Understanding Pregnancy Complications

During pregnancy, some women may experience health problems that can impact the well-being of either the mother, the foetus, or both. Even those who were healthy before becoming pregnant may face these complications, which could classify the pregnancy as high-risk.

Common pregnancy-induced complications

Gestational diabetes mellitus (GDM)

Gestational diabetes is a condition characterised by elevated blood sugar levels that arise specifically during pregnancy and typically resolve after childbirth. While it can occur at any point during pregnancy, gestational diabetes tends to be more prevalent in the second or third trimester. Most women with gestational diabetes experience otherwise normal pregnancies and give birth to healthy babies.

High blood pressure (hypertension)

High blood pressure occurs when the blood pressure in the arteries builds up to levels greater than normal. Preeclampsia is a complication of pregnancy characterised by high blood pressure, high levels of protein in the urine (proteinuria), or other signs of organ damage.

Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure was previously normal. Preeclampsia can lead to severe complications for both mother and baby. For the baby, it can reduce the amount of the mother's blood flow to the placenta, causing the baby's growth to be restricted.

Placental issues

The placenta is an organ that develops during pregnancy and provides vital support and nutrients to the developing foetus. It forms inside the uterus and attaches to the uterine wall, allowing the exchange of oxygen, nutrients, and waste products between the mother and baby.

Placental issues such as placenta previa, a condition in which the placenta covers the opening of the cervix, may occur during pregnancy. Depending on how much the placenta covers the cervix, placenta previa ranges from mild to severe. In some cases, this condition can lead to some complications during pregnancy and childbirth.

Placental abruption is a condition where the placenta detaches from the uterine wall before the baby is born, potentially leading to insufficient oxygen supply to the foetus.

Anaemia

Anaemia in pregnancy is a condition in which a pregnant woman has low levels of haemoglobin in her blood. Haemoglobin is an iron-rich protein in red blood cells that carries oxygen to tissues throughout the body, including the developing foetus.

Anaemia during pregnancy can impact foetal growth and development, potentially leading to lower birth weight due to a reduction in oxygen supply to the foetus, premature birth, and complications during pregnancy.

Hyperemesis gravidarum

Many pregnant mothers experience varying degrees of nausea and vomiting, commonly known as "morning sickness," particularly in the initial trimester of pregnancy. Hyperemesis gravidarum, on the other hand, represents a more severe form of this condition – persistent nausea and vomiting throughout pregnancy. This can result in weight loss and dehydration, necessitating intensive treatment.

Preterm labour

An average pregnancy spans approximately 40 weeks, while preterm labour initiates before the 37th week.

Miscarriage

Miscarriage refers to the loss of a pregnancy due to natural causes before reaching 20 weeks of gestation. Signs of a miscarriage may include symptoms like vaginal spotting or bleeding, cramping, or the passage of fluid or tissue from the vagina. It is important to note that vaginal bleeding does not necessarily indicate that a miscarriage is imminent or occurring. However, women who experience vaginal bleeding at any stage of their pregnancy should promptly contact their doctor.

Infections during pregnancy

Certain infections can be transmitted from a mother to her newborn during childbirth as the infant travels through the birth canal, while some infections can also affect the foetus during pregnancy. Many of these infections can be prevented or managed through the proper pre-pregnancy, prenatal and postpartum care.

Accessing the necessary care and treatment to prevent transmission of the infection to the infant while improving the mother's health begins with infection screening.

It is advisable that all expectant women undergo prenatal screening for the following infections: hepatitis B virus, hepatitis C virus, syphilis, and HIV. Some at-risk women are advised to undergo screening for additional infections, including chlamydia, gonorrhoea, and tuberculosis.

• Bacterial vaginosis
• Cytomegalovirus (CMV)
• Group B strep (GBS)
• Hepatitis B virus (HBV)
• Influenza (flu)
• Listeriosis
• Sexually transmitted infection (STI)
• Urinary tract infection (UTI)
• Toxoplasmosis
• Yeast infection

Management of pregnancy complications managed

During pregnancy, it is important not to hesitate to reach out to your doctor if something is worrying you. Regardless of the prevalence of the complication, there are ways to manage the issues that develop during pregnancy.

Prenatal care - the care you receive during pregnancy plays a crucial role in preventing complications. Babies born to mothers who do not receive prenatal care are three times more likely to have low birth weight and five times more likely to face mortality compared to those born to mothers who receive proper care.

Regular prenatal visits with doctors allow for the early detection of health issues, enabling early intervention and treatment. Many problems can be effectively treated, and others can be prevented through timely medical attention.

Additionally, doctors can guide expectant mothers on how to promote a healthy start to life for their unborn babies. Prenatal care can also play a role in recognising mental health issues associated with pregnancy, such as anxiety and depression.

Typically, your doctor will provide you with a schedule for prenatal visits, and most doctors recommend the following visit frequency:

• Approximately once a month from weeks 4 through 28 of pregnancy.
• Twice a month from weeks 28 through 36.
• Weekly from week 36 until childbirth.
• If you are 35 years or older or your pregnancy is considered high-risk, you may need to visit your doctor more frequently to ensure the well-being of both you and your baby.

Make an appointment at Gleneagles Hospitals

If you suspect that you are experiencing symptoms of pregnancy complications, get in touch with us to find out more about our Obstetrics & Gynaecology Services at your nearest Gleneagles Hospital