A guide to Pregnancy Complications - Dr. Richa Agarwal

Dr. Richa Agarwal    02-04-2016 Consult

All parents hope and expect to experience a normal pregnancy and take home a healthy child. Although the majority of pregnancies and deliveries are uneventful, some involve complications that range from minor to life threatening -- for the mother, for the baby, or for both. Complications of pregnancy may develop gradually or suddenly and without warning. One objective of prenatal care is the prompt diagnosis and treatment of these complications before they worsen. In this article, we describe the most common complications of pregnancy, their causes and symptoms, and their treatment over the following sections:

  1. Pregnancy Complications in Older Mothers - In recent years there has been a trend toward having babies later in life. But more pronounced chronic diseases in the mother, among other conditions, can have an adverse effect on the developing foetus. By medical tradition, an older mother is defined as a woman pregnant at the age of 35 or older. Although older women experience successful pregnancies and deliver healthy babies, they may encounter a variety of problems.
  2. Pregnancy Complications in Teenage Mothers -  There are special risks to a baby when the mother is not fully mature. Because most teenagers are not physically, emotionally, or financially ready to carry and care for a child, their babies tend to have low birth weight and are predisposed to a variety of illnesses. A teenage mother will need the full support of her family to live a healthy lifestyle for her and her baby. Birth weight is typically lower and babies of teens are more susceptible to certain illnesses. It will take an effort on the part of the teenage mom to ensure the health of her baby. 
  3. Preterm Birth Premature birth can be very dangerous to a new-born because it might not be developed enough to survive outside of the womb -- for example, if the lungs are not yet able to breathe. There are several reasons it happens, most of which the mother has no control over. If you suspect that you are going into labour prematurely, you should go to the hospital immediately because labour can be stopped up to a certain point. A preterm, or premature, delivery is defined as the birth of a baby between the 20th and 36th week of pregnancy. A baby born during this time is called premature. About 11 to 12 percent of deliveries in the United States are classified as premature; however, preterm deliveries are on the increase because more women are giving birth to multiple babies.
  4. Postterm Birth - A postterm pregnancy occurs when the baby has not been delivered by the end of the 42nd week. There is no health risk to the mother, but after the 42nd week the foetus may be at risk of malnutrition. Also, if it passes faecal matter -- which usually does not happen until after birth -- and breathes it in, it may develop pneumonia. A doctor may choose to induce labour two weeks past the due date. The cause of postterm pregnancy is not known. In most cases, however, it is believed that the mother misstated the exact date of her last menstrual period and the pregnancy was not postterm after all. If a woman has had one postterm pregnancy, she has a greater than average chance of this happening again in subsequent pregnancies.
  5. Ectopic Pregnancy Ectopic (out of place) pregnancy occurs when the fertilized egg develops outside the uterus. The most common location of ectopic pregnancy is in one of the fallopian tubes (structures that extend about 41/2 inches from the ovaries to the uterus and through which the egg travels from the ovary to the uterus). An ectopic pregnancy that occurs in a fallopian tube is called a tubal pregnancy. On rare occasions, the pregnancy starts to develop in the ovary, on the cervix, or attached to the surface of a nearby organ. An ectopic pregnancy is one in which the fertilized egg develops outside the uterus. One out of every 100 to 150 pregnancies is ectopic, most often in the fallopian tubes, but also in the ovary, on the cervix, or attached to another organ in the abdominal cavity.
  6. Stillbirths - Stillbirths, which come in the second or third trimester, are thankfully growing less common, but it is always sad news for the family when it happens. However, the conditions that can lead to a stillbirth, such as placenta complications and twisting of the umbilical cord, are often things that the mother has no control over. And the silver lining is that a stillbirth typically does not endanger the life of the mother. The death of the foetus at some time between the 20th week of pregnancy and birth is called stillbirth -- in medical terms, an intrauterine foetal demise. This tragic outcome of pregnancy is uncommon today because of better prenatal care and improved methods of diagnosing and treating abnormal pregnancies.
