Most pregnancies will continue
without any problems at all, however, a small percentage of pregnancies suffer from
complications. We have tried to identify some of the more common possible complications
and provide a brief overview. If you require more information or advice you should
contact your doctor.
Ectopic Pregnancy
An ectopic pregnancy is
when your fertilised egg implants inside your fallopian tube instead of your uterus.
This is a rare occurrence, but if left untreated can have serious ramifications.
If this condition is not diagnosed early in your pregnancy your fallopian tube may
rupture. At the very least this can cause future problems for your fertility or
it can be a life-threatening situation.
Symptoms
If you suffer from any
of the following symptoms seek medical advice immediately.
- Moderate
to severe pain starting on one side of your abdomen. This may spread across your
entire abdomen.
- Light
to heavy bleeding.
- Nausea
and vomiting.
- Feelings
of weakness, dizziness and fainting.
Diagnosis
If your doctor suspects
an ectopic pregnancy s/he may order some tests.
-
Blood Test - to measure levels of hCG. If your hCG level has not risen or has fallen this may indicate an abnormal pregnancy.
-
Ultrasound - this will indicate if a gestational sac is visible in the uterus or if a pregnancy is developing in your fallopian tube.
-
Laparoscopy - this is the ultimate diagnostic tool as it allows your doctor to directly view your fallopian tubes.
Treatment
Unfortunately an ectopic
pregnancy usually involves a removal of the fetus by surgery. Every effort is made
to ensure your future fertility is protected, although this is not always possible.
You will probably have some follow up blood tests and visits with your doctor to
ensure that all of the pregnancy tissue has been removed.
It is usually recommended
that following a tubal pregnancy that with future pregnancy’s you have an early
ultrasound around 6-8 weeks to determine the position of the gestational sac.
In addition to losing your
baby you may also be dealing with the emotional strain of a reduction to your future
fertility. You and your partner may deal with this differently and you may wish
to seek counseling.
For more information
Gestational Diabetes
During pregnancy your body
produces various hormones, sometimes these hormones can stop the insulin your body
produces from working properly and you may develop gestational diabetes. As result
of diabetes in pregnancy your baby may be born with a low blood sugar which will
usually be treated soon after birth. There is evidence to support that women who
suffer from Gestational Diabetes give birth to larger and heavier babies than women
who do not suffer with the condition. As a result it is more likely that you may
need a caesarean delivery, although this is not always the case.
Symptoms
If you are displaying the following symptoms you may be suffering from Gestational Diabetes.
- Excessive hunger and thirst.
- Frequent urination (especially in the 2nd trimester when you should be experiencing some relief from this).
- An increase in your blood pressure.
- Recurrent vaginal infections.
Diagnosis
A routine blood sugar test,
or glucose tolerance test, is performed on all women around the 24th-26th week of
your pregnancy. If you return an abnormal result you will be required to undergo
further tests.
Treatment
- By visiting a nutritionist you will be taught how to control your sugar levels by dietary
changes.
- In addition you will be required to perform blood tests at set times throughout the
day to check your blood sugar levels.
- If dietary changes have not controlled your Gestational Diabetes then you may need
to use insulin injections throughout the remainder of your pregnancy.
- Gestational Diabetes usually disappears after the delivery of your baby.
Miscarriage & Stillbirth
The term miscarriage is
used to describe the loss of a baby before 20 weeks of pregnancy and the term stillbirth
is used to describe the loss of a baby after 20 weeks of pregnancy.
Statistically most miscarriages
occur in the first 12 weeks of pregnancy and are usually attributed to foetal abnormalities.
Late miscarriages are often
caused by an incompetent cervix that starts to dilate long before it should. Placental
insufficiency is also a cause for late miscarriage. This is when your placenta fails
to provide enough oxygen and nutrients to your developing baby.
Symptoms
- Spotting
or bleeding from your vagina
- Mild
to severe abdominal cramps
- Dizziness
- High
fever
Diagnosis
Your doctor may possibly
want to perform an ultrasound to determine the health of your baby. This may be
an external or internal ultrasound depending on the stage of your pregnancy. Your doctor may also run blood
tests to determine your hormone levels.
