Pregnancy Problems

Published on December 2, 2020 at 12:52:42 PM PST December 2, 2020 at 12:52:42 PM PSTnd, December 2, 2020 at 12:52:42 PM PST

pregnancy problems

Every mum-to-be hopes that her pregnancy will pass with little more than a bout of morning sickness, but it's not always plain sailing. The good news is, even some of the most serious antenatal conditions can be controlled successfully as long as they're spotted early. If you're in any doubt at all, ask your gp or midwife for a check-up.

ectopic pregnancy

An ectopic pregnancy is a pregnancy that develops outside the womb - usually in one of the fallopian tubes. the main sign that your pregnancy might be ectopic is sharp pain on one side and vaginal bleeding, as the fetus grows. If this happens, see your gp immediately, even if a pregnancy test still confirms you are pregnant, because an undetected ectopic pregnancy may rupture the fallopian tube causing severe internal bleeding.

Those most susceptible to ectopic pregnancies include women who:

Have had pelvic inflammatory disease (often caused by chlamydia)

Have had endometriosis

Have had abdominal surgery (including a caesarean)

Have the contraceptive coil fitted or who are taking the mini pill

Have had a previous ectopic pregnancy

Are over 35.

An ultrasound scan may show the likelihood of an ectopic pregnancy, and a laparoscopic examination (where a tiny viewing instrument is inserted into your abdomen through a small cut) may be used to confirm and even remove it. if the fallopian tube has already ruptured, however, abdominal surgery may be necessary

Although an ectopic pregnancy can reduce your fertility, the majority of women who have suffered one, do go on to have a successful pregnancy at a later date.

placenta praevia

Tplacenta praevia is when the placenta - the organ that joins mother and baby and supplies your baby with oxygen and nutrients from your blood - is situated in the lower part of the uterus, covering all or part of the cervix.

If the placenta is still there when you come to give birth it can block the baby's exit route, and can start to pull away, causing heavy bleeding.

The only way to know where your placenta is situated is at one of your scans. If an early scan shows your placenta is near or covering the cervix, don't worry too much - it usually moves up the uterine wall as your womb stretches and the pregnancy progresses. Your condition will be monitored with scans to check this happens.

If the placenta remains covering - or partially covering - the cervix towards the end of the pregnancy, however, a caesarean birth will probably be necessary to avoid complications.

gestational diabetes

Your body has to produce extra insulin - the hormone that regulates blood sugar levels - from mid-pregnancy onwards to manage your baby's needs as well as your own. If it can't meet these needs, a higher-than-usual level of sugar may be found in the blood. This is known as gestational diabetes, a temporary condition that can come on during some pregnancies, but usually disappears within hours of your baby being born.

You'll be more susceptible to gestational diabetes if you are overweight, older, if one of your parents or a sibling is an insulin-dependant diabetic, and if you are of afro-caribbean, indian or middle eastern origin.

Although symptoms can include fatigue and frequent urination (common in all pregnancies!), you are unlikely to realise you have a problem until sugar is found in your urine during one of your routine antenatal appointments. If this is the case, you will probably be asked to undergo a blood glucose test to see if you have developed diabetes.

Gestational diabetes is a problem because high sugar levels in the blood can cross the placenta leading to a very big baby, a baby born with low blood sugar and an increased risk of congenital defects. If your condition is diagnosed early and you manage your condition carefully however, problems should be minimised.

You will be advised to cut down on sugar and caffeine and eat more frequent, smaller meals. Regular exercise is important too. In some cases you may have to have regular insulin injections. your baby's progress will probably be monitored closely too.

obstetric cholestasis

Obstetric cholestasis (oc) causes itching in pregnancy and seems to occur in women whose livers are particularly sensitive to pregnancy hormones. The main symptom is intense itching - which often starts in the palms of the hands and soles of the feet during the last 10 weeks or so of pregnancy, but can spread all over the body.

This happens when the flow of bile - a liquid produced in the liver that is normally secreted into the intestines to help digest food - is reduced. This causes bile salts to build up in the blood. as well as driving you mad with itching, this can be dangerous for your baby as it increases the risk of stillbirth.

If you notice intense itching, a blood test and liver-function test will confirm the condition. oc is then usually controlled with drugs.

Your baby will be monitored throughout the later stages of your pregnancy - and the birth is likely to be induced between 35 and 38 weeks to reduce the risk to the baby. Although your liver function normally goes back to normal after the birth, you'll have a 60-80% chance of the same thing happening if you get pregnant again.

polyhydramnios

Polyhydramnios is the medical description for an excess of amniotic fluid in the womb. It occurs in around 1 in 250 pregnancies.

Polyhydramnios tends to occur around week 30 - when you may suddenly notice your tummy swelling much more rapidly than it should. The skin on your tummy may become stretched and shiny, you may feel huge, breathless and suffer from heartburn and constipation. A scan will confirm the condition.

