Complications in Pregnancy

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Complications with pregnancy are not uncommon; most problems are relatively mild, but some carry significant health risk to the mother, child, or both.

Warning signs can alert you when pregnancy complications arise. Unfortunately, some women ignore these signs until the problem has become serious.

Danger Signs

Recognizing danger signs when they first occur helps you to get treatment before a critical situation develops. If you think something might be wrong, call your physician without delay.

Getting Answers to Your Questions

Your physician or midwife is the most reliable source for answers to your questions about problems in your pregnancy. There is much information on the web, some accurate and some not; however, none of it substitutes for your primary care provider. She is most familiar with your situation and is in the best position to help you.

When to Worry

A woman's body goes through so many changes during pregnancy that it is sometimes hard for her to know when to worry. Many changes such as heartburn, gradual weight gain, and fatigue are just part of being pregnant; however, some problems are not a routine part of pregnancy and should prompt an urgent call or visit to your doctor or midwife. The following are not normal and require medical evaluation:

• Sudden weight gain
• Sudden swelling of the hands or feet
• Vaginal bleeding
• Persistent headache
• Blurred vision or spots before your eyes
• Excessive nausea and vomiting
• Failure to gain weight or weight loss
• Leaking fluid from the vagina
• Fever
• Burning during or increased frequency of urination
• Abdominal pain
• Regular or frequent contractions (>4-6 per hour)
• Decrease in fetal movement

Miscarriage

Bleeding in the early months of pregnancy signals the possibility of a miscarriage. As many as 20 percent of pregnancies end in miscarriage. Sometimes this occurs so early in pregnancy a woman may not even know she was pregnant. Bleeding, clots, and cramping are the usual signs of miscarriage. Surgery (D&C) may be required to completely empty the uterus.

Ectopic Pregnancy

Sometimes a woman is pregnant, but the fertilized egg does not make it all the way into proper position in the uterus. As the embryo begins to grow in its abnormal location, it stretches and may tear delicate structures and blood vessels. The symptoms of an ectopic pregnancy are bleeding, low back pain, nausea, lower abdominal pain or cramping, and the usual signs of pregnancy. This can turn quickly into an emergency and requires surgery to remove the malpositioned, nonviable embryo.

Premature Labor

Premature labor and delivery are common problems of pregnancy. About 11 percent of all pregnancies in 1995 ended in delivery before 37 completed weeks of gestation. The seriousness of the problem depends on how prematurely a woman goes into labor. A change in vaginal discharge, leakage of fluid from the vagina, menstrual-like cramps, dull backache or abdominal cramping for more than one hour, or a feeling of having to push, all may indicate premature labor. Babies born prematurely run the risk of having respiratory problems, underdeveloped lungs, and are born weighing less than full-term babies.

Hypertension

Elevated blood pressure is a common complication occurring in about three percent of pregnancies. It can have adverse effects on the placenta and fetus before symptoms are apparent. It is important for you to keep your prenatal appointments so that your doctor or midwife can monitor your blood pressure. Severe blood pressure elevations can cause headaches, spots in front of your eyes, pain in the upper part of your abdomen, and fluid retention.

Decreased Fetal Movement

For various reasons, some babies have trouble getting enough oxygen in the womb. They may manifest this as a decrease in activity. Some doctors recommend that mothers do "kick counts," counting the number of times the baby kicks inside the uterus within a set time period. If your baby becomes unusually less active for more than a few hours, you should call your physician or midwife.