Complications of Pregnancy

Although we work with each of our expectant mothers and families to accomplish the most successful pregnancy, labor and delivery possible, complications may still arise.

Some of the common complications during pregnancy include:

Premature labor
Premature rupture of the membranes
Pregnancy-induced hypertension
Gestational diabetes
Placenta Previa and other bleeding disorders

Premature Labor
When a woman goes into labor three or more weeks before her due date, it is considered premature labor. One in 10 pregnant women start labor prematurely. A baby born several weeks before term may experience some complications.

Risk factors associated with developing premature labor include:

Previous preterm pregnancy or pregnancies
Twins or multiple birth
Premature rupture of membrances
Prolonged or heavy physical activity
Smoking/alcohol use
Infection
Dehydration
Incompetent cervix
First trimester bleeding

Warning signs of premature labor include:

Dull, low-backache
Pressure in the pelvic area
Blood-tinged discharge
Gush or trickle of clear fluid from the vagina
Cramping or contractions

To determine whether or not you are having contractions, lay on your left side and place your hand on your lower stomach area near your belly button. During a contraction, this area will become rigid and then relax when the contraction weakens or ends.

If you experience any of these symptoms and they do not go away after one hour, you may be in labor. You should call your doctor.

Steps you can take to help prevent premature labor include:

Consult with your doctor about limiting your physical activity such as lifting, walking or having intercourse
Rest, lying on your left side is the best for circulation. Avoid laying on your back
Avoid emotional upsets
Keep in close contact with your doctor
Take prescribed medication
Avoid dehydration by increasing fluid intake, preferably water

It is extremely important to follow your doctor’s instructions concerning rest and medication. The closer to term you are when you deliver your baby, the less risk of complications caused by premature birth.

Premature Rupture of the Membranes
This is the most commonly diagnosed problem leading to preterm delivery. The condition occurs when the protective amniotic sack of fluids surrounding the baby breaks before labor actually begins. The condition can occur at term or preterm. Once the water breaks, many women go into labor within the next 24-hours.

Some of the risk factors associated with premature rupture of the membranes include:

Teenage pregnancy
Smoking
Presence of a sexually transmitted disease
History of premature rupture of the membranes
Poor nutrition
Lack of prenantal care
Infection

The most serious complications caused by premature rupture of the membranes include:

Infection to you and/or your baby
Prematurity of the baby
Compression on the umbilical cord

When the membranes rupture in a term pregnancy, the risk of infection to you and your baby is increased if the baby is not born within 24 to 36 hours. If you are at term when your membranes rupture and you do not spontaneously go into labor, your doctor may induce labor. The baby may be delivered vaginally, unless other complications necessitate delivering the baby by cesarean section.

When the membranes rupture preterm, prematurity of the baby is the biggest concern. Babies born prematurely face complications from underdeveloped organs, especially the lungs.

An additional concern is compression on the umbilical cord. Without the amniotic fluid encasing the baby, the baby’s body might rest against the umbilical cord, closing off vital nutrients and oxygen supply.

Several tests may be conducted to more accurately measure the baby’s development and maturity, as well as tests to detect infection and determine if the baby is in distress. Based on the outcome of these tests, your doctor will determine the best course to follow for the most optimum outcome of your pregnancy.

By carefully monitoring and managing for infection and fetal distress, your doctor may be able to prolong delivery until the baby is more capable of surviving outside the uterus.

Hypertension
Hypertension in pregnancy means the mother’s blood pressure is elevated. High blood pressure, in combination with edema and large amounts of protein in the mother’s urine, could indicate a condition called preeclampsia, also known as toxemia, which can greatly affect both the mother and the baby’s health. Preeclampsia usually occurs in the last half of pregnancy.

Risk factors associated with preeclampsia include:

First pregnancy
Family history of preeclampsia or eclampsia
Multiple birth
Teenage mothers and mothers over 40
Women who have high blood pressure or kidney disease
Diabetes

When preeclampsia develops, the placenta does not get enough blood, which means the baby is not getting enough oxygen and nutrition. The condition can result in low birth weight as well as other medical complications.

Symptoms of preeclampsia include:

Headaches
Rapid heartbeat
Dizziness and nausea
Ringing in the ears
Feeling sleepy
Epigastric pain (stomach pain)
Blurred or double vision or loss of sight
Severe swelling
Decrease or lose of urine production or bloody urine

If you have any of these symptoms, you need to consult your doctor immediately. Your doctor, in consultation with you, will decide what the best course of action might be. Managing preeclampsia might include bed rest, medication, close observation and monitoring of you and the baby, which in some cases might necessitate hospitalization.

