As there are various factors that contribute to a healthy pregnancy, likewise there are various complications or difficulties that may cause a high-risk pregnancy. The article sheds light on different complications that are unexpected and may occur without warning.
Every family hopes and prays for the expectant mother to have a safe pregnancy, followed by the birth of a healthy baby. However, each pregnancy has some risks or difficulties involved, and at times they can be very dangerous to the health of an expecting mother and growing fetus. Having a high-risk pregnancy basically means that a woman has a high chance of developing complications during her pregnancy period or at the time of delivery.
Factors that can increase the risk of complications during this period or at the time of delivery include pre-existing medical conditions, poor diet, mental health, as well as the lifestyle choices made by the woman. It is not necessary that every expecting mother would have such complications; however, having some idea about them beforehand, may help to deal with them and prevent them from occurring.
Anemia: Also termed as anemia of pregnancy, is a condition wherein the body has very few red blood cells, or the cells are unable to carry oxygen to different organs of the body. During this period, a woman’s blood volume increases nearly by 50% and the concentration of red blood cells get diluted. Since the developing fetus depends on the mother’s blood, anemia can lead to poor fetal growth, preterm birth, and low birth weight. Deficiency of vitamins and minerals like vitamin B12, folic acid, iron, etc., can cause anemia. However, the condition is not considered to be severe, unless the levels fall too low.
Intrauterine Growth Restriction: Intrauterine Growth Restriction (IUGR) is a condition wherein the fetus is smaller than the expected, for a couple of weeks of pregnancy. Also termed as fetal growth restriction, the babies born with IUGR are often called small for gestation age (SGA). A fetus growing under such condition, weighs less than 90% of all other fetuses of the same gestational age, and there are chances wherein the baby may be born prematurely, i.e., before 37 weeks. Deficiency of nutrients and oxygen needed for the growth and development of organs is one of the most common causes of IUGR, which prevents cells and tissues from growing, thereby leading to a reduction in their size. The condition may be hereditary as well. Newborns often appear weak, pale, and have loose, dry skin, and wide eyes. Moreover, their umbilical cord is very thin and dull-looking, as compared to the normal shiny and fat cord.
Preterm Labor: Preterm labor or early labor, that starts before 37 weeks is mainly characterized by premature uterine contractions, rupture of the amniotic sac or membranes, or cervical dilatation. Though the actual cause of preterm labor is still unknown, premature rupture of membranes is considered to be one of the dominant causes, which may occur as a result of some chronic medical illnesses like heart or kidney disease, high blood pressure, infection, etc. Babies born under such condition are often small, have low birth weight and may need help in breathing, eating, fighting infection, and maintaining a stable body temperature.
Premature Rupture of Membranes: Premature Rupture of Membranes (PROM) is basically a rupture of the membranes or amniotic sac (sac in which the fetus develops) before the labor starts. If PROM occurs before 37 weeks, it is termed as Preterm Premature Rupture of Membranes (PPROM). The condition usually occurs due to an infection in the uterus, improper prenatal care, sexually-transmitted disease, vaginal bleeding, or unhealthy habits like smoking or drinking alcohol. The condition may also lead to complications like placental abruption (early detachment of the placenta from the uterus), compression of the umbilical cord, cesarean birth and postpartum (after delivery) infection.
Gestational Diabetes: Gestational diabetes is a complication wherein the blood glucose level gets elevated and other symptoms of diabetes start appearing during pregnancy in a woman, who has not been earlier diagnosed with diabetes. Gestational diabetes does not occur due to lack of insulin. It is caused due to blocking effects of other hormones on the insulin generated in the body. Normally, the symptoms of diabetes disappear after the delivery.
Pregnancy-induced Hypertension(PIH): PIH is a form of high blood pressure which is more common in young women with a first pregnancy, twin pregnancies, or in women affected by other health-related problems like diabetes, chronic hypertension, etc. In extreme conditions, a woman may develop eclampsia (a severe form of PIH), which occurs near the end of the third trimester and causes seizures in the expecting mother.
