Pregnancy Complications
The vast majority of women have normal, uncomplicated pregnancies and deliveries. Unfortunately, women can experience some complications during pregnancy. Some complications of pregnancy, like gestational diabetes and anemia in pregnancy can easily be prevented if you know how.
Bleeding during pregnancy, often an early pregnancy complication, can be a sign of trouble. Yet, it is not uncommon for a woman to report that she had her period while she was pregnant. Although it may seem like you are mensturating, there are often other causes for the blood, which are outlined in Periods During Pregnancy. However, bleeding in the ninth month may signify a placenta previa.
All new moms worry about when they will go into labor, but have you thought about what you would do if you went in early labor? Preterm labor will explain the signs of early labor, what you should do if it happens and how you can prevent it. If you do give birth before term, your baby may be born with a low birthweight, which can cause problems in the future.
Hypertension is an important pregnancy complication to know about because it can lead to preeclampsia, which is even more serious. Make sure you know if you are at risk of developing either of these complications in pregnancy. You may also want to read up on HELLP syndrome, which is associated with preeclampsia. Although it is rare, some women do develop cervical cancer while they are pregnant.
Most moms-to-be know how important the amniotic fluid is to their baby. But did you know that it can get too low or be produced too much? Low amniotic fluid and excessive amniotic fluid will help you learn what the signs are and how to treat it if either of these complications with pregnancy occur.
While it generally doesn't cause any complications with a woman's pregnancy, fibromyalgia can make the usual pregnancy aches exceptionally uncomfortable. Learn more about this chronic illness and how it may affect your pregnancy.
Finally, recent research has shown that new moms should get up and start walking as soon as possible to prevent the risk of a potentially fatal blood clot, doctors advise.
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Many women suffer from Gestational diabetes during their pregnancy. It is a high blood sugar condition which is caused when your body can't produce enough insulin, preventing the body from using food properly. Insulin is a hormone the pancreas makes that allows cells to turn sugar into energy, or usable fuel. If your gestational diabetes goes untreated, then it could affect your baby. If the diabetes is uncontrolled, your baby could get very big, which could in turn result in a difficult birth, or even having to have a cesarean section. There are of course people who believe that large babies are more prone to obesity later on in life.
Women are routinely tested for gestational diabetes around the 28th week of pregnancy because that is when the placenta begins producing large amounts of hormones that can cause insulin resistance.
Risk Factors Several factors may make you more prone to developing gestational diabetes. Included below are some of the more common risk factors:
- if you are a previous diabetes sufferer, you will obviously be more likely
to develop gestational diabetes during your pregnancy.
- obesity
- older women
- women suffering from high blood pressure
- women who were large babies at birth (i.e. over nine pounds)
- women with family members suffering from diabetes
Signs and Symptoms There usually are no warning signs of gestational diabetes, which is why your health care provider should test you around week 24 of your pregnancy. Some symptoms you may experience could include:
- Excessive hunger
- Excessive thirst
- Frequent and excessive urination
- Recurrent vaginal infections
- Increase in blood pressure
- Sugar in the urine (when tested in your practitioner’s office)
- Fatigue
How is it Treated?
You will need to control your glucose intake. This is done by adhering to a diet, and most doctors will suggest that you follow the nutritional guideline of the American Diabetes Association. This basically limits your intake of fats and sugars while eating the right foods to ensure you get all the other nutrients you need for your pregnancy. Exercise is also important in controlling blood sugar. If that doesn't work, then your doctor may suggest insulin shots or other medications. In 97 to 98 percent of women, the blood sugar abnormalities will disappear after delivery. Some of these women may be at higher risk of developing diabetes later in life. If all of your doctor’s instructions are followed, your baby will have a good chance of being healthy.
Preventing Gestational Diabetes
By adhering to a good diet, controlling your weight, and getting regular exercise, you will be able to reduce the risk of getting gestational diabetes.
The most common cause of anemia in pregnancy is iron deficiency. It is important to be tested for anemia at your very first prenatal visit. Even if you are not anemic at the time of your first visit, you may still develop anemia as your pregnancy progresses.
Anemia is an iron deficiency in your body, but you don’t need to worry too much about your baby as he will ensure that he gets enough iron from you. You will in fact run short of iron long before your baby does. Your baby will really start to draw on your iron reserves around week 20. Your baby may only suffer from anemia if the situation is ignored. It is when you don’t get enough iron to keep up with your body’s demands that you may develop iron-deficiency.
How to Tell if You’re Anemic
The blood tests that you take throughout your pregnancy will tell you if you are anemic or not. Be sure to keep up with the tests as you may only become anemic later on in your pregnancy when your baby starts to draw on your resources. Some of the most common symptoms associated with anemia include:
being tired
feeling weak
pale skin
palpitations
breathlessness
fainting spells
Risk Factors Certain women are more at risk at for being anemic. Some of the most common risk factors include:
women who are unable to eat well because of nausea or vomiting
having a multiple pregnancy, such as twins, where iron stores are depleted
quicker by your growing babies
having two pregnancies relatively close together
poor nutrition
How Much Iron Should You Get During Your Pregnancy?
You needed about 15mg of iron per day pre-conception, which is a fair amount. Many women who aren't pregnant do not even reach the RDA each day. Now that you are pregnant you will need almost twice the amount of iron per day. Your health care provider will more than likely advise you to take an iron supplement to try and bring your iron levels up to what they should be. Be aware that taking iron supplements can often cause constipation, nausea and vomiting, so try not to rely solely on iron supplements and eat a healthy diet.
