Common pregnancy complications and how to manage them
Pregnancy is an incredible journey, but it's important to be aware of potential complications that may arise.
The good news is that many complications can be managed with proper care and guidance.
Key Facts
Pregnancy complications can affect up to 20% of all pregnancies.
These can range from mild conditions that require minimal management to more severe issues that necessitate specialized care.
Understanding these complications is crucial for the health and safety of both the mother and the unborn child.
Gestational Diabetes
What's That?
Gestational diabetes is a type of diabetes that develops during pregnancy. Unlike other forms of diabetes, it usually resolves after delivery.
However, it can increase the risk of health issues for both the mother and baby if not properly managed.
Diagnosis
Diagnosis involves a glucose tolerance test, typically conducted between the 24th and 28th weeks of pregnancy.
If high blood sugar levels are detected, further testing may be required to confirm gestational diabetes.
Management and Treatment
Management includes monitoring blood sugar levels, following a healthy diet, exercising regularly (150min/week), and, in some cases, insulin therapy.
Regular consultations with a healthcare provider are essential to adjust the management plan as needed. It reduces the risk of adverse maternal, fetal, and neonatal outcomes.
Q&As
Can I prevent gestational diabetes?
Not entirely, but maintaining a healthy weight and diet before and during pregnancy can reduce the risk.
Will it affect my baby?
Yes, if uncontrolled, it can lead to complications such as high birth weight (and all the obstetrical complications caused by it) and preterm birth.
Does it go away after childbirth?
In most cases, yes, but it does increase the risk of developing type 2 diabetes later in life. You may have had undiagnosed diabetes mellitus before pregnancy. Thus, you should be screened for DM 6 to 12 weeks postpartum.
Preeclampsia
What's That?
Preeclampsia is a condition characterized by new onset of high blood pressure, proteinuria, and signs of damage to another end-organ system, most often the liver and kidneys, that occurs after the 20th week of pregnancy.
Diagnosis
Preeclampsia is diagnosed through blood pressure measurements and urine tests to check for protein, indicating kidney involvement, and new onset of end-organ damage (headache, blurry vision, pulmonary edema…).
Management and Treatment
Treatment involves blood pressure control medication, corticosteroids for fetal lung maturation, and close monitoring of both the mother and baby. In severe cases, early delivery may be recommended.
Q&As
Can preeclampsia be cured?
The only cure is the delivery of the baby, but management can help control symptoms.
Is bed rest recommended for preeclampsia?
Bed rest isn't universally recommended but may be advised in some cases.
Will I have it in future pregnancies?
Having preeclampsia increases the risk in future pregnancies but doesn't guarantee it.
If you have a history of preeclampsia or gestational hypertension, you are at a higher lifetime risk of cardiovascular events.
Thus, you should be referred for appropriate cardiovascular risk assessment and follow-up after delivery.
Preterm Labor
What's That?
Preterm labor is labor that begins before 37 weeks of pregnancy. It can lead to preterm birth, which may pose health risks for the baby.
Diagnosis
Preterm labor is diagnosed based on contraction frequency, changes in the cervix, and the presence of fetal fibronectin in vaginal discharge before 37GW.
Management and Treatment
Management might include bed rest, medications to delay labor, and steroids to speed up fetal lung development.
Q&As
Can I reduce my risk of preterm labor?
Yes, by avoiding risk factors like smoking and ensuring adequate prenatal care. Smoking cessation, substance use reduction, treatment of GU infections (including asymptomatic UTIs), and patient education regarding risk factors are useful to reduce the risk.
Does bed rest prevent preterm labor?
Bed rest in the left lateral decubitus position to reduce aortocaval compression and improve cardiac output is commonly used initially.
Are there long-term effects on my baby?
Preterm babies may have more health issues early on, but many catch up to their peers over time.
Prematurity is the leading cause of perinatal morbidity and mortality, and the prognosis depends on the age of the pregnancy and the NICU level of the center.
Iron-Deficiency Anemia
What's That?
Iron-deficiency anemia in pregnancy occurs when you don't have enough iron to produce adequate hemoglobin, the substance in red blood cells that carries oxygen throughout your body. This condition can lead to fatigue and an increased risk of infections.
