|Complications of Pregnancy|
Though the majority of pregnancies occur without difficulty, there are
conditions that can develop during pregnancy that will require medical
treatment. The most important of these conditions are described below:
- Pre-Eclampsia. Pre-eclampsia, also known as Toxemia, is one
of several hypertension (high blood pressure) disorders of pregnancy.
Pre-eclampsia occurs in about 5% of pregnancies in the United States.
It most commonly develops in the third trimester of pregnancy, after
the 37th week. However, this disorder can develop at any time during
the second half of pregnancy.
In pre-eclampsia, your blood vessels become constricted, resulting in
decreased blood flow to your major organs, and to your developing baby.
This condition can result in poor growth, decreased amniotic fluid, and
placental abruption (sudden breakage).
The signs of pre-eclampsia include high blood pressure; protein in the
urine; and swelling of the hands, feet, or head. Additional symptoms of
pre-eclampsia include persistent headaches, change in vision, pain or
tenderness in your upper abdomen, and nausea or vomiting. Swelling can
be a normal symptom of pregnancy and does not always indicate
pre-eclampsia. Regular monitoring of your blood pressure and urine
during your pregnancy will help your doctor to know whether or not your
swelling is normal or a sign of pre-eclampsia.
You may be at risk for pre-eclampsia if you have a past history of the
complication, had high blood pressure before this pregnancy, have a
large body size, come from a family with a history of pre-eclampsia, or
have a personal history of multiple pregnancies, Diabetes Mellitus, or
advanced maternal age (e.g., you're over 35 years old).
Women with pre-eclampsia are generally monitored in the hospital for
several days after the birth of the baby. In severe cases, women with
pre-eclampsia may be given magnesium sulfate through an IV, or may be
put on blood pressure medication. Depending on how far along you are in
your pregnancy and how severe your pre-eclampsia is, your doctor may
choose to continue to monitor you at home or in the hospital, or he or
she may decide to deliver your baby right away.
- Pre-Term Labor. Pre-term labor is defined as the
onset of labor before 37 weeks gestation (or 3 weeks before the due
date). Pre-term labor can spell disaster for your developing baby,
particularly if it occurs in the first or second trimesters of your
There is no accurate way to predict whether pre-term labor will occur.
However, there are known risk factors for this complication. Women who
have previously given birth preterm, who use illicit drugs or smoke
cigarettes, who are carrying more than one baby, who have a history of
cervical procedures, who develop infections during pregnancy, or who
have a malformed uterus are all at increased risk.
Signs of pre-term labor include: watery/bloody discharge, pelvic
pressure or pain (occurring at regular intervals and sustained for more
than 60 seconds), backache, abdominal cramps, and ruptured membranes
(also known as ‘water breakingâ€™). Doctors can often stop pre-term labor
if they can administer proper treatment quickly enough. For this
reason, it is important for you to keep the signs and symptoms of
pre-term labor in mind so that you will know when to contact your
doctor or go to the hospital emergency room.
- Gestational Diabetes. Diabetes is a disease
involving a breakdown of the normal mechanisms through which your
body's cells feed themselves with blood sugar. Gestational diabetes is
a type of diabetes that some women develop during pregnancy.
Under normal conditions, your digestive system breaks down most of the
food you eat into blood sugar (glucose). Your body's cells are able to
eat this glucose and fuel themselves in the presence of insulin, a
hormone produced by your pancreas. A normal pregnant women's body
produce more insulin than normal because her requirements have
increased with her pregnancy. Some womenâ€™s bodies have a hard time
meeting this additional demand for insulin, however. Approximately 4%
of pregnant women develop gestational diabetes and require special
medical monitoring throughout their pregnancies. Luckily, most women
can control gestational diabetes through diet and exercise. A very few
women who develop the condition require insulin shots.
Gestational diabetes often has no obvious symptoms. When symptoms are
present, they can include increased hunger, thirst or fatigue. It is
important that women undergo a glucose screening between 24 and 28
weeks gestation so that they can be checked for this condition.
The main concern with gestational diabetes is that too much glucose
will enter the fetus' blood stream, and he or she will need to produce
more insulin to compensate for this increase. This compensation process
can cause your baby to gain excess weight, which can make vaginal
delivery more difficult. If you have gestational diabetes and your
doctor suspects that your baby may be too large, he or she may suggest
that you deliver via cesarean section. Additionally, babies born to
mothers with gestational diabetes may have low blood sugar at birth,
and are at a higher risk for developing jaundice or heart problems
later in life.
Gestational diabetes is more common in certain racial groups, including
Latino, African, Native American, and Asian populations. Caucasian
women are typically at less risk. Apart from racial background, risk
factors for developing gestational diabetes include a family history of
diabetes, advanced maternal age, history of giving birth to a large
baby over 9 lbs., polycystic ovarian syndrome, history of abnormal
glucose tolerance, a mother who was large (over 9lbs.) or small (less
than 6 lbs) at birth, obesity and usage of glucocorticoid (steroid)