15 Most Common Pregnancy Complications

Pregnancy complications are the health problems experienced by the expecting mother or the developing fetus during the gestation period. These complications might also arise due to underlying health conditions in the mother present before pregnancy. However, if treated on time with the help of proper medical facilities, prenatal care, and maternal nutrition, pregnancy complications might be detected and prevented from causing further problems in the pregnancy.

Read on to know about the common pregnancy complications, their effects on the mother and the fetus, and ways to avoid adverse effects of the complications.

Common Complications Of Pregnancy

Problems during pregnancy are either due to previously existing issues or caused by hormonal and physiological changes in a woman’s body. It is important to be aware of the signs, symptoms, and risk factors for common pregnancy complications (1).

1. Anemia

The demand for oxygen and nutrients increases as the fetus grows. In anemia, the body has fewer red blood cells in blood than required to meet the oxygen needs of the mother and fetus. Iron deficiency anemia is the most common type during pregnancy and, if it is untreated and severe, it may lead to intrauterine growth retardation, fetus brain anoxia, and preterm labor. During delivery, a woman may lose blood, and if the mother is anemic, there may be a risk of complications.

Anemic mothers may feel extreme tiredness, palpitations, and shortness of breath. It also makes the body susceptible to infections, preeclampsia, and bleeding (2). Risk factors for developing anemia during pregnancy include:

• Poorly balanced vegetarian or vegan diet

• Preexisting celiac disease or Crohn’s disease

• Excess vomiting due to morning sickness

• Pregnancy with twins or more

The problem may be solved with adequate nutrition and iron supplements that your doctor may prescribe (3).

2. Gestational diabetes

High blood sugar developed during pregnancy is known as gestational diabetes. The body becomes less responsive to the hormone insulin secreted by the pancreas to control blood glucose levels.

Gestational diabetes affects about two to ten percent of the pregnancies in the US and is harmful to both mother and child. The incidence of fetal malformations is directly related to the level of glucose over the embryonic period as measured by a hemoglobin A1c level in the first trimester. Some genetic factors and being overweight before pregnancy may add to its risk.

Uncontrolled gestational diabetes may cause (4):

• A larger baby of nine pounds or above, making normal delivery difficult
• Premature delivery and breathing problems in the baby
• Risk of low blood sugar in the baby
• Increased risk of the baby developing type 2 diabetes later in life
• Congenital malformations in the baby such as cardiac, renal, neurological, skeletal, or gastrointestinal anomalies
• Intrauterine death

You can manage gestational diabetes by following a safe meal and exercise plan. Your doctor may prescribe insulin or medications if required. The mother’s blood glucose usually returns to normal post-delivery, but there is an increased risk of her developing type 2 diabetes later. Maintaining a healthy lifestyle, losing excess pregnancy weight, and regular blood glucose monitoring after delivery can help you manage the condition.

3. Preeclampsia

It is a condition that may appear approximately after 20 weeks of pregnancy and most frequently near full term, causing high blood pressure and protein in urine with signs of kidney and liver damage. It may cause reduced growth of the fetus and preterm delivery.

Preeclampsia does not initially present with any typical symptom, and regular prenatal checkups are important to detect it early. The following factors may increase a woman’s risk of developing preeclampsia in pregnancy.

• First pregnancy
• Maternal age below 20 or over 35 years
• Pre-existing high blood pressure (equal or greater 140/90 mmHg) (chronic hypertension)
• Underlying renal disease
• Family history of preeclampsia
• Diabetes
• Polyhydramnios or non-immune fetal hydrops
• Pregnant with twins or more

The symptoms of preeclampsia include:

• Sudden increase in blood pressure
• Swelling of hands and face, especially in the morning
• Sudden weight gain over days
• Headache and dizziness
• Visual disturbances
• Stomach pain below the ribs
• Nausea and vomiting
• Protein in urine detected during urine tests (last sign to develop)

If left unattended, preeclampsia may cause seizures, kidney or liver failure, and fatal blood clotting problems (5). Timely diagnosis and treatment can help most mothers recover without any adverse effects.

4. Eclampsia

It is a condition that follows preeclampsia. It may cause an onset of seizures or coma in a pregnant woman with severe preeclampsia. Eclamptic seizures may occur until postpartum. Certain neurological, vascular, genetic, or dietary factors predispose pregnant women to eclampsia (6). Its symptoms are similar to those of preeclampsia.