Iron-Rich Foods
liver
spinach
dried fruits
Maximize Your Iron Absorption
It is important to pay attention to what you drink with your iron. Taking vitamin C-rich foods along with the iron will increase absorption of the iron. However, taking caffeinated beverages along with high-iron foods will reduce the amount of iron that your body absorbs.
There are many different reasons that a woman may have vaginal bleeding during pregnancy. Some women can continue to have light periods or spotting during pregnancy, especially during the first few months. A pregnancy test would probably help to ease your mind. A visit to your practitioner may also be in order, either for early pregnancy care or to find out the reasons for your symptoms. Here is a comprehensive list of the many possible causes.
Are you experiencing first trimester bleeding? It's estimated that 25% of all women have bleeding in early pregnancy. One possible cause of this bleeding is implantation bleeding.
What is Implantation Bleeding?
Implantation bleeding is lighter than menstrual bleeding, and consists of pink or brown colored blood. Implantation bleeding occurs when the trophoblast, or tissue that surrounds the egg, attaches to the endometrium and slowly eats its way into the lining. As it does so, it eats through the mother's blood vessels, forming blood lakes within itself. When these blood lakes form near the surface of the trophoblast, they often cause implantation bleeding.
Remember, the difference between period and implantation bleeding is the amount; implantation bleeding is considerably lighter than menstrual bleeding. Menses and implantation bleeding should be different enough so that you can tell. Here are some frequently asked questions about spotting:
When does implantation bleeding occur?
Usually 5-12 days after ovulation, so just around the time that you would be getting your period. Bleeding during ovulation is something different.
What does implantation bleeding look like?
Implantation bleeding signs are a light pink or brown colored spotting.
How long does implantation bleeding last?
The duration varies for each woman.
Miscarriage
Bleeding while pregnant doesn't mean that miscarriage is certain, but it can occur. About half of the women who bleed do not have miscarriages. Miscarriage can occur at any time during the first half of pregnancy. Most occur during the first 12 weeks. Miscarriage occurs in about 15 to 20 percent of pregnancies. If you think you have passed fetal tissue, take it to the doctor's office so it can be examined.
Most miscarriages cannot be prevented. They are often the body's way of dealing with a pregnancy that was not normal. There is no proof that exercise or sex causes miscarriage.
Another problem that may cause pain and bleeding in early pregnancy is ectopic pregnancy. If pregnancy occurs in a fallopian tube, it may burst. Ectopic pregnancies are much less common than miscarriages. They occur in about one in 60 pregnancies.
A rare cause of early bleeding is molar pregnancy. It is also called gestational trophoblastic disease (GTD) or simply a "mole." It is the growth of abnormal tissue instead of an embryo.
Late Pregnancy
The causes of bleeding in the second half of pregnancy differ from those in early pregnancy. Common conditions that cause minor bleeding include an inflamed cervix or growths on the cervix.
Placental Abruption
The placenta may detach from the uterine wall before or during labor. This may cause vaginal bleeding. Only 1 percent of pregnant women have this problem. It usually occurs during the last 12 weeks of pregnancy. Stomach pain often occurs, even if there is no obvious bleeding.
Placenta Previa
When the placenta lies low in the uterus, it may partly or completely cover the cervix. This is called placenta previa. It may cause vaginal bleeding. Placenta previa is serious and requires prompt care.
Labor
Late in pregnancy, vaginal bleeding may be a sign of labor. A plug that covers the opening of the uterus during pregnancy is passed just before or at the start of labor. A small amount of mucus and blood is passed from the cervix. This is called "bloody show." It is common. It is not a problem if it happens within a few weeks of your due date.
One of the main complications in early pregnancy is ectopic pregnancy. This is when a fertilized egg implants itself somewhere other than in the uterine lining. The majority of the time, the egg will implant itself in the fallopian tubes, which is why ectopic pregnancies are also known as tubal pregnancies. However, the egg may also implant itself in the ovary, cervix or abdomen. Ectopic pregnancies never result in a live birth.
When the fertilized egg begins to grow in the wrong place, it can cause the organ in which it has implanted itself to burst. This is what makes ectopic pregnancies potentially life threatening for the women that have them. But they don't have to be. Recognizing the symptoms of an ectopic pregnancy early on can not only help save your life, but it can also decrease your risk of scarring and future fertility problems.
Signs and Symptoms
Unfortunately, some of the main ectopic pregnancy symptoms are similar to the signs of a regular pregnancy, making it easy to ignore the potential red flags. The most common symptoms of an ectopic pregnancy are:
a late period
unusual vaginal bleeding (unusual color, flow, or consistency)
a positive pregnancy test
fainting, lightheadedness, or dizziness
pain in your lower abdominal
shoulder pain
bladder or bowel pain
Feeling sharp, stabbing pain, especially in your abdomen, is a big warning
sign that you may be having an ectopic pregnancy. If you experience a combination
of any of these symptoms, make an appointment with your health care provider
as soon as you can and ask them to test you for an ectopic pregnancy.
Diagnosing an Ectopic Pregnancy
Although the rates of ectopic pregnancy are on the rise, more and more health care providers are screening their female patients for ectopic pregnancies. This means that more women can be diagnosed and treated earlier, resulting in fewer deaths from this complication.
