Pregnancy is a dream for many women who want a family. The moment they get a positive pregnancy test, the whole world changes for them. Mothers-to-be, especially those who have had babies before, know that having kids does not come cheap and expect the aches and pains to be a part of their normal lives for the better part of the year ahead. They stock up on heartburn medications and comfy pillows, and prepare themselves for a big change in lifestyle, but sometimes preparations are not enough.
Surprisingly, even women who are accepting of the efforts associated with pregnancy can be hit by a harsher reality, and that is complications and abnormalities in their pregnancy. Abnormalities in pregnancy can affect the mother, the baby or both, depending on the condition and its severity. Some of them can be controlled with medication, while others require surgical intervention. Also, some issues are relieved shortly after delivery, but others persist and leave a mark on the mother after the baby is born. Factors like maternal medical history, previous pregnancies and several health and environmental factors affect the probability of ending up with an issue. Genetic factors are also a big part of the equation in such cases.
It's important for women who get pregnant or are trying to conceive to be aware of what problems might happen in their pregnancies and how they should react to them. Here, we present 15 issues that could develop during pregnancy and threaten the health and wellbeing of the mother and her unborn child.
15 Birth Defects
Inside the womb, some babies do not develop like they should. There are sometimes problems with how they physically develop, known as structural birth defects, or with the way their bodies work, known as biochemical birth defects. They can be caused by genetic factors, such as Down’s syndrome, or by environmental causes like smoking and alcohol consumption. Some birth defects can be managed while others are fatal.
Heart defects are structural defects that are very dangerous, and can be detected in utero. Their risk increases in smoking mothers-to-be. Spina bifida is also structural, but it affects the nervous system. Both defects can sometimes be treated successfully with surgery. Other defects, like Down’s syndrome and Fragile X syndrome, are chromosomal abnormalities that cannot be treated. They can be managed later in life to give the child the potential for a life close to normal. Parents need to stay updated on the latest treatment and management techniques related to their baby’s defect, so they can give him/her the best possible life.
14 Bacterial Infections
Group B Streptococcus (GBS) is a bacterial infection in the vagina, caused by a bacteria usually found in the vagina and rectum of about 25% of normal healthy women. It is not a sexually transmitted infection, but rather occurs when the bacteria colonize the vagina. It can be transferred from the mother to the baby during delivery and have serious consequences. In some countries, testing for GBS prior to delivery is mandatory.
Women who test positive are given intravenous antibiotics during delivery and a few hours before it. If a mother is given antibiotics during delivery, the chances for delivering an infected baby are decreased, and the baby is given antibiotics after birth as well. Usually, penicillin is the safest and most effective antibiotic class for this case. A positive test is not grounds for opting for a C-section, but if other concerns are there, women who deliver by C-section do not require the antibiotic infusion because their babies do not come in contact with the bacteria.
13 Uncontrollable Sickness
Nausea and vomiting are a normal part of a healthy pregnancy. Annoying and inconvenient as they are, they are not a warning sign, but merely a result of the messed-up hormones. Sometimes medication or traditional medicine (such as ginger) is used to alleviate the symptoms and things get much more comfortable. Some women, however, are not that lucky. Hyperemesis Gravidarum is a medical condition in which excessive vomiting occurs. In this case, a pregnant woman vomits intensely throughout the day and night and she is not able to keep any food or drink in her stomach.
There is the concern about whether or not she is receiving enough calories for her and her baby to live. There is also a depletion in the necessary minerals from the body, continuous weight loss and dehydration. It is an exhausting and draining condition that takes so much energy. Some women require hospitalization to receive nutrition through intravenous lines to compensate for what they are losing.
12 Gestational Diabetes
Diabetes is a condition in which blood sugar is too high. It has a lot of complications such as tooth loss, vision and kidney problems, and inability to function. It's characterized by increased hunger, thirst, urination and exhaustion. During pregnancy, many women who were healthy pre-pregnancy can develop diabetes that diminishes to normal on its own after the baby is born. Yet, this condition increases the risk of the woman developing diabetes later in life.
Hormones produced by the placenta hinder the normal function of the pancreas, leading to this condition for some. Although it's manageable with treatment, it has its own set of undesirable complications. First, women with gestational diabetes can give birth to abnormally large babies. This creates complicated situations during delivery. Second, some babies are born with low blood sugar, requiring immediate treatment in the NICU. Continuous monitoring of blood sugar at home and at each prenatal visit is vital.
