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Pregnancy Complications

Every woman wishes her pregnancy to be safe and healthy without a hitch. But conception, pregnancy and delivery are not so simple as they seem in most pregnancies.  Some women may experience certain health issues during pregnancy that can lead to complications. These can involve mother’s health, baby’s health or both; if left untreated.

While some complications relate to health conditions that already exist before conception, others occur unexpectedly. Though most pregnancy complications are treatable, regular prenatal checkups help with the early detection and can reduce any further risk to both mother and baby.

Some of the common pregnancy complications include:

  1. Miscarriage or pregnancy loss
  2. Preeclampsia
  3. Ectopic pregnancy
  4. Gestational diabetes
  5. Placental complications
  6. Molar pregnancy
  7. HELLP syndrome
  8. Amniotic fluid complications
  9. Preterm labor
  10. Cervical insufficiency

1. Miscarriage:

In general, a miscarriage is defined as spontaneous abortion which is the unexpected end of pregnancy in the first 20 weeks. The most common type of miscarriage is the spontaneous pregnancy loss and it cannot be prevented. In some cases, a miscarriage happens even before a woman is aware of the pregnancy. However, the cause of a pregnancy loss  cannot be found in most cases.

Signs that might indicate a miscarriage can include vaginal spotting or bleeding, fluid or tissue passing from the vagina. Women who experience these signs during pregnancy should contact their doctor immediately. The common health conditions that can contribute to a miscarriage include chromosomal abnormalities, placenta problems, poor fetal growth, severe health issues of the mother and infection.

Read more about Miscarriage

2. Preeclampsia:

Pre-eclampsia is a pregnancy complication that affects some women, usually during the second half of the pregnancy or immediately after the baby is delivered. It is characterized by high blood pressure, protein in the urine and severe fluid retention.

Though the exact cause of preeclampsia involves several various factors; it is believed that preeclampsia is caused by the decreased blood flow to the placenta, the organ that nourishes the fetus throughout the pregnancy. If left untreated, preeclampsia can lead to many other serious complications and in some cases, it can be life-threatening for mother or baby or both.

Read more about Preeclampsia

3. Ectopic Pregnancy:

A pregnancy is considered ectopic when the fertilized egg attaches in some place other than the uterus. Most of the ectopic pregnancies occur in fallopian tubes and hence it is known as tubal pregnancy. In rare cases, the fertilized egg implants in an ovary or the cervix or the belly.

It is difficult to spot an ectopic pregnancy as the symptoms are similar to that of a normal pregnancy.

If the fertilized egg keeps growing in the fallopian tube, it can damage the tube or other maternal structures. This can cause life-threatening blood loss. An ectopic pregnancy cannot be turned into a normal pregnancy. Hence, ectopic pregnancy needs a quick treatment to end it which can help preserve the chances of healthy pregnancies in future.

Read more about Ectopic Pregnancy

4. Gestational diabetes:

When women without diabetes develop high blood sugar levels during pregnancy, it is known as gestational diabetes. Women who develop gestational diabetes usually have no symptoms. But it can be diagnosed during routine pregnancy screening tests.

Women who are overweight or have a family history of type-2 diabetes or suffers from PCOS are at higher risk of developing gestational diabetes. Though, gestational diabetes usually goes away after the baby is born; it can increase the risk of pre-eclampsia, depression and need for c-section if remain untreated.

Read more about Gestational Diabetes

5. Placental complications:

The placenta is an organ that forms in the uterus during pregnancy, which nourishes and protects the fetus. Usually, the placenta gets attached to the uterine wall at the upper part. But, if there are any changes in its position, it can lead to complications in the pregnancy. The two types of placenta complications which may occur, include:

  • Placenta Previa: It is a condition in which the placenta lies unusually in the lower part of the uterus, next to the cervix. Though placenta previa is not a problem in the early stage of pregnancy, it can cause complications if the placenta remains low as the pregnancy progresses. With ultrasound scans during mid-pregnancy, the position of the placenta can be observed. In a woman with placenta previa, the baby has to be delivered by c-section, as the placenta lies close to the cervix.
  • Placental Abruption: Placental abruption is a condition in which the placenta prematurely separates from the uterus before the childbirth. If placenta detaches from the uterine wall, the fetus cannot get enough nutrients and oxygen. Vaginal bleeding is the main symptom of placental abruption. The larger the area that detaches from the uterine wall, the higher is the amount of bleeding. There is no treatment to either stop detaching the placenta or to reattach it. So, if a woman is diagnosed with this condition, she might get hospitalized or given bed rest, medication to lower the blood pressure and close monitoring of the mother and baby.

