For every woman, pregnancy is an extraordinary phase in her life. Sometimes their pregnancy glow is dampened by unexpected complications during pregnancy. Many complications are prevented or managed very well with the advances in the medical field.
According to World Health Organization (WHO) data, the maternal mortality rate throughout the world has reduced to 38% between the years 2000 and 2017. The main reason for this is the easy access to healthcare professionals who provide skilled care before, during, and after pregnancy.
What are the complications during pregnancy?
The 40 weeks journey of pregnancy may bring some serious issues, a detailed explanation of each aspect will ease your nerves to a healthy and safe pregnancy.
Following are some of the serious adverse events encountered in mothers during pregnancy:
Anemia is having less or inadequate number of red blood cells (RBCs) in the blood. The following table helps us understand the causes, common symptoms, diagnostic tools and the recommended treatment:
Urinary tract infections (UTI)
A UTI is most commonly a bacterial infection affecting the urinary tract. The following table elaborates more on UTI:
Few women experience depressive moods or some of the symptoms below during and or after pregnancy.
– Sadness and a feeling low.
– A feeling that life is not worth living.
– Effect on sleep, appetite, and energy.
– Difficulty in concentration and decision-making.
If the above symptom persists for a longer period of time like a week or so, consult your healthcare professional immediately. The presence of depression during pregnancy may be detrimental to the growth of the baby and the woman herself as well.
It is high blood pressure (BP) along with the risk of damage to other organs like the liver, kidneys, etc. Women having normal BP may experience Preeclampsia around 20 weeks of pregnancy. The cause of Pre-eclampsia is associated with the placenta (the organ that helps a baby grow in the womb by supplying blood) having blood vessels that are underdeveloped or dysfunctional and do not supply normal nourishment to the baby. To manage Pre-eclampsia, the efficient approach is to deliver the baby but if the baby is not developed well, then your healthcare provider faces a difficult task. Some of the risk factors for the occurrence of pre-eclampsia are previous personal or family history of pre-eclampsia, chronic hypertension, first pregnancy, older women, obesity, multiple pregnancies, existing diseases like kidney diseases, migraines, type 1 and type 2 diabetes, etc.
Which adverse events may result due to Pre-eclampsia?
– Placenta Abruption: It is intensive bleeding occurring at the site where the placenta is attached to the inner lining of the uterus. Extensive bleeding may result if the abruption is severe, thus causing danger to you and the baby.
– HELLP syndrome: It stands for Hemolysis (breakdown of red blood cells), Elevated Liver enzymes, and Low Platelet count. HELLP syndrome is a more severe form of Pre-eclampsia with no symptoms sometimes or few like nausea, vomiting, headache, and upper right abdominal pain. It is dangerous to you and your baby.
– Eclampsia: If preeclampsia is not very well managed, it is accompanied by seizures that are termed as Eclampsia. There may not be any warning signs for Eclampsia but it is harmful to the baby as well as you.
– Numerous organs may be involved resulting in damage to kidneys, liver, lung, heart, eyes, and there may be an occurrence of brain injury due to stroke.
– Fetal growth retardation: Pre-eclampsia results in inadequate blood supply to the baby causing it to have restricted growth, low birth weight baby, etc.
– Preterm birth: Due to preeclampsia, your healthcare provider may advise on early delivery of the baby to prevent further danger to you or your baby. The premature newborn may have difficulty in breathing and other such issues.
When to seek your healthcare provider?
– Regular prenatal consults include BP records and help your healthcare provider know your risk.
– Seek help from your healthcare provider, if you experience nausea, vomiting, headaches, slurring vision, etc.
Steps to take when planning pregnancy to limit Pre-eclampsia
– If there is a previous history of Preeclampsia, be as healthy as you can be for your next pregnancy.
– Before planning pregnancy, manage diabetes or any other pre-existing condition so there are no problems later.
– Do not take any medication without the advice of your healthcare professional
Gestational diabetes is the inability of the body to produce the hormone insulin during pregnancy. This hormone is made in the pancreas so the cell in the body can utilize the glucose in the blood. Insulin resistance may occur when your body produces different hormones and undergoes a lot of changes during pregnancy.
Gestational Diabetes may start around the 24th week of pregnancy so your healthcare provider will test you regularly. There may be no significant symptoms, just medical history and certain risk factors which will help your healthcare provider diagnose you with gestational diabetes. Presences of gestational diabetes may make you more likely to develop high blood pressure during pregnancy.
What effect will Gestational diabetes have on the health of your baby?
-Your baby will be larger than the average normal baby, thus making delivery complicated.- Your baby will be larger than the average normal baby, thus making delivery complicated.
– Your baby may have to be delivered early due to complications causing it to have breathing
problems and other issues.
– At times you may have low blood glucose levels.
– The occurrence of type 2 diabetes later in life is a possibility.
How will your healthcare provider manage gestational diabetes?
Going to prenatal checkups helps to a great extent along with following your Healthcare
professional’s advice and adhering to the treatment plan as given below:
– Testing the blood glucose levels to keep them within a normal range.
– A diet plan which includes all the necessary nutrients in the right proportion and having
meals at the right times will benefit to keep control of the complication.