11 Potential For Preeclampsia
Preeclampsia is characterized by high blood pressure, proteins in the urine and sometimes swelling. Similar to gestational diabetes, preeclampsia develops in pregnant women who were healthy before pregnancy. Obesity and previous preeclampsia in previous pregnancies increase the risk of preeclampsia occurring in a woman. Multiple pregnancies and family history also play a role.
It is a dangerous condition that could lead to severe problems like strokes and seizures. It disrupts normal blood flow to the fetus and therefore can obstruct normal fetal growth and threaten the baby’s life. Managing it with medication is done only if the baby is not close to term. If a mother-to-be is more than 37 weeks pregnant and develops preeclampsia, her doctor immediately orders labor induction or a C-section to save her life and the baby’s. If not, the doctor will advise the women to go on bed rest and medication, while continuously monitoring fetal heartbeats to make sure that the baby is not in danger.
10 Breech Baby
Although the space is getting tighter and tighter for the baby, there is still a substantial amount of movement that the fetus is able to do in utero towards the end of a pregnancy. In theory, a baby settles head down in preparation for delivery starting week 32. However, sometimes the baby ends up in other positions that complicates the delivery process. Those are known as breech positions.
All breech positions have something in common in that the baby’s position is reversed, with the head up. Sometimes, the baby reverses back into normal position days before delivery, but that is not always the case. Some doctors attempt to place their hands on the stomach and push the baby into the head-down position using firm, but gentle pressure, known as external cephalic version. Most breech babies are delivered by C-section if all attempts fail to reverse them to the head down position, or if any other complications arise.
9 Not Enough Amniotic Fluid
Amniotic fluid is the fluid that surrounds the fetus throughout pregnancy. It supports the fetus by protecting against shocks and helping with lung development. In some cases, the amniotic fluid is too low. This condition is medically known as Oligohydramnios. There is concern over this condition because it may signify a problem with the kidneys of the fetus. At 4 months of pregnancy, the kidneys of the fetus start producing amniotic fluid. So a fetus with kidney failure does not produce enough amniotic fluid.
Sometimes, the fetus is perfectly normal and the decline in the amount of amniotic fluid is due to leakage. Low amniotic fluid constricts normal fetal growth and is considered dangerous enough to require hospitalization. At the hospital, the amniotic fluid is monitored and if too low, the doctor will weigh the benefits and harms of early birth by induction or C-section against those of leaving the fetus in this environment. It mostly depends on how far along the pregnancy is.
8 Too Much Amniotic Fluid
Contrary to Oligohydramnios, Polyhydramnios is a condition where there is too much amniotic fluid. It can be diagnosed by ultrasounds and by measuring the amniotic fluid index (AFI). It's a red flag that makes a doctor order a more thorough examination of the fetal health. It's linked to gestational diabetes, and therefore, in-depth measurements of blood sugar is recommended to rule out diabetes as a cause, or treat it if it is diabetes.
Increased amniotic fluid increases the risk of having a breech baby and therefore increases the incidence of birth complications. Additionally, the uterus is stretched out more than normal to accommodate the increased fluid, so it makes bleeding complications after birth highly possible. This is why in most cases a C-section is recommended. The same pressure on the uterus that causes breech positions can cause premature labor. To manage the condition, draining excess fluid and medications are given, hoping for a better result for the mother and the baby.
7 Cord Knots
Cord knots are a relatively rare condition in which the umbilical cord forms a knot on itself as a result of fetal movement. An unusually long cord may be one of the reasons that increase the possibility of this issue. As long as the knot is loose and the blood inside the cord continues to flow normally, it may present a good prognosis and the mother and baby will both survive. Rarely, there is more than one knot.
Cord knots are usually detected by ultrasound examinations, but sometimes they can be overlooked. This is why it is crucial for women who feel a lag in the baby’s movement to let their healthcare professional know about it. It's possible for the cord to cut off oxygen and nutrition and be fatal to babies even close to full term. In such cases, delivering the baby is a much better option than waiting for full-term in such a risky situation.
6 Risk Of Premature Birth
Cervical insufficiency is a condition that endangers the pregnancy. It involves the cervical tissue being weak and unable to retain a pregnancy, despite the absence of contractions. Women who have had previous miscarriages are at a higher risk. Usually, abdominal ultrasounds are not enough and transvaginal ultrasounds are needed. This is because they provide a better view of the cervix and can confirm that the cervix is the problem.
