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Complications in Pregnancy

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This is an external fetal monitor used to listen to baby in labor.

This is an external fetal monitor used to listen to baby during certain tests like the non-stress test.

Photo © iStockPhoto

Gestational Diabetes (GD):

Gestational diabetes (GD) is high blood sugar or glucose levels during pregnancy. About 4% of pregnant women will suffer from gestational diabetes. Not every mother will need to be screened using blood work, there are guidelines as to who needs to be screened with blood work. This is typically screened for in the 28th week of pregnancy, if you need additional screening with a glucose tolerance test (GTT) it will be done at this point. If you have GD, your labor may be induced.

Pregnancy Induced Hypertension/High Blood Pressure:

Pregnancy induced hypertension (PIH) is a high blood pressure disorder of pregnancy. It has long been one of the major problems for mothers in pregnancy, it may also be talked about as ecclampsia or preecclampsia. It affects 7% of first time mothers. Labor may be induced early if you suffer from severe PIH.

There are three different levels of PIH/Preeclampsia:

  1. High Blood Pressure alone
  2. High Blood Pressure and protein in urine and/or swelling
  3. High Blood Pressure, protein in urine, swelling and convulsions

Rh Factor:

In addition to the blood group (A, B, O, AB), the Rh factor is written as either positive (present) or negative (absent). Most people (85%) are Rh positive. This factor does not effect your health except during pregnancy.

A woman is at risk when she has a negative Rh factor and her partner has a positive Rh factor. This combination can produce a child who is Rh positive. If the mother and baby's blood mix, this can cause the mother to create antibodies against the Rh factor, thus treating an Rh positive baby like an intruder in her body. Rhogam is given to help prevent this sentiszation.

Placenta Previa:

Placenta previa is where all or part of the placenta covers the cervix or opening of the uterus. True placenta previa occurs in about 1 in 200 pregnancies. Many times early ultrasounds may show a placenta previa, but later as the uterus grows, the condition resolves itself. If it is still present at the end of pregnancy a cesarean section may be performed to prevent bleeding.

Oligohydramnios (Low Amnitotic Fluid):

When a woman is said to have too little amniotic fluid she has oligohydramnios. This is defined as having less than 200 ml of amniotic fluid at term or an AFI of less than 5 cm. This means that during an ultrasound the largest pocket of fluid found did not measure 1 cm or greater at its largest diameter. Though sometimes it is actually related to maternal hydration, meaning that mom hasn't been well hydrated. There is also some indication that amniotic fluid levels drop as the time of birth comes near. Many practitioners will have you drink fluids and rexamine you via ultrasound.

Polyhydramnios (High Amniotic Fluid):

Polyhydramnios is the opposite end of the scale, being defined as 2000 ml of fluid at term or greater. This occurs in fewer that 1% of the pregnancies.

While some feel that polyhydramnios is a cause for preterm labor because of uterine distension, polyhydramnios in and of itself is not a predictor for preterm labor, rather the cause of the increase in fluid is predictive of whether the pregnancy will go to term.

Polyhydramnios is more likely to occur when:

  • There is a multiple gestation.
  • There is Maternal diabetes.
  • There is a congenital malformation.

Breech and Other Malpositions:

Breech babies are not in the normal head down position. This happens about 3-4% of all births at the end of pregnancy. Babies are usually in malpositions for a variety of reasons, including:

  • Uterine anomalies
  • Fetal issues
  • Multiples
  • Other conditions

There is also a position known as transverse, meaning that the baby is lying sideways in the uterus. Since it would be difficult to give birth to a baby in this way, your practitioner may do an external version or do a cesarean section for your birth. There are also some practitioners who will do vaginal breech births.

Preterm Labor:

Premature labor is a very serious complication of pregnancy. 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.

  • Contractions or cramping
  • Bright red bleeding
  • Swelling or puffiness of the face or hands
  • Pain during urination
  • Sharp or prolonged pain in your stomach
  • Acute or continuous vomiting
  • Sudden gush of clear, watery fluid
  • Backache
  • Intense pelvic pressure

There may be other signs your doctor tells you to look for, be sure to call if you are concerned.

Incompetent Cervix:

An incompetent cervix is basically a cervix that is too weak to stay closed during a pregnancy. Therefore resulting in a preterm birth and possibly the loss of the baby, because of the shortened gestational length. It is believed that cervical incompetence is the cause of 20 - 25 % of all second trimester losses. This incompetence generally shows up in the early part of the second trimester, but possibly as late as the early third trimester.

It is generally categorized as premature opening of the cervix without labor or contractions. Diagnosis can be made either manually or with ultrasonography.

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