Treatment
It may not be necessary
to take any action if your miscarriage has occurred early in your pregnancy, as
it is likely that your body will expel the contents of your uterus naturally. However if this does not
happen naturally it may be necessary to perform the surgical procedure called Dilation
and Curettage (D&C), to manually remove the remains of your pregnancy.
If you have an incompetent
cervix it may be possible to treat this by placing a stitch into the cervix to prevent
it from further dilating.
Although most women do
not suffer any long-term physical affects from a miscarriage the emotional effects
should not be underestimated. You and your partner may cope in different ways after
the loss of your baby and seeking help through counseling may be beneficial.
Obstetric Cholestasis
Obstetric Cholestasis is
a rare condition that occurs in pregnancy and is characterised by extreme itching
in the mother. A normal functioning liver produces bile that moves through the intestine
and assists in the digestion of food. In sufferers of Obstetric Cholestasis bile
acid levels build up and cause toxins, or poisons, to enter the mother’s blood and
cause the following symptoms. It is important to identify this condition as it can
be a serious concern for the health of your baby, especially after 36 weeks gestation.
Symptoms
-
Extreme itchiness, especially on the palm of the hands and soles of the feet. This may be the only symptom that presents itself. Itchiness is often worse at night.
-
Itchiness that may spread to the rest of the body.
-
Jaundice.
-
Dark coloured urine.
-
Pale stools.
-
These symptoms may become more pronounced with subsequent pregnancies.
Diagnosis
- Often
by the process of elimination.
- Blood
tests that should include a bile acid test and liver function test.
- If
a negative result is first detected and itching persists, tests should be repeated.
Treatment
- There
is little that can be done to treat this condition. Some women report finding relief
by using homeopathic therapies.
- It
is most likely that you will be induced around 36-38 weeks gestation to provide
the greatest chance of a safe delivery of your baby.
- Following
the birth of your baby, symptoms disappear quite quickly and your liver function
should return to normal. However, you should have a follow up blood test to confirm
this.
For More Information
Itchy Moms, an online support
group and resource.
Placenta Praevia
Placenta Praevia is the
term used to describe when your placenta is positioned in the lower half of your
uterus. Many women are told early in their pregnancy that they have a low lying
placenta, but in about 95% of cases it will move naturally to the upper half of
the uterus in the second half of pregnancy.
There are varying degrees
of severity of this condition and this will determine your Doctor’s treatment:
- Complete Praevia
- this is when your placenta entirely covers your cervix
- Partial Praevia
- this is when your cervix is partially covered.
- Marginal Praevia
- this is when your placenta is just touching your cervix.
If your placenta is completely
or partially covering your cervix it may not be possible to give birth to your baby
by vaginal delivery.
Symptoms
You will probably be aware
of your condition prior to any symptoms becoming apparent.
- You may spontaneously bleed prior to the onset of labour.
- This bleeding is usually painless and can be brought on by lifting, sneezing and coughing,
or sexual intercourse.
- If you bleed at any time throughout your pregnancy you should seek medical advice.
Diagnosis
Placenta Praevia is usually
identified during routine ultrasound tests. Internal examination should be avoided
as it can cause more bleeding to occur.
Treatment
Depending on the severity
of your condition you will probably be advised to
- Be cautious in your physical activities.
- Get plenty of rest.
- A follow up ultrasound will be conducted between 28-34 weeks of your pregnancy to
assess if your placenta has moved.
- Possibly be confined to bed rest
- Possibly be hospitalised and you and your baby will be monitored
- It is likely that you will have a caesarean section to deliver your baby. All attempts
will be made to delay delivery until after the 37th week of your pregnancy.
For Further Information
Placental Separation
This is when your placenta
separates or peels away from your uterus. You will suffer from major bleeding either
into your uterus or from your vagina and your baby will suffer from reduced oxygen
and nutrient supply. Although placental separation is quite rare it is very serious.