If you do not already have a confirmed pregnancy, your health care provider will offer you a urine pregnancy test. If this comes up positive, a blood test will be ordered to measure your levels of hCG (human chorionic gonadotropin). Based on the date of your last menstrual period, the approximate length of your pregnancy and appropriate hCG levels can be assumed. HCG levels in an ectopic pregnancy tend not to rise as quickly as they would in a regular pregnancy. If your bloods tests show that your hCG levels are lower than they should be, there is a very good chance you are experiencing an ectopic pregnancy.
Your health care provider will probably also do a pelvic exam to see if there are any signs of pregnancy. She or he will also be checking for anything that seems unusual. Alternatively, an ultrasound can also be used to check for and confirm an ectopic pregnancy. However, getting an accurate visual diagnosis of an ectopic pregnancy is not always easy.
Since it is hard to visually detect any kind of pregnancy before six weeks, if you suspect you are experiencing an ectopic pregnancy early on, you may require regular monitoring of your hCG levels until you reach the six-week mark. If, by this time your hCG levels are still not rising as fast as they should be, an ultrasound can be used to determine the likelihood of an ectopic pregnancy.
Treatment
If it is caught early enough, ectopic pregnancy treatment can be quite simple. Methotrexate is administered to women who have been diagnosed with an ectopic pregnancy in the early stages. This is an injected drug that will dissolve the fetus and allow the body to reabsorb it. It is a noninvasive procedure and reduces the amount of scarring to your reproductive organs.
More advanced cases of ectopic pregnancies require surgery to end the pregnancy. While in the past this was major surgery and required a large incision to be made, today the procedure has been simplified into laparoscopic surgery.
A laparoscope is a long and hollow tube that has a light on the end, allowing the doctor to see inside and insert telescopic surgical tools. This procedure is not very invasive; only a small incision (big enough for the laparoscope) is made in your lower abdomen. Sometimes, another small incision is made for the surgeon's tools. If there is extensive internal damage or bleeding, a more invasive procedure may be required.
After your treatment, you will require further monitoring and a follow-up to ensure that your hCG levels return to zero. If the levels do not decrease, you may require further treatment, usually with methotrxate to dissolve any residual pregnancy material.
It is important to receive treatment for an ectopic pregnancy as soon as possible. If left untreated, an ectopic pregnancy can result in the mother's death.
In the Future
Many women who have experienced an ectopic pregnancy worry about their chances of successfully conceiving later on. Although experiencing an ectopic pregnancy puts you at a greater risk of having the same complication in the future, many women go on to successfully conceive a child a year after their ectopic pregnancy. However, if your reproductive organs have been severely damaged, either by the ectopic pregnancy itself or by the surgery required to treat it, then your fertility may be hindered. Speak with your health care provider about any concerns you may have regarding your fertility after treatment for an ectopic pregnancy.
Risks and Prevention
Damage to the fallopian tubes, either through scarring or a blockage, is one of the main causes of an ectopic pregnancy. Scarring can be caused by surgery but it can also be caused by infections, like pelvic inflammatory disease, gonorrhea and chlamydia. Seeking immediate treatment for these problems can minimize your risk of scarring and help prevent an ectopic pregnancy.
Other factors that can increase your risk for ectopic pregnancy include becoming pregnant after the age of 35, previously experiencing an ectopic pregnancy, and having surgery on your fallopian tubes. Unfortunately, these risk factors are not always preventable.
Additionally, if you have an IUD in place when you become pregnant, there is a good chance the pregnancy will result in an ectopic pregnancy. Receiving fertility treatments can also increase your risk.
Identifying the signs of an ectopic pregnancy early on will not only minimize any scarring incurred by the treatment, it may also save your life. If you think you may be pregnant, or if you know you're pregnant, and feel any discomfort or pain (especially in your stomach), make an appointment with your health care provider right away.
A molar pregnancy occurs when chromosomal abnormalities prevent the pregnancy from developing properly. There are two possible types; a complete and an incomplete molar pregnancy. An incomplete molar pregnancy forms an embryo that halts development, while a complete molar pregnancy develops a strange placenta and no fetus. It occurs when the nucleus of an egg is either lost or inactivated, causing the sperm to duplicate itself because the egg is lacking genetic information. This results in lack of fetus, placenta and amniotic membranes. The uterus will then grow rapidly, leading to bleeding into the uterine cavity or to vaginal bleeding.
A partial mole is more frequent and occurs when two sperm fertilize the same egg, causing partial placentas, membranes, or even a fetus present in a partial mole. This will often cause genetic problems with baby.
Signs and Symptoms of a Molar Pregnancy
· Intermittent, brownish discharge
· Nausea and vomiting (more severe than morning sickness)
· Pulmonary embolization
· Vaginal bleeding
· Hyperthyroidism
· Increased hCG levels
· No fetal movement or heartbeat detected
· Rapidly growing uterus
· Pregnancy induced hypertension prior to 24 weeks
· Passing of tissue that appears to be grape-like
· An ultrasound demonstrating a "snow storm effect"
How is it treated?
Normally the pregnancy will end spontaneously on its own, with the passing of a grape-like mass. If not, suction can be used to evacuate the mole from the uterus. If the woman doesn’t want to continue with childbearing, sometimes a hysterectomy is offered. hCG levels will continue to be taken several times per week until they normalize and pelvic exams will also be performed for precautionary reasons. It will probably be recommendeded that you avoid pregnancy for one year.
Preventing Molar Pregnancies
Molar pregnancies may be due to a nutritional deficit of protein yet can also be caused by an ovulation defect. Some studies show that getting plenty of animal protein and vitamin A through green leafy and yellow vegetables and yellow fruits may help reduce the incidence of molar pregnancies.
