starts suddenly.
- You feel out of breath when you are lying flat, and feel you need to sit or stand up to breathe properly.
- You feel as if you can’t lie in bed at night and need to sit upright to sleep.
- You have swelling of both legs/feet or ankles.
- You are coughing or wheezing.
- You feel more tired than usual and do not have enough energy to do normal daily tasks.
Call 999 or go to Accident and Emergency (A&E) if you have any of these symptoms. Tell them if you have shortness of breath as well.
- You feel faint and dizzy, or you pass out.
- You are having any kind of chest pain.
- You are coughing up blood.
- You are having heart palpitations (your heart feels like it is not beating at a normal rhythm or is beating too fast).
- You have swelling in one leg.
- You feel as if you are gasping for air, or it is becoming harder and harder to breathe.
Doctors should give you tests to find out why you have these symptoms.
What tests should I have for breathlessness in pregnancy?
Blood tests to check that:
- you have enough iron in your blood
- your organs are working properly
- your heart is not under too much pressure.
A physical examination to check:
- if your breathing changes when you are lying down
- if you have a cough or any chest pain
- what your breathing sounds like (a chest auscultation).
You may also have:
- a chest X-ray,
- an ultrasound scan of your legs (to check for blood clots),
- an ultrasound scan of your heart (an echocardiogram),
- an electrocardiogram (ECG) to check the rhythm of your heart.
If your doctor is worried about your lungs, you may be offered:
- a computed tomography (CTPA) scan, or if this isn’t suitable for you,
- a ventilation/perfusion scan (VQ scan).
Are these scans safe in pregnancy?
Some of these scans expose you and your baby to small amounts of radiation. These are usually thought to be safe in pregnancy, but there may be a small increase in the risk of cancer. For most people, the risk of scans is much smaller than the risks of not getting the right diagnosis and treatment.
Some scans may not be suitable for you if you have other medical problems. For example, a CTPA scan is not usually suitable for people with severe kidney problems.
Your doctor should talk to you about the risks to you and your baby of having each scan.
They should also explain the benefits of the scan and the risks to you and your baby of not having the scan. This will help you make an informed decision. You might find it helpful to look at our information on making decisions in pregnancy – risks, benefits, consent and your rights.
Getting help for breathlessness in pregnancy
The symptoms of anaemia, peripartum cardiomyopathy, pulmonary embolism and pulmonary oedema are like some symptoms of pregnancy. This means they can sometimes be dismissed by your midwife or doctor as normal.
It can help if you:
- describe how you feel (your symptoms) clearly
- explain how your symptoms are affecting you and let them know you are worried
- show them this information and ask if it could be any of these conditions
- ask a friend or family member to come with you and support you.
If you are not happy with your treatment, you have a right to ask for a second opinion.
NICE Clinical Knowledge Summary – Breathlessness. Available at: NICE Clinical Knowledge Summary – Breathlessness. Accessed: 10/24. Page last reviewed: 07/24. Next review: Unknown.
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