Common Pregnancy Complications

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acare women health pregnancy

Understand the Possible Complications

Pregnancy

What if I have a complication in my pregnancy?

Complications in pregnancy can involve the mother’s health, the baby’s health, or both. Some women have health problems before they become pregnant and these need to be managed differently or more closely in pregnancy.

Other problems can arise during the pregnancy. For women with a complication in the pregnancy, it can be an incredibly anxious time. Keep in mind that whether a complication is common or rare, there are ways to manage problems that come up during pregnancy.

It is critical that you listen to the advice of your doctor, and understand any treatment plan they put in place for you.

acare women health pregnancy complications

The best possible chance of having a safe pregnancy and a healthy baby is when health problems are under control and you get good prenatal care.

Threatened Miscarriage

What is a threatened miscarriage?

A threatened miscarriage is when a woman has vaginal bleeding coming from the womb in the first 20 weeks of pregnancy, sometimes accompanied by cramping or backache. In a threatened miscarriage, the cervix remains closed and in some cases a miscarriage can potentially be avoided by seeking medical advice and treatment.

Threatened miscarriage occurs in around 20% of pregnant women, and of those women who experience a threatened miscarriage, around 12% will actually miscarry.

Miscarriage is a term used for a pregnancy that ends of its own accord, within the first 20 weeks of gestation. It is not always clear why miscarriage happens, but it is important to remember that in almost all cases, miscarriage is not anyone’s fault.

acare women health Threatened Miscarriage

It is thought that earlier, more common miscarriages are likely to do with chromosomal developments. If a baby has too many or not enough chromosomes, it will not develop properly.

If a miscarriage happens during the second trimester (Weeks 14-20), it is sometimes the result of a significant underlying health condition in the mother.

Signs to look out for:

  • Mild to severe back pain and/ or stomach cramps (often worse than normal menstrual cramps).
  • White-pink vaginal mucus
  • Contractions (very painful, happening every 5-20 minutes)
  • Brown or bright red bleeding with or without cramps
  • Large clot like material passing from the vagina
  • Sudden decrease in signs or symptoms of pregnancy

Managing Threatened Miscarriage/Miscarriage

  • If you have the symptoms of a miscarriage, you will likely be given an ultrasound scan to determine whether your pregnancy is viable and progressing normally in your womb.
  • If your pregnancy is continuing as normal, you will be treated with ‘threatened miscarriage’, and likely be told to rest and avoid any major exertion. You may also be treated with luteal support with human chorionic gonadotrophin (hCG) or progestogens (related to the hormone progesterone) to help maintain the pregnancy.
  • Unfortunately, if a miscarriage is confirmed, this will inevitably end the pregnancy.
  • If a miscarriage is confirmed, you will need to discuss the right options for management with your doctor. In some cases, the pregnancy will pass out of the vagina naturally in a week or two.
acare pregnancy

Some women may feel concerned about taking medications during pregnancy. But in some cases, medication is essential for you and your baby. Listen to your doctor’s advice.

Ectopic Pregnancy

Ectopic pregnancy may occur due to the following:

  • An infection or inflammation of the fallopian tube causing a blockage
  • Scar tissue left behind from a previous infection or an operation on the tube
  • Previous surgery in the pelvic area or on the tubes can cause adhesions
  • An abnormality in the tube’s shape can be caused by abnormal growths or a birth defect.

What is ectopic pregnancy?

An ectopic pregnancy occurs when the fertilized egg attaches itself in a place other than inside the uterus, usually the fallopian tubes. The fallopian tubes are not designed to hold a growing embryo, and a fertilized egg cannot develop normally in an ectopic location.

Ectopic pregnancies are relatively common, occurring in around 1 in 50 pregnancies.

Signs to look out for:

  • Sharp or stabbing pain that may come and go, and vary in intensity.
  • The pain may be in the pelvis, abdomen or even the shoulder and        neck.
  • However, there can also be no pain.
  • Vaginal bleeding, heavier or lighter than your normal period
  • Gastrointestinal symptoms
  • Weakness, dizziness, or fainting

You should contact your doctor immediately if you are experiencing sharp pain or weakness, dizziness, fainting and/or have bleeding or spotting.

When an ectopic pregnancy is confirmed, it may be treated in any of the following ways:

  • Your doctor may prescribe a medication, which allows the body to absorb the pregnancy tissue so that the fallopian tube avoids damage that would require surgery. This depends on how far the pregnancy has developed.
  • If the tube has become damaged from the ectopic pregnancy, all or part of the fallopian tube may have to be removed. Any bleeding from the fallopian tube needs to be stopped promptly and emergency surgery is needed.
  • Laparoscopic surgery (key hole surgery with a small incision) under general anesthesia may be performed. This is when a surgeon uses a laparoscope to remove the ectopic pregnancy and repair or remove the affected fallopian tube. If the ectopic pregnancy cannot be removed by the procedure, then another surgical procedure called a laparotomy may be done (open surgery with a bigger incision).

Premature Rupture of Membranes

Water Breaking

What is it?

Premature rupture of the membranes (PROM) is when the amniotic sac holding the fluid, which surrounds your baby in the womb, breaks before you go into labor. Many women will go into labor within 24 hours once their waters break. But if your waters break before the 37th week of pregnancy, it is called ‘premature rupture of membranes.’ The earlier your waters break, the more serious it is for you and your baby because infection may develop.

