Complications of pregnancy

1. Complications of pregnancy Selma Sosic

2. Pregnancy Background: • Each pregnancy lasts approximately nine months, which is then broken down into three different trimesters that are each three months. Within each trimester, there are problems that each woman can face, caused by many different variables such as genetics, lifestyle habits, and more. Each problem may or may not have an effect on the mother and the fetal well being.

3. First trimester

4. Miscarriage • More than 80% of miscarriage cases occur within the first three months of pregnancy • These miscarriages are most commonly caused by chromosomal abnormalities in the baby • Can also be caused by infections, maternal chronic illnesses, reproductive organ abnormalities, lifestyle choices, diets, pre-existing conditions and more. • Miscarriages may also have an increased risk on women as they progressively age.

5. Miscarriage Signs & Symptoms Treatment • Vaginal bleeding • Extreme nausea • Abdominal pain • High fever • If the uterus is not empty and still contains placental or fetal tissue, a doctor will preform a dilation and curettage (D&C) to dilate the cervix and remove the remaining tissue. • Another common way to deteriorate the existing placental tissue is by certain medications that cause the contents in the uterus to expel. This option may is a more ideal alternative in the case that surgery is not wanted.

6. Ectopic pregnancy • During a normal pregnancy, the ovaries release an egg into the fallopian tube. When the egg meets with the sperm, the egg then continues into the uterus to grow for the next 9 months. Occurring in one in fifty pregnancies, the fertilized egg does not move to the uterus, but stays in the fallopian tube, which is called an ectopic pregnancy. • Ectopic pregnancies can be caused by history of pelvic inflammatory disease, certain sexually transmitted diseases such as chlamydia and gonorrhea, use of fertility drugs, and infertility treatments such as in vitro fertilization • In most cases of an ectopic pregnancy the baby has no likelihood of surviving and can be very life threatening to the mother if the tube ruptures and causes severe bleeding.

7. Ectopic pregnancy Signs & Symptoms Treatment • Nausea • Vomiting • Lower, sharp abdominal cramps • Dizziness • Weakness • Treating an ectopic pregnancy can be done through an emergency surgery if the tube is ruptured, or a laparoscopic surgery if the tube is not ruptured and the pregnancy has not progressed very far. Medications can also be administered to stop the growth of the pregnancy tissue. This treatment may be beneficial if the tube is not ruptured and the pregnancy has not progressed far.

8. Drug & alcohol abuse • Alcohol is known to be the leading cause of developmental and physical birth defects in newborn children across the world. • When a person smokes during pregnancy, nicotine and cancer-causing drugs pass from mother to baby. • Smoke can also cause a fetus to stop receiving nourishments and further damage the growth of organs such as the heart, muscles, joints, and face. • Drugs such as cocaine or heroine can be transferred across the placenta to the baby if ingested by the mother during pregnancy. It can also cause the baby to be born addicted to these drugs and can suffer through withdrawal symptoms such as irritability, convulsions, diarrhea, fever, sleep abnormalities, and joint stiffness.

9. Drug & alcohol abuse • Fetal Alcohol Syndrome: • May occur within pregnancies where drug and alcohol is abused • When a child is suffering from the affects of Fetal Alcohol Syndrome, it may have visible characteristic deficiencies such as small head circumference, developmental delay, organ dysfunction, and epilepsy. • A baby can also be at risk of a small size and low birth weight along with intellectual disability and behavior problems.

10. Second Trimester

11. Preterm Premature Rupture of membranes (pprom) • When the amniotic fluid is released due to the breaking of the amniotic sac. • Once PPROM occurs, it most likely leads to a preterm labor, causing it to be a large concern amongst doctors because the baby may be too premature to sustain life outside the womb. • There is no one clear reason why PPROM occurs, it is believed that an infection of the amniotic membrane is an underlying problem in many cases along with overstretching of the uterus and amniotic sac.

12. Preterm premature rupture of membranes (pprom) Signs & Symptoms Treatment: • PPROM will be diagnosed through an examination of the cervix, which may show a leaking fluid from the cervical opening. • An antenatal corticosteroid medicineis used to speed up the fetal lung maturity in the situation that the baby is to be born earlier than the expected due date. If the amniotic membrane has severely been ruptured, the OBGYN will begin to induce labor with medications if it is not starting naturally. This is done in order to speed up delivery and reduce the risk of infection.

