Your pregnancy – Pregnancy Complications
By far the majority of pregnant women progress through their pregnancies without problems. Though some, for all sorts of reasons do not. Complications can arise at any stage of pregnancy and pose different grades of risk to the health and well-being of a mother and her baby. If managed carefully and well, these risks can often be reduced.
Some of the more common pregnancy complications will be included here, but this is not intended to be an exhaustive list. If you are particularly concerned, speak with your midwife or doctor. Feeling anxious about developing a pregnancy complication will not make you more vulnerable to experiencing one.
If you have had a complication with an earlier pregnancy, have a specific family history or a pre-existing medical condition then you may be more likely to develop a pregnancy complication.
Early Pregnancy Complications
Occurs where the fertilised egg implants outside the uterus. The likelihood of this occurring is around 1:200 women. If a woman has had an ectopic pregnancy before or has had surgery on her fallopian tubes, the likelihood increases. Surgery is required to remove the embryo and this can become a medical emergency if the fallopian tube ruptures.
Is the most common pregnancy complication and occurs in around 15% of early pregnancies. It is thought that the reason why miscarriages occur is because there is a major interruption in the chromosomal development of the foetus very early after conception, making it incompatible with life. Most women go on to conceive successfully and carry a healthy pregnancy after miscarrying. A support group for women who have experienced a loss of their baby through miscarriage is SANDS; check their website for more information.
Is a complication of excessive nausea and vomiting. Hyperemesis is more common within the first trimester, and occurs in around 1:200 pregnancies. This is also more common in women who are overweight or obese, first time mothers, those whose own mothers experienced it and mothers carrying multiple babies. Medication is occasionally prescribed but if the vomiting is so extreme that dehydration is the result, hospitalisation and rehydration with intravenous fluids is occasionally necessary.
Mid Pregnancy Complications
An Incompetent Cervix
Is where there is incomplete closure of the cervix. Instead of being closed tightly and sealed with a thick mucous plug, the cervix is shorter and dilated. This can lead to miscarriage and premature rupture of the membranes. One of the management options is to use surgical sutures to close the cervix during pregnancy. A few weeks before the due date, the sutures are removed.
Can develop during pregnancy because of low haemoglobin. The extra fluid components in a pregnant mother’s blood cause it to become more dilute, this then causes a drop in the haemoglobin levels. Because of the importance of red blood cells in transporting oxygen to the baby, pregnant mothers have regular blood tests to check Hb levels. Treatment options vary from the simple e.g. an increase in iron rich foods in the diet or iron tablets, to the more complex such as a blood transfusion.
Can occur in babies with blood types A, B or AB and whose mothers have blood type O. When some of the baby’s red cells enter the mother’s circulation, her body perceives these as a threat and she makes antibodies to “attack” the baby’s red blood cells. Treatment includes phototherapy if the baby is jaundiced at birth or occasionally a blood transfusion.
Is where the placenta is lying so low in the mother’s uterus that is partially or completely covering the cervix. Bleeding is common and when it comes time to deliver, the placenta obstructs the baby’s descent out of the uterus. Depending on the grade of placenta praevia, a caesarian section delivery may be necessary.
Intra-Uterine Growth Retardation
Can occur in around 10% of pregnancies. In women who are having their first baby, who are older mothers or who’ve had more than four babies previously, it is also more common. The size of the baby is estimated on abdominal palpation so if your midwife or doctor has any concerns, you may be referred for an ultrasound. Accurate estimates can then be made of your baby’s size so it can be compared with your gestation and normal foetal growth patterns.
Premature labour occurs in around 7% of pregnancies. It is more common in women who have had pregnancy complications, who have had a premature baby before, who smoke, drink alcohol, take illicit drugs or who have oral health problems such as gum or periodontal disease. If labour cannot be halted and the baby is still immature, steroids may be given to the mother to help her baby’s lungs mature. For more support and information contact the National Premmie Foundation.
Late Pregnancy Complications
Deep Vein Thrombosis
“D.V.T.” can occur in a leg vein or occasionally in a pelvic vein during pregnancy. Thrombosis refers to a blood clot and is more common in women who are overweight, smokers, those with a family history or pregnant women who don’t move around as much as they could. The risk is that if the clot dislodges it could migrate to the heart or the lungs and block off a major blood vessel. Treatment is with blood anti-coagulants.
