Your pregnancy – Pregnancy Complications
By far the majority of pregnant women progress through their pregnancies without problems.
For a range of reasons, some 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.
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.
Early Pregnancy Complications
The likelihood of a fertilised egg implanting outside the uterus 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.
As the most common form of pregnancy complication, miscarriage occurs in the early stages of around 15% of pregnancies.A support group for women who have experienced a loss of their baby through miscarriage is SANDS; check their website for more information.
Hyperemesis, excessive nausea, is more common within the first trimester, and occurs in around 1:200 pregnancies. It’s also more common in women who are overweight, first time mothers, those whose own mothers experienced it and mothers carrying multiple babies.
Mid Pregnancy Complications
An Incompetent Cervix
Where there is incomplete closure of the cervix, the mucous plug is not sealed and 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.
Low levels of haemoglobin can be a pregnancy risk, due to the importance of red blood cells in transporting oxygen to the baby. Treatment options vary from increasing iron-rich foods to more complex treatments, such as a blood transfusion.
When babies with blood types A, B or AB have mothers with blood type O, her body perceives these as a threat and she makes antibodies to “attack” the baby’s red blood cells, should they enter her bloodstream.
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
The size of a baby is estimated on abdominal palpation, so if your midwife or doctor has any concerns about growth retardation, you may be referred for an ultrasound. Accurate estimates can then be made so it can be compared with gestation and normal foetal growth patterns.
Women who have pregnancy complications, have had a premature baby before, or people who smoke, drink alcohol, take illicit drugs or have oral health problems such as gum or periodontal disease, are more prone to premature labour. For more support and information contact The Neonatal Trust New Zealand, or your local Plunket nurse.
Late Pregnancy Complications
Deep Vein Thrombosis
“D.V.T.” can occur in a leg or pelvic vein during pregnancy. These blood clots are more common in women who are overweight, inactive, smokers, or have a family history. If the clot dislodges it could migrate to the heart or the lungs and block off a major blood vessel. Treatment is anti-coagulants.
Elevated blood pressure
High blood pressure is more common in first time mothers and those with a genetic history for it. One of the standard measurements taken during ant-natal checks is a blood pressure recording. Check PEARLS for more information.
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. 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 (Polyhydramnios) or too little (Oligohydramnios) amniotic fluid
The quantity of fluid surrounding the baby can be an indication of general well-being and lung and kidney functions. A sudden increase in abdominal could indicate problems. An ultrasound can estimate with accuracy the amount of amniotic fluid and detect problems.
The placenta can produce hormones which alter the effectiveness of the hormone insulin. 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. Check Diabetes New Zealand for more information.
When the placenta sheers off the uterine wall, it is regarded as an obstetric emergency as the placenta is the baby’s lifeline for oxygen and nutrients. The mother will feel pain and may experience vaginal bleeding, especially if there is a blood clot forming between her uterine wall and the placenta. An immediate caesarean section delivery of the baby becomes necessary.
During any stage of pregnancy, a mother can notice changes in their baby’s movements and an ultrasound confirms the baby has died. There may be no obvious cause for the death, which makes it very hard, understandably, for parents and family members to accept why it occurred.
This condition is where the digestive enzyme, bile, builds up in the liver and progresses into the blood. It affects 1-2 pregnant women in 1,000 (there is a genetic tendency) with extreme itching, particularly on the hands and feet. If this cannot be controlled with creams or medication, the mother may be induced. Check this on-line support group Itchy Moms for more information.
Symphysis Pubis Dysfunction
SPD occurs when pubic ligaments become so lax that the pelvic bones do not align correctly. 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:
- Vaginal bleeding or a sudden gush of fluid
- Sudden abdominal pain
- A change in your baby’s movements
- Itching or rashes
- Sudden swelling of extremities or weight increase
- Unrelenting headaches, sensitivity to lights, or dizziness
- Blurring/darkening of vision, dots or light flashes across field of vision
- A temperature over 37.5 degrees Celsius
- Continuous vomiting or infrequent urination (with burning sensation)
Coping with complications that can arise in pregnancy
The range of physical complications described above can take their toll not only on us physically, but also mentally and emotionally.
Learning that complications have arisen can cause concern for you and your partner, and may lead you to experience higher levels of stress and possibly other emotional and mental health problems. It is therefore important to try and monitor how you are feeling, and be aware if you are finding it difficult to cope emotionally and mentally after such events. Talking with your health professional and even having the opportunity to debrief and express your views can be very helpful to help you come to terms with what is/has happened, and provide an opportunity to access additional support.
For more information about managing stress in pregnancy visit COPE: Centre of Perinatal Excellence