Getting Pregnant Again
If you are considering getting pregnant again, it is best to have genetic counseling prior to conceiving before you try again. If you’ve had a previous uncomplicated molar pregnancy, then your risk of having another molar pregnancy is about 1-2%.
Placenta Previa is when your placenta moves and covers part or all of the cervix. This is not a common pregnancy complication as about 1 in every 250 pregnancies may have placenta previa. Placenta previa can cause severe bleeding during pregnancy. An uncontrolled hemorrhage may even put the mother and baby’s life in danger, and should this happen the baby will be delivered by caesarean section, even if the baby's due date is weeks away. There are actually three types of previa:
1. Complete previa : occurs when the cervical os is completely covered
2. Partial previa : involves only a portion of the cervix being covered by
the placenta
3. Marginal previa : extends just to the edge of the cervix
Signs and Symptoms
Diagnosing a previa is usually made when there is painless bleeding during the third trimester. If you are bleeding, it is unwise to do a vaginal exam until an ultrasound has ruled out a placenta previa. Bleeding from your vagina during the second or third trimester may be the first sign of placenta previa, although in many cases there are no signs at all. However, there is a 10% false positive diagnosis rate, usually because of the bladder being overfull. There is also a 7% false negative rate, typically caused from missing the previa that is located behind the baby's head. Other reasons to suspect a previa include:
premature contractions
abnormal presentation (breech, transverse, etc.)
uterus measuring larger than it should according to dates
Risk Factors
There are a few predisposing factors. The following can increase your risk for placenta previa:
advanced maternal age
increased parity (number of pregnancies)
previous uterine surgery (regardless of incision type)
Treatment
Treatment of placenta previa depends on how far along your pregnancy is and how much bleeding you are experiencing. If it is diagnosed after the 20th week of your pregnancy, and you are not experiencing any bleeding, you may be simply asked to cut back on your activities, and increase the amount of time you spend in bed. You should, however, be alert for any bleeding in which case you will be put on bed rest, be told to refrain from sexual intercourse and be monitored more closely by your practitioner. This is because up to 90% of complete previas will resolve by term. However, if you are found to be bleeding you may be hospitalized until both you and your baby are stabilized, and even then you may be told to stay in bed as much as possible until the baby is ready to be delivered.
If bleeding is very heavy, transfusions may be necessary until the fetus is mature enough for delivery. Steroid injections may be used to speed fetal lung maturity. Ultimately, the goal is to try to keep the pregnancy going until at least 36 weeks, at which point the baby may be delivered by cesarean to reduce the risk of massive hemorrhage.
Complications
True placenta previa at term is very serious. Complications for the baby include:
problems for the baby, secondary to acute blood loss
intrauterine growth retardation due to poor placental perfusion
increased incidence of congenital anomalies
Risks for Mother Include:
life-threatening hemorrhage
cesarean delivery
increased risk of postpartum hemorrhage
increased risk of placenta accrete; placenta accrete is where the placenta
attaches directly to the uterine muscle
Preterm labor is usually defined as having regular contractions and dilation of your cervix before the 37th week of your pregnancy. This can either be done deliberately by your health care provider due to a pregnancy complication that you or your baby have developed, or it could be spontaneous.
What Causes Preterm Labor?
Abnormal placenta or even severe Cervix complications
Genital tract infections. Bacteria may cause the sac to weaken and cause
a premature rupture, which then would lead to a preterm birth
Chronic maternal illnesses such as pre-gestational diabetes, sickle cell
anemia, severe asthma etc.
Risk Factors
The following risk factors are related to premature labor and can be controlled by you. Eliminating the ones that apply to you will give your baby the best chances of being carried to term (between 38 and 42 weeks).
Smoking
Alcohol use
Drug abuse
Inadequate weight gain
Inadequate nutrition
Gum infection
Heavy physical labor
Infection
Hormonal imbalance
Incompetent cervix or premature cervical effacement and dilation
Uterine irritability
Placenta previa
Chronic maternal illness such as high blood pressure, heart, liver, kidney
disease, or diabetes
Extreme emotional illness
Under age seventeen
Over age thirty-five
Low educational or socioeconomic level
Structural abnormalities of the uterus or large fibroids
Multiple gestations
Fetal abnormality
History of premature deliveries
How do You Know if You are Experiencing a Preterm Labor?
Preterm labor is a very serious complication of pregnancy. Unfortunately, many women do not understand the signs of preterm labor. Early detection can help prevent premature birth and possibly enable you to carry your pregnancy to term or to give your baby a better chance of survival. If you experience any of the below signs or symptoms, be sure to contact your health care provider immediately:
An increase of vaginal discharge especially a sudden gush of clear watery
fluid from your vagina
Spotting or bright red blood from your vagina
Menstrual like cramping or more than 5 contractions in an hour
Increase in pressure in the pelvic area
Low back pain or pressure, or a change in the nature of lower backache
Swelling or puffiness of the face or hands
Painful urination, signifying urinary tract, bladder or kidney infection
Acute or continuous vomiting
Intense pelvic pressure
How Can You Prevent Preterm Labor?
One of the first things that your practitioner will tell you to do if you are having contractions is staying very well hydrated. What happens with dehydration is that the blood volume decreases, therefore increasing the concentration of oxytocin (hormone that causes uterine contractions) to rise. Hydrating yourself will increase the blood volume. Others things that you can do would be:
Pay attention to signs and symptoms of infections (bladder, yeast, etc.)