5. HELLP syndrome

The word HELLP stands for hemolysis (breakdown of red blood cells), elevated liver enzyme levels, and low platelet count. It is a rare disorder occurring in the third trimester but can start soon after childbirth. HELLP is a life-threatening complication common in pregnant women with preeclampsia, eclampsia, or pregnancy-induced hypertension (high blood pressure). Its symptoms include:

• Tiredness

• Swelling of face and hands

• Stomach pain (upper right side)

• Severe headache

• Nausea and vomiting

The condition may have serious complications for the mother and baby, and treatment involves delivering the baby, even if preterm. However, your doctor may put you on medication, depending on the severity of the condition.

6. Ectopic pregnancy

In an ectopic pregnancy, the embryo gets implanted outside the uterus, usually in the fallopian tubes. The embryo fails to grow properly due to the lack of adequate space and nutrition and ultimately dies in most cases.

It happens when the egg cannot be moved properly from the fallopian tubes either due to a blockage or a malfunction of the hair-like filaments inside the tube that propel the egg towards the uterus. Factors that increase the risk of an ectopic pregnancy include:

• Reversal of tubal sterilization

• Past infections or inflammation of the fallopian tubes

• Fallopian tube defects

• Some treatments for infertility

• Fallopian tube damage by a ruptured appendix

The growing embryo may rupture the fallopian tube causing pain, internal bleeding, and shock. Immediate surgery is necessary if it happens. Other symptoms of ectopic pregnancy include:

• Prolonged morning sickness and breast tenderness
• Positive beta-hCG
• Cramps and pain in the lower abdomen or pelvis
• Amenorrhea followed by irregular vaginal bleeding and spotting

You should consult your doctor if you experience any unusual pregnancy symptoms to prevent the need for emergency surgery (7).

7. Infections

Infections, such as the common cold or skin infections, are not much of a concern during pregnancy, but some may lead to preterm birth, low birth weight, or congenital disabilities in the baby. Infections that may prove dangerous during pregnancy include:

• Zika virus infection

• Bacterial vaginosis

• Hepatitis

• Toxoplasmosis

• Urinary tract infection

• Yeast infections

• Group B streptococcus bacterial infection (causes blood infections, pneumonia, and meningitis in newborns)

To reduce the risk of infections during pregnancy, avoid eating undercooked meat, wash vegetables and fruits thoroughly, do not share food and drinks with people, wash your hands frequently, and do not handle cat litter (spreads toxoplasmosis) (8).

8. Hyperemesis gravidarum

Most pregnant women experience nausea and vomiting (morning sickness) in the first trimester. Hyperemesis gravidarum is unusually severe and persistent nausea and vomiting. Chances of this condition increase if:

• You are pregnant with two or more babies

• Placental cell development is abnormal (molar pregnancy or hydatidiform mole)

• You are prone to motion sickness

Hyperemesis gravidarum causes weight loss, electrolyte imbalance, and dehydration, resulting in an inadequate supply of nutrients to the growing fetus. Try to avoid any trigger for nausea such as certain noises, lights, smells, or a car ride. If you are diagnosed with it, your doctor may prescribe medications to control vomiting (9).

9. Miscarriage

Miscarriage is the spontaneous loss of a fetus before 20 weeks of gestation (after that, it is known as a stillbirth). Its symptoms include abdominal pain with cramps, back pain, bleeding, or passing clots from the vagina. Risk is usually higher in women older than 35 years and those with a history of miscarriages. Genetic and chromosomal defects may be responsible for a miscarriage. Other factors include:

• Smoking, drug or alcohol abuse

• Hormonal issues or problems with the reproductive organs

• Immune disorders

• Clotting disorders

• Infection

• Excess weight

• Infections or other chronic diseases of the mother

Most miscarriages occur within the first seven weeks of pregnancy, and the rate usually drops after detection of fetal heartbeat (10).

10. Deep vein thrombosis

Risk of developing blood clots in veins increases during pregnancy and three months postpartum. This may be the body’s mechanism to minimize blood loss during childbirth. Blood flow decreases in the legs during pregnancy as the pressure on the pelvic blood vessels increases with the growing fetus.

A blood clot in the legs or arms is known as deep vein thrombosis (DVT) and causes swelling, pain, and tenderness of the affected limb. Talk to your healthcare provider if you have a personal or family history of blood clots or a clotting disorder.

