Obstetrical, Medical and Surgical Complications of Pregnancy

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During any pregnancy, there is always a risk of complications arising regardless of whether you possess any risk factors or not. Starting prenatal care early helps to detect any problems before they become serious and develop into dangerous health complications. In a lot of cases, when a condition is caught early it can either be treated or managed for the duration of pregnancy. Moreover, STDs and infections that can cause harm to the baby would be detected early and steps to prevent a bad outcome will be immediately taken. Contact your health provider immediately if you suspect you might be pregnant or schedule an appointment with one of our OB/GYNs in Manhattan today to confirm your pregnancy and begin prenatal care.

Complications during pregnancy

Whether the complications you develop are severe or minor, early detection can increase the survival chances of the fetus and prevent preterm labor. There are some minor conditions that lead to preterm birth if they are not treated or managed properly. While others can also be life-threating for both the mother and the child. In some cases, the fetus would have to be removed early regardless of stage of development in order to save the mother’s life. Below is a list of some of the complications that may arise.

Preeclampsia: High blood pressure during pregnancy; this usually begins after the 20th week of pregnancy and can occur after childbirth. It can lead to brain, kidney, liver and eye damage in some mothers and in severe cases this may lead to coma or death of the mother. If severe preeclampsia is detected, your doctor will immediately move to deliver the baby regardless of the developmental stage of the baby in order to save the mother’s life1.

Gestational Diabetes: This occurs during pregnancy and is the inability of the mother’s body to properly break down sugar2. One of the more serious complications of this is the excessive growth of the fetus. This condition is called macrosomia, the baby becomes too big for delivery and may get stuck during vaginal birth. In a lot of cases, the doctor would advise the mother to deliver through cesarean as in this case it is the safer option for both mother and child. Note, gestational diabetes has no symptoms and is diagnosed by screening for it3. This is included in your prenatal care as your doctor would begin screening at the 24th week of pregnancy.

Polyhydramnios: This is a condition in which there is too much amniotic fluid in the sac. This condition can lead to preterm labor and consequently preterm birth. Your doctor can treat this by performing an amniocentesis. The level of amniotic fluid is monitored throughout pregnancy as too little or too much will may lead to health complications for the child. In the case of too little amniotic fluid, this may cause growth retardation and other birth defects1.

Intrahepatic cholestasis of pregnancy (ICP): This is a condition in which the flow of bile is reduced. This results in the buildup of bile in the liver and the eventual spilling of substances known as bile acids into the blood stream and tissues2. This causes a severe itching sensation all over the mother’s body.

Anemia: This is when the mother’s body does not have enough healthy red blood cells to deliver oxygen to the rest of the body. This may lead to preterm labor/birth. This iron-deficiency anemia experienced by mothers can easily be treated or managed with iron supplement pills.

Hyperemesis Gravidarum:  This is an extreme case of morning sickness (nausea and vomiting) suffered by mothers and in some cases the mother would need to be hospitalized. Severe weight loss may result from this condition and an IV line may be needed in order to provide the mother and child with the required nutrients and fluids3.

UTI (Urinary Tract Infections): This is a bacterial infection in the urinary tract and can be easily treated with antibiotics. Some common symptoms are: a burning sensation during urination, reddish discoloration of urine, nausea, back pain, urine smells horrible, etc.

Ectopic Pregnancies: An ectopic pregnancy is a condition in which the fetus develops outside the uterus. The fetus may attach to the fallopian tube, abdominal cavity and cervical canal. This occurs as a result of STDs such as chlamydia, pelvic inflammatory disease, infections, endometriosis, or some other reproductive disorders. In this case, as pregnancy progresses, the danger to the mother increases depending on where the fetus has attached. If it is located in the fallopian tube, this may cause the tube to rupture. Moreover regardless of the location, this type of pregnancy is usually very painful and can lead to death of the mother. In most cases, the fetus is removed to preserve the mother’s life before the fetus gets too far along in development, thereby causing further health complication for the mother1.

Placenta Abruption/Accreta/Previa: These are conditions in which there is a problem associated with the placenta. These can lead to preterm labor/birth resulting in birth defects and low birth weight1. In placenta abruption, the placenta detaches from the uterus while in accreta the placenta is attached too deeply in the uterus walls and finally in previa the placenta is attached at a low point of the uterus walls1&4. This results in the partial or complete coverage of the cervix.

Possible complications to both mother and child during surgical delivery (cesarean)

There are a number of risks associated with surgical delivery to both mother and child. Moreover, the rate of cesarean births in the United States has been on the rise. With a rate that is over 25%, this means that more than a quarter of all births in the United States is done through surgery deliveries5. This would not be a problem if almost of these births actually required surgical intervention. The problem is more and more women who do not need this procedure are opting for cesarean delivery rather than vaginal delivery. What they failure to realize is, C-sections are considered major surgery and a lot of complications can arise for both mother and child. Below is a list of possible complications.

 

  • Infection: There is a risk of infection at both the incision wound and the lining of the uterus (endometritis)6.
  • Premature Birth: A baby may be delivered too early if the gestational dates was inaccurately calculated leading to preterm birth and low birth weight5.
  • Breathing Problems for Babies: It has been observed that babies born through cesarean have more breathing problems during the first few days than those born vaginally. As such, a lot of babies that are delivered by cesarean require breathing assistance during the first few days.
  • Fetal Injury: Baby may be nicked during incision, however this is very rare and cuts are usually superficial and not serious.
  • Blood Clot: A C-section increases your chances of developing deep vein blood clots in the leg and pelvic regions. If these blood clots travel to the lungs or block blood flow at different sites, it can result in life-threating health complications such as strokes (when the blood cloth travels to the brain).
  • Increases risks of complications in future pregnancies: Multiple C-sections increase the risk of complications in future pregnancies. In some cases due to the scarring on the uterine walls, the placenta either partially or completely covers the cervix due to the lower placement of attachment (placenta previa) or attaches too deeply to the uterine walls (placenta accreta)3&4. There is a risk of uterus tearing open at the site of prior C-section incision during future pregnancies6.
  • Extended Recovery: With vaginal birth, the mother recovers within a few days to a few weeks. This is not the case with C-section, it can take anywhere from a couple of weeks to months for the mother to recover. About 7% of women have reported pains around their incision 6 or more months after surgery.
  • Maternal Mortality: There is a higher chance of complication resulting in death with C-sections than with vaginal births.
  • Reaction to Medication: The mother may experience a negative reaction to the anesthesia given during surgery or pain medications given afterwards.
  • Injury to Mother’s Organ: Though uncommon, surgical injuries to the mother’s bladder and bowels might occur. If this happens, then a second surgery might be needed to perform repairs.
  • Adhesions: A C-section may result in scar tissues around the pelvic region that are painful. The mother may develop complications such as placenta previa during future pregnancy as a result of these adhesions5.
  • Hemorrhaging and excessive blood loss: Heavy bleeding may occur during and after surgery. This can be life-threating.

 

Complications happen, but most of the time the outcome depends on early detection. Visit us at 67th Street OB/GYN Total Women’s Health Care for more information/ to consult with an obstetrician in Manhattan today.

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