Elevated blood pressure
Can frequently occur during pregnancy and is one of the symptoms of Pre-Eclampsia. This is more common in first time mothers and those with a family/genetic history. An elevated B.P. can lead to problems with blood flow through the placenta and a shortage of oxygen to the baby. This is why one of the standard measurements taken during ant-natal checks is a blood pressure recording. Check PEARLS for more information.
Occurs when a mother who has an Rh-negative blood group is carrying a baby who is Rh-positive. She can develop antibodies which attack her baby’s red blood cells. During a first pregnancy this is not so much of an issue but with subsequent pregnancies it can be. An injection of Anti-D is routinely given to all Rh-negative women after they deliver. It can also be given during pregnancy if necessary.
Too much amniotic fluid – Polyhydramnios or too little – Oligohydramnios
The quantity of fluid surrounding the baby can be an indication of its general well being and how its lungs and kidneys are functioning. A sudden increase in a pregnant mother’s abdominal size or the skin becoming tense across her tummy are signs that there may be problems. An ultrasound can estimate with accuracy the amount of amniotic fluid and detect problems.
Is another complication which occurs in around 1-3% of pregnant women. The placenta can produce hormones which alter the effectiveness of the hormone insulin. In mild cases, it may be possible to control Gestational Diabetes through diet alone, though insulin injections may become necessary. Gestational Diabetes can increase the chances of developing hypertension (high blood pressure) or diabetes later in life. Check Diabetes Australia for more information.
Can occur when the placenta sheers off the uterine wall. This is known as an obstetric emergency as the placenta is the baby’s lifeline for oxygen and nutrients. The mother will feel pain though may not have any vaginal bleeding, especially if there is a blood clot forming between her uterine wall and the placenta. Alternately, she may have a large vaginal bleed. An immediate caesarian section delivery of the baby becomes necessary.
Can occur at any stage of pregnancy. Generally the mother notices a change or stop in the baby’s movements and an ultrasound confirms the baby has died. There may be no obvious cause or reason for the baby to die whilst still in the uterus, which makes it very hard, understandably, for parents and family members to accept why it occurred.
Is a condition where the digestive enzyme, bile, builds up in the mother’s liver and then progresses into her blood. This condition affects 1-2 pregnant women per 1,000 and there is a genetic tendency. One of the symptoms is extreme itching of the skin, particularly on the hands and feet. If this is very distressing and cannot be controlled by creams, lotions or medication, the mother may be induced to deliver her baby. Check this on-line support group Itchy Moms for more information.
Symphysis Pubis Dysfunction
Occurs when the mother’s pubic ligaments become so lax and affected by pregnancy hormones, that they do not keep the pelvic bones aligned correctly. This is very uncomfortable and causes pain on walking, moving, lifting and general activities. Corsets and physiotherapy are very useful in alleviating discomfort. So is resting and limiting unnecessary weight bearing activities.
Call an Ambulance or Check immediately with your Doctor if you experience any of these:
- Any vaginal bleeding at any stage through your pregnancy, or a sudden gush of fluid.
- Any sudden pain in your abdomen or in your epigastric “stomach” area.
- A change in your baby’s movements from their usual activity level.
- Itching or rashes on your skin.
- Sudden swelling of your body, in particular your hands, ankles and feet.
- A sudden weight increase which shows you are retaining too much fluid. This could mean you have developed Pre-Eclampsia.
- A stabbing, unrelenting headache and sensitivity to lights.
- A feeling that something is not quite right but you cannot identify what it is.
- Feeling dizzy, light-headed or faint.
- A blurring of your vision, floating particles across your field of vision, bright dots in front of your eyes, sudden brilliant flashes of light or darkening of your vision.
- An elevated temperature over 37.5 degrees Celsius.
- If you are unable to tolerate any food or fluids and are vomiting continuously. If your urine output decreases which may indicate you are dehydrated.
- Burning or scalding when you pass urine which could indicate you have a urinary tract infection.
- Your urine will be tested when you go for your ante-natal checks. If protein or sugar is detected this may indicate a problem with Pre-Eclampsia or Diabetes. You may then be referred for additional tests.