Keeping all of your appointments with your practitioner and calling whenever you have questions or symptoms. A lot of women are afraid of jumping to conclusions but it is much better to be incorrect than to be in preterm labor and not be treated. Also, be sure to follow your practitioner’s recommendations as to limitations on strenuous activity, including sexual intercourse and hours spent on the job
Getting good dental care
Avoiding smoking, cocaine, alcohol, and other drugs not prescribed by your doctor
Get tested for any infections, especially those of the genital tract
This being said, not all preterm births can be avoided, since not all are due to preventable risk factors.
How is Preterm Labor Treated?
The best key is always prevention and early detection. Make sure to ask your practitioner to discuss the signs and symptoms of preterm labor to you and your partner at your next visit. Prompt medical treatment is aimed at halting or postponing premature labor. Some of the treatments involved with preterm labor include:
Hydration (Oral or IV)
Bed rest (Home or Hospital), usually left side lying, limitations on sexual intercourse
Medications. These are used either to stop labor, to prevent infection or to help your baby’s lung develop more quickly in preparation for the birth. Drugs that relax the uterus (tocolytic agents) may be administered to stop contractions.
Evaluation of your baby (Biophysical profile, non-stress or stress tests, amniotic fluid volume index (AFI), ultrasound, etc.)
If the mother and/or child are in imminent danger from illness or other problems, no attempt is made to prevent labor and child is delivered.
Pregnancy is a joyful time for most mothers: it can be exciting, fun, and gives you lots to look forward to. But pregnancy also comes with a lot of responsibility, including frequent visits to your health care practitioner. Now that you are pregnant you have probably noticed that your health care providers are frequently checking your blood pressure. Blood pressure must be monitored during pregnancy because of a condition called pregnancy-induced hypertension. If you are pregnant, be sure that you get your blood pressure levels checked out frequently to avoid developing this condition.
What is Hypertension in Pregnancy?
Pregnancy-induced hypertension is a condition that causes elevated blood pressure in a mother-to-be. In order to be diagnosed with pregnancy-induced hypertension, your blood pressure levels must be higher than 140/90 mmHg during the last half of your pregnancy. Pregnancy-induced hypertension can be quite serious as it can lead to various complications both for you and your baby. In fact, preeclampsia and eclampsia, severe forms of pregnancy-induced hypertension, are the leading cause of infant and maternal death in the United States.
Also called toxemia and gestational hypertension, pregnancy-induced hypertension is found in about 5% to 10% of all pregnancies in the United States. It is the most common medical problem associated with pregnancy but there is no known cause or cure for the condition. However, there are specific symptoms of hypertension in pregnancy. If you notice these hypertension symptoms, speak with your health care provider immediately.
What causes Pregnancy-Induced Hypertension?
To date, there is no known cause for pregnancy-induced hypertension. It is thought that the condition may begin in early pregnancy, during embryo implantation. Generally, blood vessels in the uterus stay relaxed during implantation and pregnancy. People with pregnancy-induced hypertension appear to have abnormally constricted blood vessels. This could be the cause of hypertension.
Risk Factors for Pregnancy-Induced Hypertension
Though the cause for pregnancy-induced hypertension is unknown, there does appear to be certain risk factors associated with the condition. These include:
having your first baby before the age of 20 or after 35
having a history of diabetes
having a history of hypertension (high blood pressure) before pregnancy
having multiple births (twins, triplets etc.)
being of African descent
Types of Pregnancy-Induced Hypertension
There are three main types of pregnancy-induced hypertension:
Gestational Hypertension: Gestational hypertension is the most common form of hypertension in pregnancy. It is diagnosed if a woman’s blood pressure is higher than 140/90 in the last half of her pregnancy. No other signs or symptoms accompany this type of hypertension.
Preeclampsia: Preeclampsia is a more serious form of pregnancy-induced hypertension. It is diagnosed when a mother’s blood pressure is higher than 140/90 in the last 20 weeks of pregnancy, and when protein is found in urine samples.
Eclampsia: Eclampsia is one of the most serious forms of pregnancy-induced hypertension. It causes convulsions or coma in the late stages of pregnancies.
Symptoms of Pregnancy-Induced Hypertension
All expectant mothers should be aware of pregnancy-induced hypertension symptoms. These include:
blood pressure readings above 140/90, or significantly higher than normal
protein found in the urine (caused by damaged kidney filter)
edema (swelling), especially in the face and neck
sudden weight gain
blurred or double vision
headache
seeing flashing lights or spots
urinating only small amounts
abdominal pain
nausea and dizziness
Complications Associated with Pregnancy-Induced Hypertension
Pregnancy-induced hypertension can be very dangerous for both you and your baby. If left untreated, it can easily worsen, leading to severe preeclampsia or eclampsia. Effects of pregnancy-related hypertensions include:
leaky blood vessels, leading to swelling and weight gain
leaky vessels in the lungs, causing shortness of breath
leaking liver vessels, causing swelling and liver damage
protein leaks in the kidneys, which can lead to low birth weight babies
Typically, these complications will disappear after your baby is born, however, damage to the organs can still result. Some of the most serious complications of pregnancy-induced hypertension include:
blindness, liver rupture, and kidney failure in the mother
placental abruption, in which the placenta separates from the uterus possibly
resulting in stillbirth
brain damage to mom, caused by swelling, convulsions, and coma
HELLP syndrome, which can destroy the body’s red blood cells, liver,
and stops the blood from clotting
Treatment
There is no known cure for pregnancy-induced hypertension. If hypertension occurs late in your pregnancy, your health care provider may suggest bed rest and increased blood pressure monitoring. Certain hypertension medications may also be prescribed. Usually, delivery is the best treatment for pregnancy-induced hypertension. Once your baby is born, symptoms of the condition disappear. Labor may be induced or a c-section performed. If hypertension occurs early in pregnancy you health care provider will suggest that you weigh the risks and benefits of carrying to term or having an early cesarean section.