Your baby regulates the amount of amniotic fluid around him by regularly swallowing and weeing out small quantities of it. If he's having trouble doing this, polyhydramnios can be the result. Problems arise if it stops the baby getting into the correct position for a straightforward birth (a caesarean may be advised), or if the over-stretched womb triggers an early delivery.

swollen ankles and feet

Officially known as oedema, swollen feet, ankles and hands are extremely common during pregnancy, particularly in the late months. The problem is you are carrying more weight and fluid than normal and gravity simply takes the fluid down to your ankles and your hands. This is compounded by the fact that you've got a baby sitting in your pelvis and that can interfere with the return of blood from your legs.

oligohydramnios

This is the medical term for too little amniotic fluid in the womb. If oligohydramnios is found in the very late stages of pregnancy or when you become overdue (as is most common) and your baby is of a normal size - your midwife will probably just keep a close eye on you for the rest of your pregnancy and during labour.

If oligohydramnios is discovered earlier, however your baby's heart rate and development may need to be closely monitored. You may be offered an amniocentesis test to check for potential genetic abnormalities.

Although oligohydramnios can happen for a variety of reasons, studies have shown a link to dehydration in some cases - another good reason to ensure you drink plenty of water during your pregnancy.

depression in pregnancy

As many as one in 10 mums-to-be experience depression during pregnancy. It can be confusing and worrying to feel low at a time when everyone expects you to be blooming, but if you find yourself feeling unusually tearful or anxious do talk to your gp or midwife. In most cases the depression lifts as soon as the baby is born, and being able to talk openly about your fears to someone you trust can really help. Anti-depressants and/or counselling can be prescribed in extreme cases.

pre-eclampsia

although some swelling of your feet and ankles is normal in the later stages of pregnancy a more sudden swelling of the hands, feet and face, possibly accompanied by rapid weight gain and/or headaches and blurred vision and upper abdominal pain can all be signs of pre-eclampsia.

pre-eclampsia is high blood pressure condition caused by a defect in the placenta. it is quite common – midwives are trained to look out for it at every antenatal check – but it can be life-threatening for you and your baby if it's not controlled immediately.

With triplets and more you might be able to breastfeed two and bottle-feed the others on a rota basis, perhaps expressing your own milk for the bottles. Or you may feed all of them at different times, especially if some are smaller than others and need more regular feeds.

Although the basics are the same as with single babies, breastfeeding more than one is more exhausting and you'll burn more calories. So make sure you rest, have lots of water to drink, and eat well. And don't expect miracles. Getting the hang of breastfeeding can take time, but the benefits are great, especially for smaller, premature babies.

If pre-eclampsia is diagnosed (a simple blood pressure check and urine sample will confirm it) you will probably be admitted to hospital for monitoring and treatment. If that happens to you, take a big bag. only the birth of your baby will cure pre-eclampsia, so you're unlikely to be allowed to leave before the birth. Pre-eclampsia tends to get worse as time goes on, so even though you might feel absolutely fine, the aim of taking you into hospital will be to prolong the pregnancy safely for as long as possible to give your baby the best possible chance.

Mums over 40

Very overweight women

First time mums

Mothers with a gap of 10 years or more between babies

Women with blood pressure problems, kidney disease or diabetes

Women carrying twins or multiples

Those with a family history of the condition.

constipation

The same slowing of the gut that causes indigestion can give you constipation too.

To get things moving:

Increase your intake of fibre – wholemeal bread and rice, fruit and vegetables.
Drink more water.
Try to exercise each day – or simply walk a little more.
Don't take iron tablets – (or discuss with your midwife or gp if taking an iron supplements already to see if a gentle alternative may be suitable, e.g. spatone a natural iron supplement - spatone is an ideal alternative for people who cannot tolerate high dosage oral iron.
Although you can't prevent pre-eclampsia, the best way to protect yourself and your baby is to make sure you go along for all your antenatal check-ups. also be sure to report any of the symptoms mentioned above to your midwife or gp as soon as you notice them.

For further information on pre-eclampsia log on to this singhealth site.

miscarriage

Miscarriage is, unfortunately, an all too common event. around one in four pregnancies are thought to end in miscarriage - when a baby is spontaneously lost between conception and 24 weeks. (after 24 weeks, the loss of a baby is referred to as a still birth.)

The most common signs that you might be having a miscarriage are heavy bleeding - usually including clots or a small, slow leakage of brown blood – combined with abdominal pain. however some women will experience none of these symptoms and only find their pregnancy has ended during one of the routine ultrasound scans.

But not all bleeding during pregnancy leads to miscarriage. around half of all women who have a 'threatened miscarriage' with bleeding, especially during the first three months of pregnancy, do go on to deliver a healthy baby.

If you experience any vaginal bleeding at all during your pregnancy always consult your gp or midwife. they may suggest a scan or take a wait-and-see approach and you may be told to rest - but the fact is, whatever you choose to do at this point will have little effect on the outcome of your pregnancy.

If a miscarriage is confirmed by ultrasound you may be given a few different options:

To go home and let nature take its course (your body will evacuate the pregnancy naturally at some point).

To have a minor operation under general anaesthetic called erpc (evacuation of retained products of conception), which will remove any remaining tissue.

In some cases, they may offer tablets that will speed up the natural miscarriage process.

It can be very frustrating and extremely upsetting, but in most cases no cause will be found for your miscarriage, even if investigations are carried out. this does not mean that what has happened is your fault. most women who experience a miscarriage do eventually go on to have a successful pregnancy next time.

Because miscarriage is unfortunately so common, and providing there are no obvious complications, most women who lose a baby in this way will not be offered any further medical help or investigation until they have had recurrent miscarriages (at least three in a row).