Diagnosis
It's diagnosed through lab tests such as iron indices, peripheral blood film, and complete blood count (CBC), which measures hemoglobin, hematocrit, and ferritin levels. Low levels indicate anemia.
Management and Treatment
Management includes taking iron supplements as prescribed by your healthcare provider and eating iron-rich foods like lean meat, spinach, and iron-fortified cereals. Regular blood tests may be necessary to monitor your condition.
Q&As
Can iron-deficiency anemia harm my baby?
It can lead to low birth weight and preterm birth, so managing it is crucial. Maternal: angina, CHF, infection, slower recuperation, and PTL (preterm labor). Fetal: decreased oxygen-carrying capacity leading to fetal distress, IUGR, low birth weight, and fetal neurodevelopment.
Will taking iron supplements constipate me?
Iron supplements can cause constipation. Drinking plenty of water and eating fiber-rich foods can help. Oral iron should be taken with citrus juice (vitamin C) to enhance absorption.
How long will I need to take iron supplements?
Typically, until your iron levels normalize, often throughout pregnancy and possibly postpartum.
Placenta Previa
What's That?
Placenta previa occurs when the placenta covers part or all of the cervix inside the uterus.
This condition can cause severe bleeding before or during delivery.
Diagnosis
It's typically diagnosed during an ultrasound exam in the second trimester or when painless bleeding occurs during the pregnancy (without contraction).
Management and Treatment
Management may involve pelvic rest, avoiding intercourse, possibly bed rest, and medication to reduce the risk of bleeding.
Delivery by cesarean section (C-section) is often necessary, but if the implantation is not close to the internal os of the cervix, you may have a normal vaginal delivery.
You should discuss your choices with your obstetrician.
Q&As
Can placenta previa resolve on its own?
In some cases, as the uterus grows, the placenta may move away from the cervix.
Is bed rest mandatory for placenta previa?
Not always, but avoiding activities that could trigger bleeding is crucial.
Will I definitely need a C-section?
Most women with placenta previa will require a C-section to ensure safety.
Hyperemesis Gravidarum
What's That?
Hyperemesis gravidarum is a severe form of morning sickness characterized by excessive nausea and vomiting, leading to weight loss, dehydration, and electrolyte imbalances.
Diagnosis
Diagnosis is based on the severity of symptoms, including weight loss (> 5%), dehydration, some lab tests (measurement of urine ketones, serum electrolytes, and renal function), and ruling out other causes of vomiting.
Management and Treatment
Treatment may involve hospitalization for IV fluids and nutrition, anti-nausea medications, and dietary changes like eating small, frequent meals, as well as vitamin and electrolyte replacement.
Q&As
Is hyperemesis gravidarum harmful to my baby?
It can be if it leads to severe weight loss and malnutrition. Treatment is important.
Will I experience it in all my pregnancies?
If you've had it in one pregnancy, you're more likely to have it in future pregnancies.
How can I manage nausea at home?
Eating dry, bland foods and ginger can help.
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Adriana Paola
8 Jan 2024
I have a common cold runny nose sore throat cough etc and I have a 3 week old baby how can I manage? Can I kiss her can I carry her is it bad if I’m to close to her face? I need help #help
#commoncold #baby #newborn
As a pediatric nurse I would advice that you not be in her face/kiss her if you dont need to be. She’s too little for medication and a common cold to us is RSV for them.
27 Mar 2024
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Adriana Paola
What about a sinus infection?
27 Mar 2024
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Nathali
15 Jul 2023
Second pregnancy, my first one was a miscarriage that happpened when I was 6 weeks and 5 days pregnant. Today I am 6 weeks 3 days pregnant. Getting really nervous to hit that date again, any suggestions on how to manage my anxiety ?
I’m going through the same thing 😢 sending hugs ❤️ I just try to stay calm and pray i tell myself my son told GOD to send me another blessing because of how sad I was it might sound strange lol but that’s how I’m dealing with mine sending love and prayers🙏🏾you got this!
27 Mar 2024
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Nathali
That’s what I’ve been doing as well. Putting all my faith in the lord, hoping that my baby will be just fine. But I have a feeling that everything will be just fine ! Sending blessings and prayers your ways as well.
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