Symptoms
- Contractions
of the uterus
- Abdominal
pain and tenderness
- Foetal
distress
- You
may display symptoms of shock
- Internal or vaginal bleeding
Diagnosis
Placental separation is
usually confirmed by using ultrasound equipment.
Treatment
You will most likely be
hospitalised and you and your baby will be monitored. It is likely that your
baby will be delivered early by caesarean section.
Pre-eclampsia
Pre-eclampsia is a serious
condition in pregnancy and if left untreated can lead to placental failure and eclampsia.
Eclampsia can cause maternal seizures, coma and possibly death. It is unlikely that
your condition would develop to this stage, as your doctor or midwife should be
able to pick up the early warning signs at your regular check ups.
Symptoms
- Sudden
and severe swelling of hands and feet and face
- High blood pressure
- Headache
- Dizziness
- Fever
- Irritability
- Blurred
vision
- Decreased
urinary output
- Abdominal pain
Diagnosis
It is likely that your
doctor or midwife will detect early warning signs during your regular antenatal
checkups by checking your
- blood pressure
- protein
levels in your urine
Pre-eclampsia can come
on very suddenly so you will need to be aware of the symptoms and advise your doctor
immediately if you suspect anything out of the ordinary.
Treatment
- If
your condition is mild you will be required to rest.
- Possibly
given medication
- Possible
hospitalisation
- It may be necessary to deliver your baby early by caesarean section.
For More Information
Pre-eclampsia Research Laboratories
Premature Birth
If your baby is born prior
to 37 weeks gestation they are considered to have been born prematurely.
Most premature babies will
suffer some complications as a result of their immature development; however with
the care provided by neonatal health professionals survival rates for premature
babies continue to improve.
Giving birth to a baby
prematurely is not only physically draining but can also be very emotionally challenging.
Most mothers and fathers that have gone through the experience would suggest getting
as much support as possible.
Rhesus Factor Problems
This problem usually affects
second and subsequent pregnancies rather than the first pregnancy. Complications
can arise if you and your partner have different Rhesus factors in your blood. You
will be checked for your Rhesus factor in your routine blood tests conducted at
the beginning of your pregnancy. If you are Rh negative (Rh-) then it is important
to test your partner for their Rh factor to detect if they are compatible or not.
If your partner is Rh positive (Rh+) it is likely that your baby will also be Rh+
and this is incompatible with your blood group. Your body will make antibodies to
fight off this foreign invasion if your blood comes into contact with your baby’s
blood (this usually happens during the delivery of your first baby).
Your subsequent pregnancies
will have the potential for complications as your body tries to fight against your
baby’s red blood cells.
Treatment
Fortunately Rhesus Factor
problems are easily treated.
If you are Rh- you will
routinely be given an injection of anti-D, which destroys any antibodies that may
have developed in your blood stream after your first pregnancy
For subsequent pregnancies
you will be checked for the appearance of any antibodies in your early blood tests.
You may also have regular blood tests throughout your pregnancy to ensure that you
have not developed any more antibodies.
When Should You Call Your Doctor?
If you suffer from one or more of these symptoms you should call your doctor immediately and seek his/her advice. If your doctor is unavailable you should consider going to your nearest emergency department or call an ambulance.
- Vaginal
bleeding or vaginal discharge that is different.
- If
you suspect that you are leaking amniotic fluid.
- Headaches
that are frequent and severe.
- If
passing urine is painful or causes burning sensations.
- Vomiting
or nausea that is severe and persistent.
- Abdominal
pain or cramping.
- Frequent
dizzy spells or fainting.
- If
you suffer from blurred vision, white lights or flashes, or dots in front of the
eyes.
- Sudden
swelling in hands, feet, and face.
- If
you have an injury to your abdomen.
- If
you notice a dramatic decrease in your baby's movements.
- High
fever, over 38º Celsius orally.
- Any
symptoms that you are concerned about and would like medical guidance.