Preeclampsia (also known as toxemia or pregnancy-induced hypertension) is characterized by high blood pressure, fluid retention that shows up in the second half of pregnancy, and protein in the urine. It can be either mild or severe; in its most severe form, it can develop into HELLP syndrome. Serious cases can restrict blood flow to the placenta. Should the blood flow to the placenta be restricted it could seriously harm your baby.
It is more likely to occur in first pregnancies and beyond the 20th week of gestation. Although preeclampsia is a rare pregnancy complication, if you ensure that you are getting all the right prenatal care and keeping all of your prenatal appointments the chances that your health care provider will pick up the problem early enough to treat it.
Risk Factors
The following factors put women at greatest risk of developing preeclampsia:
Carrying multiple fetuses
Those over the age of forty
Women with eating disorders
Those who already have chronic high blood pressure
If it is your first pregnancy
Being African American
If your mother or your spouse’s mother had preeclampsia during her
pregnancy
Signs and Symptoms
If you experience any of the following symptoms make sure to call your practitioner:
If, after the 20th week of pregnancy, your blood pressure rises to 140/90
or more when you have never had high blood pressure
Sudden weight gain unrelated to excess food intake
Severe swelling of the hands and face
Unexplained headaches or fever
Esophageal or stomach pain or itching
Vision disturbances, such as blurred vision
Protein in the urine or very low urine output
Rapid heartbeat
Confusion
Treatment
Luckily, if you are receiving regular medical care, preeclampsia is almost always caught early enough to be managed successfully. The first option is usually to reduce your blood pressure. This is usually done by getting plenty of rest, attaining a proper diet, exercising, stress reduction and medication if needed. The ultimate treatment however is delivery. Only then will you be cured. During your pregnancy the baby’s condition will be assessed regularly.
In cases of severe preeclampsia, the treatment is usually more aggressive. Intravenous magnesium sulfate helps prevent progression of preeclampsia. If the fetus is close to term, and/or if its lungs are determined to be mature, immediate delivery is usually performed. Luckily, in almost all women with preeclampsia who also have chronic hypertension, blood pressure returns to normal following delivery. Although preeclampsia is not a very common complication, it is definitely not something to be taken lightly, so be sure that you keep your prenatal appointments and have all the tests done that need to be done.
HELLP syndrome is a severe form of preeclampsia, characterized by high blood pressure, vomiting, and other symptoms. The term HELLP is an anagram, made up of the first letters of the three main signs of the illness: Hemolysis (the breakdown of red blood cells in the body), Elevated Liver function, and Low Platelet count (which contributes to poor blood clotting). HELLP syndrome typically develops in the third trimester of pregnancy, though it can occur earlier. Some women also develop HELLP syndrome in the days immediately following delivery.
HELLP syndrome occurs very rarely, only affecting between 0.2% and 0.6% of all pregnant women in North America. Pregnant women with preeclampsia are more likely to develop HELLP syndrome. In fact, about 10% of women with preeclampsia will develop the condition. The majority of HELLP sufferers do recover fully. Unfortunately though, 2% of women and 8% of babies affected by HELLP syndrome die as a result of complications caused by the illness.
What Causes HELLP Syndrome?
No one is really sure what causes HELLP syndrome. It seems to be related to preeclampsia and eclampsia, and usually occurs as a complication of one of these conditions. However, HELLP syndrome can also occur in the absence of both preeclampsia and eclampsia.
Who’s At Risk For HELLP Syndrome?
Unfortunately, because no cause for HELLP syndrome is yet known, doctors aren’t able to pinpoint who will develop the condition. It seems that any pregnant woman is at risk for developing HELLP syndrome, though there are a few factors that may increase your risk. These include:
being under 20 or over 35
being pregnant for the first time
having high blood pressure, preeclampsia, or eclampsia during your
pregnancy
having HELLP syndrome, preeclampsia, or eclampsia during a previous pregnancy
Symptoms of HELLP Syndrome
HELLP syndrome is often accompanied by a number of different symptoms. It is important that you be aware of these symptoms and seek medical help immediately if you develop any of them. Symptoms include:
nausea
vomiting
severe headaches
pain in the upper right side of the abdomen, just under the ribs
edema, or water retention
high blood pressure
convulsions
low blood platelet count
elevated liver enzyme count
Sometimes the pain caused by HELLP syndrome can be confused with heartburn. If your heartburn does not radiate up your chest or does not subside after taking antacids, visit with your health care provider for an examination.
Treating HELLP Syndrome
There is no easy cure for HELLP syndrome. The only sure way to control the syndrome is by delivering the baby. If your baby is older than 34 weeks, it is likely that she will be delivered immediately, probably by cesarean section. Typically, symptoms disappear within a week of delivery.
If your baby is under 34 weeks and your symptoms are less severe, your health care provider may recommend bed rest and close monitoring until your baby reaches 34 weeks. You may be given medications to control your high blood pressure, along with increased fluids. You may receive intravenous corticosteroids, which will help your baby’s lungs to grow and develop more quickly.