Placenta Previa: Placenta previa is a common complication wherein the placenta is attached close to, or covers the cervix (opening of the uterus). The condition may result in excessive bleeding or hemorrhage at the lower part of the uterus, or the area of the placenta that covers the cervix. Other risk factors involved are abnormal implantation of the placenta, slow fetal growth, preterm birth, birth defects, and infection during pregnancy.
Hydramnios: Hydramnios is a condition in which there is excess of amniotic fluid around the fetus. The condition may lead to birth defects, premature rupture of membranes or amniotic sac, placenta abruption, and umbilical cord prolapse (fall out of place). Diabetes, gastrointestinal abnormalities, heart failure, congenital failure, twin-to-twin transfusion syndrome, etc., are some factors that may contribute to hydramnios in pregnant women.
Rh Disease: Rh disease is a rare condition that occurs when there is an incompatibility between the blood types of the mother and the baby. Every individual has a blood type (O, A, B, or AB), and an Rh factor, either positive or negative, that defines certain specific characteristics. If an Rh negative mother has a baby who is Rh positive, complications may occur if the baby’s red blood cells cross to the Rh negative mother, especially at the time of delivery when the placenta detaches, or during miscarriage or abortion.
Basically, in this disorder (Rh disease), the mother’s immune system considers the baby’s Rh positive red blood cells as foreign bodies and responds by generating antibodies to fight and destroy these foreign cells. Generally, during a first pregnancy, Rh sensitization is not likely, but it only becomes a problem in future pregnancies with another Rh positive baby. As the mother’s antibodies cross the placenta to fight the Rh positive cells or destroy red blood cells in the baby’s body, the newborn may become anemic or have other complications like jaundice, or organ enlargement.
Post-term Pregnancy: Post-term pregnancy lasts more than 42 weeks, often due to miscalculation of conception dates. Basically, near the end of the third trimester, the placenta begins to age and is not able to function properly. Moreover, the amniotic fluid volume also starts decreasing, as a result, the fetus may get poor oxygen supply and stop gaining weight.
Multiple Pregnancy: This occurs when more than one egg fertilizes and implants in the uterus. A family history of multiple pregnancies, older age, high parity (one or more previous pregnancies), the use of certain ovulation stimulating medications, etc., can contribute to multiple pregnancies. Though it’s not a severe complication, preterm labor and birth, PIH, anemia, birth defects, miscarriage, cesarean delivery, postpartum hemorrhage, etc., are some difficulties that may be associated with it.
Ectopic Pregnancy: This is a complication wherein the fertilized egg implants itself outside the uterus, near the Fallopian tube. The condition is more common in women affected by infertility problems, endometriosis, sexually-transmitted disease, etc. Women who have undergone tubal surgery or use intrauterine conception device (IUD) might also be susceptible.
Miscarriage: Also termed as spontaneous abortion, miscarriage is defined as early pregnancy loss, which may be categorized into following types: threatened (spotting and bleeding in the first trimester), complete (the fetus, placenta and other tissues are passed with bleeding), incomplete (some parts of the tissues remain in the uterus), missed abortion (the fetus dies but doesn’t pass out of the uterus), septic (infected miscarriage), and recurrent (more than three miscarriages).
Stillbirth: Also termed as intrauterine fetal death or demise, it’s an extremely unfortunate condition wherein the baby dies in the uterus. Diabetes, high blood pressure, congenital abnormalities, Rh disease, placenta problems, etc., are some of the causes of stillbirth.
Postpartum Hemorrhage: Postpartum hemorrhage is another complication in which, there is excessive bleeding after the delivery. The condition is more common after cesarean birth, wherein the uterus continues to contract and expels the placenta. As a result, these contractions compress the bleeding vessels in the area where the placenta was connected, leading to intense postpartum bleeding and hemorrhage.
To overcome the aforementioned pregnancy related complications, regular visits to a health care provider is very important especially, if a woman has a prior medical problem. While diagnostic tests can help identify these complications, the proper use of recommended medications can enable any woman with medical problems to enjoy a healthy and successful pregnancy.
Disclaimer: This HerHaleness article is for informative purposes only, and should not be used as a replacement for expert medical advice.