It's mostly asymptomatic, but some women experience cramps, back pain, increased vaginal discharge or spotting as a result of this condition. The early dilatation of the cervix puts the mother-to-be at risk of premature birth. The first treatment option is progesterone supplementation. Alternatively, a surgery known as cervical cerclage is done if the pregnancy is less than 24 weeks along. It involves closing the cervix with strong sutures that are removed towards the end of pregnancy to help prevent premature birth.
5 Incompatible Blood Types
Rh compatibility is an extremely important factor that has to be considered during conception. Rh factor is a protein on red blood cells, and a positive Rh indicates the presence of this protein. Simply, if a mother and a father have compatible Rh blood types, their baby will be safe. Otherwise, the baby is at risk of being incompatible with the mother.
If this happens, the baby may develop a condition known as Erythroblastosis Fetalis. Fetal red blood cells normally move across the placenta to the mother's circulation throughout pregnancy, and the most transfer is during labor. Incompatibility between the maternal and fetal blood types will make the mother’s blood treat the baby’s blood as a foreign substance and attack it. Fetal blood transfusions can be done to protect the baby, but it's a very delicate and highly sensitive process. It requires transferring blood to the baby every week or two until the pregnancy can be terminated by delivery.
4 Placenta Previa
Placenta Previa occurs if the placenta partially or totally covers the mother’s cervix. Bleeding can result from this condition and can range from light to heavy bleeding that requires a blood transfusion. If the bleeding is too severe, it could lead to premature labor. In most cases, the bleeding usually subsides on its own. Previous surgeries, multiple pregnancies, and being older than 35 at the time of conception increase the risk of this condition.
Ultrasound examinations reveal the position of the placenta, which is dependent on where the embryo was implanted in the first place. It's done routinely or after an episode of bleeding. During the pregnancy, it's possible for the uterus to push the placenta higher, resolving the issue automatically. If that doesn't happen, a C-section is required to deliver the baby, and the mother-to-be is advised to avoid extreme physical effort and sexual activity until delivery.
3 Developing Blood Clots
Vaginal bleeding could signify blood clots being formed between the uterus and the placenta, or in the folds of the outer membrane of the fetus. This is medically known as a Subchorionic Hematoma. Usually, the bleeding is light, happens during the first trimester and subsides later. It's an uncommon condition that is not considered very dangerous. It's detectable by ultrasounds even when the woman is experiencing no symptoms.
While most clots dissolve on their own, some of them place the woman at risk for extreme bleeding. This puts the mother's and the baby's life at risk and increases the possibility of preterm labor or miscarriage. The size of the clot is a key player in the prognosis. Like placenta previa, this condition also calls for bed rest and avoidance of high physical or sexual activity until the clot dissolves. This is why it's important for pregnant women to let their doctors know if they are experiencing bleeding. The doctor will examine all the factors and causes of the bleeding and assess the situation to make a sound medical decision.
2 Placental Abruption
Placental Abruption is the partial or complete separation of the placenta from the uterus during pregnancy. It causes heavy bleeding and deprives the fetus of necessary nutrients and oxygen and can therefore be life-threatening. It is rare, but dangerously jeopardizes the mother and the baby and increases the chances of preterm birth and stillbirth. It can also negatively affect the mother due to blood loss. Interestingly, placental abruption can also be secondary to preeclampsia, but can also occur from trauma or accidents.
It can also result from subchorionic bleeding that involves large clots that do not dissolve. If the baby is not close to term, hospitalization is necessary and if the condition stabilizes, the pregnancy may continue. The condition may also develop closer to term, in which case delivery and taking chances in the NICU is safer than continuing an unsafe pregnancy. Usually, week 34 is an important milestone that determines which approach will be followed.
1 Ectopic Pregnancy
In normal pregnancies, the embryo is implanted inside the uterus, forms the placenta and starts growing gradually. In an ectopic pregnancy, the embryo is implanted outside the uterus, usually inside the fallopian tube. This happens when the ovary produces the egg inside the fallopian tube and it gets fertilized by the sperm, however it doesn’t travel to the uterus as it should. Embryos have no chance of survival outside of the uterus and they have to be removed by medication or surgery.
An ectopic pregnancy usually has no symptoms at first, and the woman may not even know that she is pregnant. Yet, it could be shown as light bleeding, pelvic pain (usually on one side of the body), and weakness. If untreated, it could lead to fallopian tube rupture, which is dangerous. Chances of having a baby later are a little lower, so women who experience ectopic pregnancy should consult with a fertility doctor if they wish to get pregnant again.