– Physical activity reduces your blood glucose levels and promotes increased insulin sensitivity thus the body can function well in a lesser quantity of insulin.
– Your baby’s health will be kept in check by regular sonography.
– If the above measures do not make much change in your health status, your healthcare
professional may prescribe medications like Insulin, metformin, or any other medication
suited for your condition.
Genetic disorders may result if there is a defect in the baby’s genes and chromosomes manifesting
as physical abnormalities or other health issues. Following are some possibilities that cause the higher incidence of babies having genetic disorders, they are:
– If you have a family history of any genetic disorder.
– If your previous child has some kind of genetic disorder.
– If any one of the parents has a chromosomal defect.
– Older age of mother (35 or older) or older father (40 or older).
– If there is a prior history of miscarriage or stillbirth.
– Few of the birth defects may occur due to alcohol, drugs or environmental factors.
What are the different types of genetic disorders which occur during pregnancy?
The various types of genetic disorders are as described below:
– Single gene disorder: Wherein a gene is altered resulting in disease.
– Chromosomal abnormalities: These disorders are seen when there is a missing or additional chromosome or parts of chromosomes. Down’s syndrome is a frequently encountered disorder that is characterized by the presence of an additional chromosome 21.
– Complex disorders: These occur when there is genetic history in the family along with unfavorable environmental causes. Some examples include heart diseases, cleft palate, etc.
– Teratogenic disorders: Teratogens are substances that cause abnormalities in the body, if babies are accidentally in presence of teratogens, they may have teratogenic disorders. Some teratogens are alcohol, drugs, lead, high levels of radiation, infections, medications, and other dangerous substances.
What is genetic screening and course of management for genetic disorders?
Genetic screening is done to ascertain if there are any abnormalities in the baby. The course of treatment for Genetic disorders varies from medical therapy during pregnancy or surgical
interventions after birth.
Fetal growth retardation or Intrauterine Growth Retardation(IUGR):
Fetal growth restriction is when a baby in the womb has reduced growth than expected compared to other babies at that same period of pregnancy.
What measures are taken to manage IUGR?
IUGR is managed based on the extent of fetal retardation. This is determined by sonography and Doppler sonography (blood flow to the baby) and the number of weeks of pregnancy and other factors.
– You will be instructed to monitor your fetal movement for a day.
– If the IUGR is significant, you will be asked for hospital admission and or early delivery or immediate C-Section.
What are the complications for your baby due to IUGR?
The fetus may be delivered early thus causing it to have breathing problems and other problems due to underdeveloped organs. There may even be chances of stillbirth or death.
Some tips to prevent IUGR include the following:
– Even with preventive measures there is no guarantee as it can occur in any pregnancy.
– Avoiding factors like smoking, alcohol, and drug use may help prevent IUGR.
– Maintaining a healthy diet and adequate physical activity can help.
Recurrent pregnancy loss (RPL) or recurrent miscarriages:
You may suffer from RPL if you have lost your 3 back-to-back pregnancies before reaching 20 weeks of gestation counting from your last period date.
What can we do to manage RPL?
According to the cause, the treatment will vary, your healthcare professional will correct the problem with suitable medications as per causes or help with surgical interventions and in case of genetic problems in vitro fertilization techniques can be used. In some cases where the cause may be hard to ascertain, therapy with progesterone or low-dose aspirin may help. Counseling and support will help you ease your burden.
What are the complications during delivery?
Some of the complications occurring during delivery are as follows:
Slow or no progress in Labor: The labor may not occur as anticipated due to ineffective contractions, less dilation of cervix, the infant does not come down the birth canal as easily as expected. A C-Section may help safely deliver your baby or minor cases medication which increases contraction is given to ensure safe delivery.
Perineal tear: The area around the vagina may tear due to the baby descending out of the vaginal opening if the tear is small it heals on its own but larger tear may require surgery.
Issues with umbilical cord: The umbilical cord may get caught up around the baby’s arms, legs, etc. while the baby is passing out of the birth canal. Sometimes the umbilical cord can get near the neck of the baby or gets pressed or gets delivered before the baby, in which case the healthcare provider will schedule a C-Section.
Heart rate changes: Often there are changes in heart rate, which may be regularized by changing the position of the mother. But if there are significant problems, then the healthcare professional will perform a C- Section.
Early water breaking: Usually labor starts within 24 hours of breaking of water, if it does not start then it is induced when it is near the expected date of delivery (EDD). Infection is a major concern if your water breaks before 34 weeks, since you are asked to admit to the hospital.
Perinatal asphyxia: It is a condition that results when the baby does not get sufficient oxygen while in the womb, during labor, delivery, or after its birth.
Shoulder dystocia: While in delivery the baby’s head may descend easily out but one of the
shoulders may get stuck.
Extensive bleeding: The excess bleed may result from the tears to the uterus or when the uterus fails to contract for delivery of placenta. Your healthcare provider will be at your arm’s length to take care of any adverse events during your delivery.
When do you need special attention during delivery?
– When the pregnancy exceeds the term to about 42 weeks.
– C-Section was done in your previous pregnancy.
– In the case of older pregnant women.
Simply following the health care professional’s advice will help you overcome most of the difficult situations and you will emerge victorious with your healthy baby as a trophy.