Persistent Cough and Chest Pain During Pregnancy: What to Do?

I have been pregnant and have had a persistent cold for over a month, with a cough that won't go away. I am also coughing up small amounts of blood and experiencing pain in my chest and back?

I am currently 19 weeks pregnant.
At first, I thought I had a cold, so I went to the obstetrics and gynecology department, but the doctor advised against taking medication for a mild cold and suggested letting it resolve naturally.
Since I also had phlegm, and it persisted for two weeks, I couldn't stand it anymore and went back for another visit.
The doctor prescribed medication, which helped a bit, but now it has been over a month.
Recently, I have been experiencing sharp pain in my back behind my chest whenever I cough.
A couple of days ago, I even coughed up a small amount of blood, which made me very anxious, so I went to see an ear, nose, and throat specialist.
The doctor only mentioned that I have throat inflammation and, due to my pregnancy, prescribed only an expectorant.
Currently, I still have phlegm, but I feel much better than at the beginning of the cold.
However, I still experience pain in my back when I cough, and I coughed up blood again a couple of days ago.
I would like to ask the doctor what I should do.
Is it safe for a pregnant woman to have an X-ray?

A-Ting, 20~29 year old female. Ask Date: 2017/05/01

Dr. Chen Junwei reply Pulmonology

The current cough has been evaluated by several physicians, and given the improvement in symptoms, it is recommended to continue symptomatic treatment.
Chronic pharyngitis or mild bronchitis can easily cause slight hemoptysis due to persistent coughing; however, if there is any worsening, an X-ray is still advised.
At 19 weeks of pregnancy, X-rays are generally considered safe, but if there are still concerns, you can ask the physician to use a lead shield during the imaging.

Reply Date: 2017/05/01

More Info

Dealing with persistent cough and chest pain during pregnancy can be quite concerning, especially when accompanied by symptoms like coughing up blood. It's essential to approach this situation with caution and to prioritize both your health and that of your baby.

Firstly, it’s important to understand that during pregnancy, the body undergoes numerous changes that can affect the respiratory system. Hormonal changes can lead to increased mucus production, and the growing uterus can put pressure on the diaphragm, making breathing feel more laborious. However, a persistent cough lasting over a month, especially with chest pain and hemoptysis (coughing up blood), warrants immediate medical attention.

Given your symptoms, it’s crucial to follow up with a healthcare provider who specializes in maternal-fetal medicine or a pulmonologist. While your ENT specialist diagnosed you with throat inflammation and prescribed expectorants, the presence of blood in your sputum is a red flag that should not be ignored. Coughing up blood can be caused by various conditions, ranging from minor issues like bronchitis to more serious concerns such as pneumonia or pulmonary embolism.
Regarding your question about X-rays during pregnancy, it is generally avoided unless absolutely necessary due to the potential risks to the developing fetus. However, if your doctor deems it essential for diagnosing a serious condition, they will take precautions to minimize exposure, such as using lead shielding.
In the meantime, here are some strategies to help manage your symptoms:
1. Stay Hydrated: Drinking plenty of fluids can help thin mucus, making it easier to expel. Warm fluids, such as herbal teas or broths, can also soothe your throat.

2. Humidify the Air: Using a humidifier in your room can help keep the air moist, which may ease coughing and throat irritation.

3. Rest: Ensure you are getting enough rest. Your body is working hard to support both you and your baby, and adequate sleep can help your immune system function optimally.

4. Avoid Irritants: Stay away from smoke, strong odors, and allergens that can exacerbate your cough.

5. Gentle Coughing Techniques: If you feel the urge to cough, try to do so gently to avoid straining your chest muscles, which can lead to pain.

6. Consult Your Doctor About Medications: While some medications are safe during pregnancy, others are not. Discuss with your healthcare provider about what you can take to alleviate your cough and any associated pain.

7. Monitor Your Symptoms: Keep a close eye on your symptoms. If you experience increased pain, difficulty breathing, or if the blood in your sputum increases, seek immediate medical attention.

8. Consider Alternative Therapies: Some pregnant women find relief through acupuncture or chiropractic care, but always consult with your healthcare provider before starting any new treatment.

In summary, while minor respiratory issues can often be managed at home, your symptoms indicate a need for further evaluation. Do not hesitate to seek a second opinion or ask for a referral to a specialist if you feel your concerns are not being adequately addressed. Your health and the health of your baby are paramount, and it’s crucial to ensure that any underlying issues are properly diagnosed and treated.

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