Complications Associated With HELLP Syndrome
There are a number of complications of HELLP syndrome. Mothers are especially at risk if they develop HELLP syndrome. Possible complications include:
seizures, as a result of restricted blood flow to the organs caused by high
blood pressure
anemia, caused by breakdown of red blood cells
problems with blood clotting, including Disseminated Intravascular Coagulation
(DIC), which can cause internal hemorrhaging.
placental abruption
difficulty breathing, caused by fluid buildup in the lungs
Liver damage or liver failure
kidney damage or kidney failure
stroke
Possible Effects on Baby
If your baby is over 37 weeks of age, it is very likely that she will suffer no physical complications as a result of HELLP syndrome. Younger babies may face long term effects of Hellp syndrome, such as growth retardation or complications associated with premature birth.
Preventing HELLP Syndrome
There is no sure fire way to prevent HELLP symdrome. However, by having frequent medical checkups and by taking care of your body, you are more likely to avoid developing the condition.
If you are at high risk for developing HELLP syndrome, be sure to be monitored by your health care provider. If you notice any symptoms of HELLP syndrome, call your health care practitioner or go to the nearest emergency room.
Amniotic fluid surrounds the developing fetus in the amniotic sac, and performs some important functions. The amniotic fluid:
provides protective cushioning
protects the baby and uterus from infection
serves as a backup of nutrients and fluids for your baby
allows your baby to move about and breath
helps in the development of the respiratory, digestive and musculoskeletal
systems
What Causes Oligohydramnios During Pregnancy?
There are several different causes of low amniotic fluid, which include:
leaking or ruptured membranes : your membrane may possibly have a small tear
in it and your health care provider may discover this during an exam
placenta complications : should your placenta stop producing enough nutrients
to feed your baby, he may stop recycling fluids which would reduce the amniotic
fluid in the sack
eating disorders
fetal abnormalities : if your baby has kidney problems, he may stop producing
enough urine to keep the amniotic fluid levels up in the sack
Signs and Symptoms of Low Amniotic Fluid
There are several signs that may lead you to suspect low levels of amniotic fluid. These include:
leaking fluid
small measurements
lack of feeling movement from your baby
an amniotic fluid index (AFI) of 5cm or less
How it Affects the Baby
One of the main concerns is that your placenta may not be functioning correctly, which could lead to a number of complications. You may have a premature birth, or the amniotic fluid may get so low that your baby will compress the umbilical cord and starve himself of oxygen. Low amniotic fluid may also prevent some of the vital organs and systems we all rely on for fully developing.
Treatment
Sometimes, replacing fluid through maternal oral or IV hydration may be used to help correct the condition. Other times, amnioinfusion is used. If low amniotic fluid is seen in a post-term pregnancy, most practitioners will induce labor.
Amniotic fluid surrounds the developing fetus in the amniotic sac, and performs some important functions. Some of these include:
provides protective cushioning
protects the baby and uterus from infection
serves as a backup of nutrients and fluids for your baby
allows your baby to move about and breathe
helps in the development of the respiratory, digestive and musculoskeletal
systems
Signs and Symptoms of Excess Amniotic Fluid
Rapid development of your uterus could be the first sign to cause your health care provider suspect that you may have an excess of amniotic fluid. Later on in your pregnancy around the second or third trimester, you may not be able to feel your baby moving around.
Other tell-tale signs may include:
unusual abdominal pains and indigestion
fluctuating weight
extreme swelling of your feet and ankles
a uterus that may measure larger than it should
How it Affects the Baby
In many cases this will actually resolve itself, however should your situation be on the extreme side you health care provider can remove some of the amniotic fluid through a procedure known as therapeutic amniocentesis. They will insert a needle into your uterus and simply remove some of the fluid from the amniotic sac.
Treatment
If there is excessive fluid, an amniocentesis may be performed to remove some fluid. Approximately half the cases of polyhydramnios resolve themselves.
Most women find their pregnancies to be very enjoyable, but pregnancy can definitely have its difficult times. Whether it’s morning sickness, insomnia, or just plain old fatigue, being pregnant can really take it out of you. When you are pregnant and fighting an illness though, things can be even worse. Women with fibromyalgia, a chronic pain disorder, often wonder if they will be able to deal with the demands of a pregnancy.
What is Fibromyalgia?
Fibromyalgia is a relatively unknown illness, even though it affects between 3 and 6 million Americans every year. Fibromyalgia is a syndrome that causes widespread and chronic pain in your body. This pain is also accompanied by numerous other symptoms and often has a great impact on your freedom and enjoyment of life. Fibromyalgia syndrome seems to attack more women than men, with 80% of sufferers being female. Onset of this syndrome generally occurs during early adulthood or middle age and is characterized by symptoms that wax and wane over periods of time.
Symptoms of Fibromyalgia
Fibromyalgia symptoms are painful and can be debilitating. Fibromyalgia attacks the muscles throughout your body, causing them to ache, burn, and twitch. If you are suffering from the syndrome, you probably feel achy all over, especially in the arms, lower back, shoulders and neck area. Fibromyalgia causes tingling in the fingers and toes, severe fatigue, headaches, and sleep problems. The syndrome is also associated with abdominal pain and gastrointestinal complications. Additionally, many suffers have to deal with anxiety and depression triggered by their fibromyalgia.
There is currently no cure for fibromyalgia and treatments are also limited in their effectiveness. Generally, antidepressants and pain suppressants are used to treat the symptoms of fibromyaligia. This lack of effective fibromyalgia treatment is basically due to the minimal knowledge researchers have about the syndrome. No one is completely sure of the causes of the illness and thus no appropriate treatments for fibromyalgia have yet been found.