6. Molar pregnancy:

Molar pregnancy is an abnormal form of pregnancy in which an abnormal mass is formed inside the uterus after fertilization, instead of a normal embryo. A molar pregnancy can be of two types: complete and partial.

  • Complete Molar Pregnancy: In a complete molar pregnancy, there is no development of the fetus at all. This occurs when an empty egg is fertilized by the sperm.  In this type of molar pregnancy, the placenta grows as in case of a normal pregnancy and produces the pregnancy hormone hCG, but there is no fetus developing inside.
  • Partial Molar Pregnancy: In a partial molar pregnancy, the fetus develops but cannot survive. This type of molar pregnancy occurs when a mass develops that contains both an embryo and the abnormal cells. The development of the fetus is hindered by the rapid growth of abnormal cells which  does not support the survival of the fetus.

A molar pregnancy needs dilation and curettage (D&C) immediately, as the molar tissue continues to grow and can turn into cancer.

7. HELLP syndrome:

HELLP syndrome is a rare liver and blood clotting disorder that can affect women during pregnancy. It is most likely to occur immediately after the baby is delivered but can occur at any time after 20 weeks of pregnancy or even before in rare cases.

HELLP means – H for Hemolysis (break down of red blood cells in the blood), EL stands for elevated liver enzymes which is a sign of liver damage and LP stands for Low platelet count. HELLP syndrome is a more severe form of preeclampsia which can rapidly become life-threatening for both the mother and the baby. It may develop suddenly even before the high blood pressure is detected or it may develop without any symptoms. The symptoms of HELLP syndrome include nausea, vomiting, headache and upper abdominal pain.

8. Amniotic fluid complications:

Amniotic fluid is a liquid in the sac that surrounds the fetus during pregnancy. Too much or too little amount of amniotic fluid can lead to complications during pregnancy. If the amount of amniotic fluid is high, it increases the pressure on the uterus which can lead to preterm labour. Also, excess amniotic fluid can result in premature rupture of amniotic membranes, placental abruption and postpartum hemorrhage. And too little amniotic fluid can cause birth defects, growth retardation or stillbirth.

9. Preterm Labor:

A labor is considered a preterm, when it happens after 20 weeks and before 37 weeks of pregnancy. When a woman delivers her baby prior to 37 weeks, it is called a preterm birth and the baby is considered premature. Usually, a preterm labor is diagnosed when regular uterine contractions cause either dilation (opening) or effacement (thinning out) of the cervix.

The best way to treat preterm labor is to proceed with the delivery, even if the mother is not yet at her due date. A baby born prematurely will be at a higher risk for health problems, as the vital organs such as the lungs and brain are completely developed in the final weeks of the pregnancy.

Women are at a greater risk of having a preterm labor, if they have

  • A history of recurrent miscarriages
  • A history of preterm births
  • An incompetent cervix
  • Uterine fibroids
  • Urinary tract Infections
  • Inadequate care during pregnancy

If a woman experiences the symptoms of preterm labor, she would be given bed rest and medications to stop the contractions, which help to prevent preterm birth.

10. Cervical insufficiency:

ADuring pregnancy, the baby’s growth puts an extra pressure on the mother’s cervix. In rare cases, pressure increases to much extent for the cervix to handle, which causes the cervix to open before the baby is ready to born. This condition is known as an incompetent cervix or cervical insufficiency.

Cervical insufficiency is usually diagnosed by measuring the length of the cervix by performing an ultrasound. Women with this condition would be advised to get bed rest, prescribed with vaginal suppositories of the progesterone hormone and a procedure known as cerclage, if required. Cerclage is a minor surgery, in which the cervix is sewn closed in order to strengthen it and prevent miscarriage or premature delivery.

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