13. Placenta previa • The placenta is an organ that is created during pregnancy to nourish the fetus, remove its waste, and produce hormones to sustain the pregnancy • Placenta previa occurs when the fetus’s placenta partially or totally covers the mother’s cervixand the placenta is attached to the lower area of the uterus

14. Placenta previa Signs & Symptoms Treatment • Severe bleeding throughout the pregnancy • Placenta previa usually stops without any kind of treatment because as the uterus grows, the placenta usually moves higher in the uterus and away from the cervix, but can commonly reoccur throughout the remainder of the pregnancy • The mother will be restricted to bed rest for part of the pregnancy and will most likely require a caesarean section to safely deliver the baby and to provide care for the mother.

15. preeclampsia • Preeclampsia is when a pregnant woman develops high blood pressure and protein in the urine after the twentieth week of pregnancy • This may also prevent the placenta from receiving enough blood, causing the baby to be born at a smaller size. It is also one of the leading causes of premature • The cause of preeclampsia is not known, but is suspected to be related to poor nutrition, high body fat, damage to the blood vessels, or insufficient blood flow to the uterus and has many risk factors associated with it including a history of diabetes, kidney disease, lupus, or rheumatoid arthritisbirths

16. preeclampsia Signs & Symptoms Treatment • Swelling in the feet, legs, and hands • Protein in the urine • Severe headaches • Abdominal pain • Bood pressure greater than 140/90 • The only cure to preeclampsia is to deliver the baby, commonly by a caesarean section

17. Third Trimester

18. Preterm labor • When a baby is born before 40 weeks, it is considered preterm labor because the baby was born before the full term was completed • Preterm labor can lead to an underdeveloped child suffering the symptoms of bleeding in the brain, underdeveloped organs, an increase of infections such as meningitis and sepsis, problems with kidney function, and jaundice • The earlier the baby is born, the more likely the baby will have more complications and the majority of infantile deaths are due to the consequences of a premature delivery.

19. Preterm labor Signs & Symptoms Treatment • problems leading to preterm labor can include existing maternal conditions such as preeclampsia, kidney disease, heart disease, diabetes, infection, or cervical infections such as gonorrhea, chlamydia, syphilis, trichomoniasis, or gardnerella • When recovering from a preterm birth, the baby will require medical attention in a neonatal intensive care unit. The baby will be in an incubator to maintain a warm environment without a risk of infection. The baby will be attached to a machine to monitor the breathing, blood pressure, heat rate, and temperature. In some cases, the baby will need to have a supply of oxygen in the situation that the lungs are not yet fully developed.

20. Intrauterine growth restriction (iugr) • Acondition at which an unborn baby is smaller than it should be due to it not growing at the proper weight inside the womb • The delayed growth puts the baby at certain risk of health problems during pregnancy, delivery, and after birth including: low birth weight, decreased oxygen levels, hypoglycemia, low resistance to infection,trouble maintaining body temperature, and abnormally high red blood cell count • The cause of IUGR has many possibilities, most likely including a problem with the placenta but can also be caused by maternal diabetes, high blood pressure or heart disease, kidney or lung disease, malnutrition, anemia, sickle cell anemia, smoking, drinking, or abusing drugs

21. Intrauterine growth restriction (iugr) Signs & Symptoms Treatment • a small gestational age for the baby, and the weight of the fetus is below the tenth percentile (less than ninety percent of the babies in the range of the same gestational age) • Fetal monitoring through electrodes placed on the mother’s stomach • Amniocentesis

22. Gestational diabetes • Gestational diabetes is a situation where pregnant women have high blood glucose sugar levels present in their bodies and accounts for roughly 4% of all pregnancies • Gestational diabetes does not indicate that a person had diabetes before pregnancy, nor does it indicate that the person will have diabetes after birth • The women that are commonly diagnosed with gestational diabetes include ones who are overweight, family history of diabetes, have too much amniotic fluid, having sugar in their urine, and impaired glucose tolerance or impaired fasting glucose (blood sugar levels are high, but not high enough to be diabetes)

23. Gestational diabetes Signs & Symptoms Treatment • This can be diagnosed through a glucose blood test to determine how the body metabolizes the glucose • This complication can be monitored and controlled in many situations if the woman monitors blood sugar levels four times per day, follows specific dietary guidelines instructed by the doctor, exercising after obtaining the doctor’s permission, monitoring weight gain, and taking insulin if necessary