Fibromyalgia and Pregnancy
Not very much is known about the course of fibromyalgia during pregnancy. In fact, there seems to be conflicting evidence between researchers and doctors as to the effects of pregnancy on the syndrome. It is generally accepted that more fibromyalgia research must be performed in order to get an accurate idea of what happens to fibromyalgia syndrome during pregnancy.
In 1997, one of the only studies ever done on fibromyalgia and pregnancy was conducted in Norway. A small number of pregnant women were included in the study, some with fibromyalgia and some without. The study found that an overwhelming number of those pregnant while suffering from fibromyalgia reported a drastic increase in the severity of their symptoms. The third trimester was by far the most challenging during their pregnancy, with symptoms increasing in frequency. Most of the women in the study reported that their symptoms remained more intense than normal until about three months after they had delivered. They also had a greater incidence of post-partum depression. On a brighter note, the babies born to women with fibromyalgia were all healthy, full-term, and of a good birth weight.
Many doctors however, disagree with the idea that pregnancy makes fibromyalgia worse. Doctors who treat fibromyalgic patients actually argue that pregnancy helps to lessen and even eliminate the symptoms caused by fibromyalgia. Many pregnant women say that, after their initial nausea and morning sickness passed, they actually felt better than they did before they were pregnant. It is theorized that this could be due to the ovarian hormone relaxin. During pregnancy, the amount of relaxin in a woman’s body increases up to 10 fold. It has also been found that relaxin supplements help to ease symptoms in many women with fibromyalgia.
Fibromyalgia and Breastfeeding
Though the effects of pregnancy on fibromyalgia are unknown, more is known about breastfeeding and fibromyalgia. Numerous studies have been done in the area and conclusions seem to support that fibromyalgia makes breastfeeding quite difficult. This is not to say that it cannot be done, only that there are some extra things to keep in mind if you do decide to breastfeed.
Breastfeeding tends to be difficult because of the chronic muscle pain caused by fibromyalgia. Most women will have their symptoms return soon after they give birth, making breastfeeding even harder than it is normally. It is important to make feeding time as stress free as possible, both physically and emotionally.
Use pillows to support your own head while you feed your baby. Think about getting a support or sling to prop your baby up, so you don’t have to support his weight all on your own. You may find that lying down on the bed with your baby facing you will also make feeding easier; it will give you some extra time to rest. Be sure to nurse in a quiet area away from the hustle and bustle of daily life – this will reduce your own stress level and give you some time to bond with your little one.
Thinking about Getting Pregnant?
If you have fibromyalgia you may be wondering whether or not you should get pregnant. Rest assured that fibromyalgia will have no negative effect on your baby whatsoever. Therefore, the main issue is whether you feel your body can handle a pregnancy. Unless you have extreme complications, most women find that pregnancy is something to pursue even with fibromyalgia. If you do decide to get pregnant, here are some things to keep in mind:
Try to plan your pregnancy at least a year ahead of time, so you can begin
to build up your strength.
Reduce the amount of stress in your life as much as you possibly can.
Try to conceive when your symptoms are less intense. Avoid conceiving during
a symptom flare up.
Speak with your doctor about your medications. Not all medications are safe
to continue during pregnancy..
Maintain a healthy diet and work out moderately (but don’t overdo it).
Avoiding Postpartum Blood Clot
Although the chances of such clots are rare, they are four times greater for pregnant women and new mothers, a large 30-year study found, confirming what doctors have long observed.
Mayo Clinic researchers looked at medical records from 1966 to 1995 of 50,000 pregnant women who lived in Olmstead County, Minn., where data has long been gathered for a long-term health surveillance project.
The researchers focused on blood clots in leg veins (known as deep vein thrombosis) and clots that broke loose and lodged in the lungs (known as pulmonary embolism).
The incidences of deep vein thrombosis and pulmonary embolism were small - only 105 cases occurred over the 30-year period - but the problem is of concern because it is frequently fatal when it does happen.
In roughly one-fourth of pulmonary embolism cases in general, the first and only symptom is sudden death, said Dr. John A. Heit, lead author of the study appearing in Tuesday's Annals of Internal Medicine.
When the researchers compared similar age groups, they found the pregnant women and those who had given birth within the past three months were four times more likely to have these serious blood clot problems than non-pregnant women.
Nearly all of the women in the study were white, so researchers said their findings might not apply to women of other races.
In an editorial accompanying the study, Dr. Richard V. Lee of the State University of New York at Buffalo said that within the past 20 to 30 years pulmonary embolism has overtaken all other causes of maternal mortality.
An American College of Obstetricians and Gynecologists committee is drawing up guidelines on the subject, said Dr. Gary Hankins, an obstetrician and the committee's chair.
The top tip for all new moms: Get out of bed and start walking as soon as possible. For women with risk factors - such as obesity, a history of clots, and prolonged bed rest during pregnancy - doctors may consider using leg compression devices in the hospital to get the blood moving.
But blood thinners don't lead the list of possible solutions because of potential complications, like excessive bleeding.
``Anticoagulants should be reserved for a very small group, those only with a significant risk,'' Hankins said. ``We don't want to recommend a strategy that could do more harm than good.''
Heit said aspirin has been shown to be effective for preventing stroke and heart attack but it appears not to help prevent blood clots in leg veins.
Deep vein thrombosis, most commonly known as a potential danger of long airplane flights, strikes an estimated 2 million Americans a year, and about 200,000 Americans die every year from pulmonary embolisms.
