Common Maternal Pregnancy Complications
Pregnancy affects women in different ways. Many have no complications or abnormalities, and pregnancy progresses with only the normal discomforts associated with carrying and delivering a child. Nevertheless, there are some common conditions that can arise even in women who have no health problems prior to their pregnancy. In the case of maternal complications it is important to be under the care of a physician who can diagnose and manage these early, preventing an adverse outcome. Gestational diabetes, hypertensive disorders, and blood clots (thromboembolic disorders) are some common maternal complications that pregnant women should be familiar with, in order to be sensitive to any symptoms they may develop.
Pregnancy presents a metabolic challenge to the mother. For around 10% of women with normal blood sugars prior to pregnancy, gestational diabetes develops. To detect this, a glucose screening test is performed between the 24th and 28th week of the pregnancy. After drinking a specific amount of a glucose drink, the pregnant woman has her blood sugar checked one hour later. If her blood sugar level is too high, a three hour glucose tolerance test is performed. Two of the four values in this test must be elevated to diagnose gestational diabetes.
Gestational diabetes is treated first with a special diet. The pregnant woman checks her blood sugar before eating and two hours after each meal. If this does not bring blood sugars under control, insulin may be required. Even in women who do not have gestational diabetes, careful dietary management can reduce weight gain and decrease the size of the baby. The major complications of gestational diabetes are macrosomic (large) infants who are difficult to deliver. The baby may also experience low blood sugar following delivery.
High blood pressure is another common maternal complication. From gestational hypertension, an elevation of the blood pressure alone, to preeclampsia, a combination of high blood pressure, edema (swelling), and protein in the urine, this is dangerous for both mother and baby. In addition to increasing the risk of a seizure in the mother, high blood pressure affects the kidneys and can cause decrease blood flow to the placenta and the baby. Growth restriction of the baby and oligohydramnios (too little fluid) can result.
The earlier blood pressure problems are diagnosed, the better for both mother and baby. With bed rest most women are able to continue their pregnancy but careful monitoring is required. Occasionally medications are needed to prevent seizures, a stroke, or kidney damage. Careful monitoring of both mother and baby by a physician is important.
Blood clots (thromboembolic disease) are more common in pregnancy due to the increase in clotting factors protecting the mother from bleeding at delivery. These blood clots usually begin in the lower extremities but can progress and even go to the lungs (pulmonary embolus). This complication must be recognized and treated quickly. Symptoms of a swollen leg, along with heat and pain can be signs of a deep venous thrombosis (DVT). Developing varicose veins during pregnancy is another common complication related to venous health.
Although maternal complications during pregnancy can be serious and scary, it?s important to keep in mind that the majority of pregnancies are perfectly normal, without serious complications. Keeping regular appointments with a healthcare provider, and educating oneself about symptoms and side effects that may indicate complications, are both effective ways to keep healthy and cared for during pregnancy.