  7. Miscarriages -  A miscarriage (in medical terms, a spontaneous abortion) is the expulsion from the uterus of the foetus and placenta before the beginning of the 20th week of pregnancy. At that point, the foetus is not developed enough to survive outside the uterus on its own. (After the 20th week of pregnancy and before the 36th week, expulsion of the foetus and placenta is considered premature delivery.) Most miscarriages occur within the first 14 weeks of pregnancy. It is impossible to know how many miscarriages occur during the first month of pregnancy, before many women may even realize they are pregnant. The only indication may be a slightly late menstrual period with a heavier than normal flow. However, about 15 percent of known pregnancies end in miscarriage.
  8. Multiple Births Twins and triplets are often seen as an additional blessing on a growing family. But multiple births also can cause complications, the most serious of which is premature birth. Because the babies may not be ready to live outside the mother's womb, treatment of multiple births mostly involves preventing premature labour, and lots of bed rest is a common method. The number of multiple births is increasing as women wait until they are older to have a baby and use fertility drugs to conceive. According to the National Centre for Health Statistics, between 1980 and 2000, the number of twin births increased 74 percent, and the number of triplets, quadruplets, and other higher order births increased five fold.
  9. Placenta Complications - A woman shouldn't experience any vaginal bleeding during pregnancy. If you do, it may be a sign of placenta previa or placental abruption. These are two conditions in which the placenta does not behave normally, and they almost always lead to a caesarean section.  In placenta previa, the placenta is located low in the uterine cavity, partially or completely covering the opening of the cervix. As the lower portion of the uterus stretches and dilates during the latter weeks of pregnancy, portions of the placenta may be torn from their attachment to the wall of the uterus. This leads to variable amounts of bleeding, ranging from light to profuse.
  10. Caesarean Section -  Caesarean section is necessary when a normal birth would endanger either the mother or the baby. This can be due to the size and position of the baby, the presence of bacteria, or because of multiple births. There are two types of caesarean section, but modern medicine has made both of them extremely safe procedures. Caesarean section is the delivery of a baby by cutting through the abdominal wall and uterus and removing the baby through these incisions. Almost 30 percent of all births in the United States are by caesarean section.
  11. Birth Defects - All expectant parents dream of having normal, healthy children. Unfortunately, sometimes this does not happen. Although most babies are born normal and whole, about 3 percent are born with some form of abnormality. Fortunately, about half of these imperfect babies have only minor defects that can be easily corrected, leaving no trace. In the other half, however, the defect may be severe and even life-threatening. Different types of Birth defects are also called congenital anomalies, can affect nearly every organ of the baby's body. In some cases, these defects are visible on the surface of the body; in other cases, the defects involve internal organs, such as the heart or intestines. Another type of defect, called an inborn error of metabolism, is not visible but rather is an abnormality of the chemical system of the body in which normal chemical reactions in certain organs cannot occur.
  12. Rh Incompatibility -  If a mother and foetus don't have compatible blood; there can be severe complications for the foetus. Furthermore, any foetus the mother carries in the future is at risk, too, unless a doctor takes the proper steps to sensitize the mother. 
  13. Diseases during Pregnancy - The majority of women enter pregnancy healthy and remain so until delivery of the baby. Aside from a variety of minor problems -- for example, backache, morning sickness, and constipation -- the woman generally tolerates the many changes in her body that result from pregnancy. In some cases, however, either the mother enters pregnancy with a medical problem or a problem develops during pregnancy. Some of these conditions affect only the mother, while others may affect both mother and baby.
  14. Abnormalities of Labour -  As complicated as labour is, there are a number of situations that can arise that would present a danger to the mother, the baby, or both. The baby and the umbilical cord must be correcting positioned in the birth canal throughout the process for a healthy delivery. While a condition as mild as slow labour can be easily corrected with medicine, several other complications are more severe. The remedy for many of these complications is birth by caesarean section. Labour is defined as the process by which the uterus rhythmically contracts and expels the baby and placenta. Labour is a progressive process that generally does not stop until the baby and placenta have been delivered.