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А-а-а, те-- а-а-а- Like, seven weeks, а-а-а, pregnant patient. А-а-а, got fever, a- and cough. Started with cough and fever. Fever remains for one day. At that time, reports were CRP positive and NLR ratio is raised. But after four day-- after one day, fever subsides. But still, uh, there is, uh, severe cough is present since four to five days. And now, yesterday, uh, like, uh, reports came normal of NLR and CRP also normal. But still, she is having constant irritation in her, uh, uh, uh, throat region. And, uh, with that co-co-- uh, the irrit ation, she got the cough. And after cough, she get, uh, irritable sensation in her, uh, uh, uh, throat and her trachea. Uh, and, uh, uh, in night, uh, these things increase when she lie down. And, uh, in, uh, afternoon also, she's having, uh, uh, the episodes, uh, af-- around in 15 to 20 minutes repeatedly. What... To you next.

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CDC pregnancy respiratory infection cough fever when to seek emergency care 2025

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https://www.cdc.gov/hearher/maternal-warning-signs/index.htm…

This needs same-day clinical assessment by her obstetric clinician, primary-care clinician, or urgent care, especially because she is only 7 weeks pregnant and the cough is severe, repetitive, and worse when lying down.
The pattern could be a viral upper-respiratory infection with post-viral throat/airway irritation. Other possibilities that should be assessed include COVID-19 or influenza, asthma/bronchospasm, post-nasal drip, reflux into the throat, or less commonly pneumonia or pertussis. A normal CRP and neutrophil-lymphocyte ratio do not rule these out.
The worse-at-night/lying-down throat and tracheal irritation also makes reflux a possible contributor, even without obvious heartburn. Reflux in pregnancy can cause chronic cough, hoarseness, and laryngeal irritation. - Creasy & Resnik's Maternal-Fetal Medicine, p. 1565
What the clinician should check today
  • Temperature, pulse, respiratory rate, oxygen saturation
  • Lung examination for wheeze or crackles
  • Throat/nose examination and reflux symptoms
  • COVID-19 and influenza testing if available and clinically appropriate
  • Consider pertussis assessment if the cough becomes spasmodic, causes vomiting, features a “whoop,” or there has been exposure
  • Review every medication already taken, including cold syrups and herbal remedies
Until she is seen
  • Keep well hydrated with warm fluids.
  • Honey in warm water/tea can soothe cough in an adult, if she is not allergic and does not have a reason to avoid sugar.
  • Use warm salt-water gargles, saline nasal spray, and a clean humidifier.
  • Sleep with the head and chest elevated. Avoid meals for 2-3 hours before bed, and try left-side sleeping.
  • Avoid smoke, vaping, perfumes, and other throat irritants.
  • Do not start combination cough/cold medicines, decongestants, antibiotics, or herbal preparations without pregnancy-specific medical advice. This is particularly important in the first trimester.
  • For fever or pain, ask the treating clinician/pharmacist about acetaminophen/paracetamol. Avoid self-medicating with NSAIDs such as ibuprofen unless specifically told to take them.
Seek emergency care now if there is shortness of breath, wheezing with difficulty speaking, chest pain, blue lips, fainting/confusion, coughing blood, inability to keep fluids down, fever of 38 C / 100.4 F or higher that returns or persists, or rapid worsening. CDC lists breathing difficulty, chest pain/fast heart rate, and fever in pregnancy among urgent maternal warning signs in its maternal warning signs guidance.
If influenza is suspected, pregnancy is a higher-risk state and clinicians may start treatment promptly rather than waiting for a test result. The current ACOG influenza guidance advises prompt evaluation and empiric antiviral treatment when clinically suspected.
The key next step is not repeating CRP/NLR, but an in-person respiratory assessment today.
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