Doctor at home during pregnancy in Berlin — when does it make sense?

Which complaints we treat during pregnancy

During pregnancy the usual acute complaints of life still happen and routine antenatal visits do not cover them. Classic pictures where we are glad to come: respiratory infections, acute sinusitis, febrile gastroenteritis, urinary tract infection (with a lower antibiotic threshold in pregnancy, because ascending infections can cause preterm risk), migraine, skin problems, allergies. In therapy we consistently check pregnancy compatibility of every prescription — the Embryotox database is our standard reference, and in doubt we consult Embryotox directly or postpone therapy to the obstetric practice. Paracetamol is our standard antipyretic, ibuprofen is avoided in the third trimester, aspirin not used for pain.

What we deliberately do NOT cover but escalate to a maternity hospital: any vaginal bleeding during pregnancy, any lower abdominal pain that feels like contractions or colic, any suspicion of water breaking (including unclear discharge), any marked change in fetal movement from 24 weeks onwards, any severe headache with visual disturbance or right upper-quadrant pain (preeclampsia suspicion), any raised blood pressure above 140/90, any dyspnoea with chest pain (pulmonary embolism — pregnancy raises the risk). For these pictures every half hour counts and the right place is the maternity A&E of the hospital where pregnancy is followed — Charité Virchow, Vivantes Friedrichshain, Helios Buch or the chosen clinic.

Practical note: have the Mutterpass (maternity record) ready for our visit. We read the due date, prior findings, any risk factors and frame our treatment around this. We document our visit in a doctor's letter and recommend you show it at the next antenatal check with your gynaecologist or midwife — antenatal care is not our domain but routine obstetric follow-up, which you are connected to anyway.

Example: UTI at 28 weeks of pregnancy

A pregnant patient in Schöneberg, 28 weeks, calls on a Sunday with burning on urination and a pulling lower-abdominal discomfort. No bleeding, no contraction-like pain, good fetal movements. We come, review the Mutterpass and vitals, run a urine dipstick (leukocytes and nitrites positive), take the history (no allergies). Diagnosis: UTI in pregnancy, low antibiotic threshold at this stage because of preterm risk. Therapy: fosfomycin single dose (established in pregnancy), generous fluids, clear escalation triggers (fever, flank pain, contraction-like pain → maternity clinic). Follow-up with the gynaecologist on Wednesday agreed. Symptoms resolve within 48 hours.

What we cover — and what is hospital-only

• We cover: cold, sinusitis, bronchitis, gastroenteritis, migraine, UTI, skin and allergy pictures, febrile infections.
• We consider: Embryotox recommendations, trimester-specific drug choice, gestational diabetes, thyroid substitution.
• Hospital escalation immediately for: vaginal bleeding of any volume, contraction-like pain, water breaking, marked change in fetal movement.
• Hospital escalation immediately for: severe headache with visual disturbance, BP > 140/90, right upper-quadrant pain (preeclampsia suspicion).
• Hospital escalation immediately for: dyspnoea with chest pain, sudden unilateral leg swelling (thromboembolism suspicion).
• Antibiotics in pregnancy: we prefer pregnancy-approved agents (penicillins, cephalosporins) and avoid tetracyclines and fluoroquinolones.
• Please have the maternity record (Mutterpass) ready — we use due date and documented findings.