Gestational Diabetes
Gestational diabetes is the most frequent complication of pregnancy. Like diabetes, gestational diabetes prevents the body from using food properly. With gestational diabetes, although the body is producing enough insulin, its effects are partially blocked by hormones made in the placenta. The larger the placenta grows, the more these hormones are produced and the greater insulin resistance becomes.

High blood sugar levels resulting from the insulin resistance can cross the placenta and affect your baby.

Risk factors associated with the development of gestational diabetes include:

Obesity
Family history of diabetes
Previous birth of large baby (over 9 pounds), stillbirth or a child born with a birth defect

Gestational diabetes is generally not the cause of birth defects. However, babies born to mothers with gestational diabetes are at a greater risk of developing respiratory distress syndrome and my develop macrosomia, which means the baby is very large. Occasionally, the baby may grow too large to be vaginally delivered and must be delivered by cesarean.

Gestational diabetes also increase the risk of hypoglycemia (low blood sugar), jaundice and other chemical imbalances in the newborn.

Children born to a mother with gestational diabetes are also at higher risk of developing Type II diabetes later in life.

Although insulin shots are sometimes necessary to control blood sugar levels, by carefully monitoring and managing gestational diabetes, health problems for you and your baby can be avoided and, many times controlled through diet. It is important to maintain normal blood sugar levels and at the same time get enough nutrients to stay healthy.

In most cases, blood sugar levels will return to normal after delivery. However, gestational diabetes puts the mother at a higher risk of developing Type II diabetes later in life.

Abnormalities of the Placenta
Abnormalities of the placenta are usually indicated by vaginal bleeding or hemorrhaging. These conditions can be very serious, even life-threatening to the mother and child.

Hemorrhaging early in the pregnancy (before 20 weeks) may indicate the baby is delivering early, miscarrying, an ectopic pregnancy or molar pregnancy. Later in the pregnancy, placenta previa and placenta abruption are the leading abnormalities which affect the placenta.

Placenta previa is a condition where the placenta attaches in the lower uterine section and may impede the delivery of the baby. It is most common after the first trimester of pregnancy and occurs in about one in 200 births.

Risk factors associated with development of placenta previa include:

Numerous and rapid succession of pregnancies
Increased age
Uterine scarring

Symptoms of placenta previa include bright red, painless bleeding from the vagina. The blood loss may not be substantial at the onset and a blood-stained discharge may continue. However, as the pregnancy progresses, hemorrhages may be more severe, causing a substantial amount of blood loss.

If your pregnancy is at term when you develop symptoms of placenta previa, your condition as well as that of the baby is evaluated. Once your condition has been stabilized, your doctor may choose to deliver the baby by cesarean.

If your baby is premature when the first signs of bleeding occur, the doctor will closely monitor you and the baby, most often in a hospital setting. If there is no additional bleeding, you may be allowed to return home, but activities will be restricted.

There are a number of serious complications associated with placenta previa. If you experience any bleeding from the vagina during pregnancy, you should consult your doctor immediately. Your doctor will advise you as to the appropriate course of treatment for your condition.

Abruptio placentae is the premature separation of a normally implantes placenta from the uterus after the 20th week of pregnancy. In most cases, the condition is marked by bleeding from the vagina and severe abdominal pain. In some cases, the symptoms are not obvious but can be life-threatening to mother and baby.

Risk factors identified with development of abruptio placentae include:

History of abruptio placentae
Hypertension during pregnancy
Smoking or cocaine use
Increased age
Multiple pregnancy
Trauma
Increased amniotic fluid

If your baby is premature when you experience abruptio placentae and the placenta abruption is not significant, your doctor may monitor your condition and that of your baby closely for any indications of distress.

If your baby is at term when you experience placenta abruption, or if the abruption is significant, regardless of the maturity of your baby, your doctor may want to proceed with the delivery. A cesarean birth may be necessary if vaginal delivery is not eminent, the baby is experiencing stress or the condition poses a threat to your life.

Watching Baby Grow
Complications of Pregnancy
Labor & Delivery
Pain Relief Medications & Anesthetics
Cesarean Birth & VBAC