At times, the clot may break off and travel to the lungs (pulmonary embolism), which may be fatal. You should seek immediate medical attention if you experience any symptoms of pulmonary embolism such as difficulty in breathing, chest pain, blood with cough, or irregular heartbeat (11).

11. Less or excess amniotic fluid

Amniotic fluid protects the growing baby from external shocks, maintains constant temperature around the fetus, and aids in healthy development. Too much of this fluid (polyhydramnios) may lead to overdistension of the uterus, and the mother’s water may break preterm. It also increases the risk of hemorrhage after delivery. Polyhydramnios may indicate abnormality of mother or fetus, but in some cases coexist with a normal pregnancy.

Too little amniotic fluid (oligohydramnios) may interfere with the proper development of muscles, bones, limbs, lungs, and digestive system of the fetus (12). Oligohydramnios almost always indicates the presence of some abnormality.

12. Preterm birth

WHO estimates that there are about 15 million preterm births (before completing 37 weeks of gestation) every year. It is categorized as extremely preterm (before 28 weeks), very preterm (28-32 weeks), and moderate to late preterm (32-37 weeks).

The majority of these births are spontaneous but may be medically affected due to some complications with the mother or baby. Common causes include multiple pregnancies, infections, genetic predisposition, and chronic disorders, such as diabetes and high blood pressure. Complications arising from preterm births are the leading cause of fatal problems among children under five years of age (13).

13. Cervical incompetence

It is ripening of the cervix much before the completion of the gestation period. The cervix is unable to retain the fetus even in the absence of contractions or labor. It usually occurs in the mid-second trimester or early third trimester due to some structural or functional defects in the cervix. It may be congenital or acquired as a result of infection or inflammation. Your doctor may suggest non-surgical or surgical measures depending on the severity of the condition (14).

14. Placental complications

Rare complications during pregnancy that involve the placenta include (15):

• Low-lying placenta: The placenta usually grows away from the cervix with advancing pregnancy. However, at times it may stay low in the uterus and almost cover your cervix. This is also known as placenta previa. An ultrasound scan detects it at about 18 to 21 weeks in pregnancy. If the position is not seen to change even at 32 weeks, a cesarean section may be required for childbirth. Even if vaginal delivery is possible, there’s a high chance of heavy bleeding, which may be a health risk for you and your baby.

• Placental abruption: It is a serious condition in which the placenta gets detached from the uterus wall. Risk factors for placental abruption include smoking, hypertension, preeclampsia, eclampsia, cocaine use, and injury to the abdomen. It may cause abdominal pain and vaginal bleeding with contractions. The risk of premature birth, growth defects, and stillbirths may increase.

15. Rh incompatibility

When a woman with Rh-negative blood group conceives a baby who has Rh-positive blood, antibodies are produced in the mother’s body against fetal red blood cells (RBCs). These antibodies may reenter and attack the fetal RBCs. Generally, the first pregnancy proceeds without complication, but if subsequent pregnancies are with Rh-positive blood groups, then the stored maternal antibodies attack and break down the fetal RBCs into bilirubin, causing jaundice, low muscle tone, and lethargy in the newborn. The condition is better prevented than treated using RhoGAM (medication to control immune response) under medical supervision (16).

Several pregnancy complications may be prevented by simple lifestyle and dietary changes. Others may be detected early by strictly following prenatal checkup schedules and discussing with your doctor any unusual symptoms such as stomach pain, excess nausea and vomiting, headache, vaginal bleeding or spotting, or cloudy urine. Complications detected early can be treated and prevented from becoming serious for the wellbeing of the mother and the baby.

References

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Dr. Irene (Eirini) OrfanoudakiPhD, MD

   

Dr. Irene (Eirini) Orfanoudaki is a gynecologist-obstetrician, having a private practice in Heraklion, Crete, and collaborating with private health clinic 'MITERA' - Euromeda in Heraklion. With around 21 years of experience as a gynecologist-obstetrician, she specializes in ultrasound, colposcopy, minimal and advance gynecologic surgery, aesthetic gynecology, fertility consulting, menopause consulting, operative obstetrics, high-risk pregnancy, normal deliveries, antenatal, intra-parum, postnatal care, breast diseases, and teenage issues.

Read full bio of Dr. Irene (Eirini) Orfanoudaki