Signs to look out for:

Your waters may break as a ‘gush’ of fluid or you may just feel damp. The fluid is a clear or pinkish color. Sometimes the fluid may be a green-brown color or slightly blood-stained. The amount of fluid you lose may vary from a trickle to a gush.

What are the treatment options?

PROM is usually diagnosed by a vaginal inspection. An ultrasound scan may also be used to help estimate the amount of fluid around your baby. A swab test of the fluid may help to decide if your waters have broken. Once your waters have broken, you will be at a higher risk of infection. Most women will go into labor themselves within the first week after their waters break.

You may be offered treatment to reduce the risk of infection and reduce the chance of problems caused by your baby being born early. A course of steroid injections may also be offered to help with your baby’s development.    

Premature Labor and Birth

What is it?

Preterm birth is defined as delivery prior to 37 weeks.

Signs and symptoms to look out for

  • Menstrual cramping or subtle back-ache or genuine contractions.
  • A ‘show’ (when the plug of mucus that has sealed the cervix during pregnancy comes out of the vagina)
  • Sudden breaking of waters

What are the treatment options?

If you have signs and symptoms of premature labor, you need to be assessed. Pregnant women are usually observed in the hospital.

If there is evidence of premature labor, the doctors may be able to provide medication (tocolytics) to stop your contractions temporarily. This hopefully allows time for steroid injections to be given. Steroids can reduce the risk of the baby suffering from the complications of being born very early (particularly breathing difficulties and bleeding). In a few serious situations, bed rest and medication are necessary to help the pregnancy go full-term.   

acare Premature Labor and Birth

 

Preeclampsia

What is it?

Preeclampsia is a condition in pregnancy that needs to be treated quickly to avoid developing into potentially life threatening complications, including seizures and serious liver dysfunction. It is diagnosed when a woman has high blood pressure- she may also have protein in her urine and swelling (water retention).

Preeclampsia affects about 2-6% of first pregnancies.

Signs to look out for

Gestational hypertension (high blood pressure) is common in pregnancy and can be a risk factor for preeclampsia or for having a small baby.

Mild Preeclampsia: High blood pressure, water retentions (significant swelling particularly in ankles and face that does not go down ) and protein in the urine. 

Severe Preeclampsia: headaches, blurred vision, inability to tolerate bright light, fatigue, nausea/ vomiting, urinating small amounts, pain in the upper right abdomen, shortness of breath, and tendency to bruise easily. Contact your doctor immediately if you experience blurred vision, severe headaches, abdominal pain, and or urinating very frequently.

Although it is important to keep a look out for symptoms, you can be reassured that your doctor will regularly check your blood pressure, protein in urine, and may order blood tests to evaluate if you have preeclampsia and how serious it is.

What are the treatment options?

The only real treatment for preeclampsia is to deliver your baby. If you have preeclampsia, you doctor will want to do that as soon as possible. 

However, depending on how close you are to your due date, and how well-developed you baby is, your doctor will make a decision on whether to deliver your baby or prescribe medication. If it’s necessary, the doctor will manage your blood pressure with medication until it is safe to delivery your baby.

Gestational Diabetes

What is it?

Gestational diabetes is a type of diabetes that affects around 2-5% of women in pregnancy

The amount of glucose in the blood is controlled by a hormone called insulin. However, during pregnancy, some women have higher than normal levels of glucose in their blood and their body cannot produce enough insulin to transport it all into the cells. In most cases, gestational diabetes goes away after the woman gives birth. High levels of glucose can lead to a bigger than average baby.

Signs to look out for

It is common for there to be no clear signs or symptoms in the case of gestational diabetes, but symptoms can include:

  • Increased thirst
  • Nausea
  • Frequent urination
  • Tiredness
  • Recurrent infections of bladders, vagina or skin
  • Blurred vision
  • Bigger than average baby for the stage of pregnancy

What are the treatment options?

Gestational diabetes can usually be controlled with diet and exercise. Some women with gestational diabetes will need insulin to control blood glucose levels.

acare women health Gestational Diabetes

Can you do anything to reduce your risk of complications in pregnancy?

It is important to make sure you are looking after you and your baby throughout your pregnancy. The good news is there are things you can do that will help you stay healthy and can reduce the risk of miscarriage and complications

  • No smoking during pregnancy
  • No drinking alcohol during pregnancy
  • Eating a healthy, balanced diet
  • A healthy weight before getting pregnant
  • Asking your doctor before stopping any medicine you take or taking any new medicine.

If you have any concerns about existing health conditions or have any symptoms that are worrying you, you should always discuss these with your doctor. Speaking to your doctor and getting the right treatment when necessary will reduce your risk of complications and help keep you and your baby safe.    

Coping with Complication

Managing an existing health condition or discovering you have a complication in your pregnancy can be a very stressful time. You will of course be anxious about the well-being of your child.

Remember that your clinician will likely have treated women with similar problems and that most women will go on to have a successful pregnancy and a healthy baby when managed properly.

You may find that your partner is also anxious and it is important to make sure that you are both well informed. Know all the facts about your condition and understand how it can be successfully treated.

acare women health Coping with Complication

TIPS AND ADVICE

  • Write down any questions you or your partner have about your condition and take them to your next doctor’s appointment.
  • Ask your doctor about reputable websites online where you can get more accurate information.
  • Talk to your partner, a trusted family member, or friend. Communication is important and it can help to discuss your concerns and support each other.

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