Potential Pregnancy Complications
Pregnancy is not a disease. Pregnancy is however a condition and one best monitored and managed by physicians who specialize in Obstetrics. As nature has intended, most pregnancies will go off without a hitch. Some pregnancies however will unfortunately encounter complications, and when these complications occur, it is of the utmost importance that they be promptly recognized and addressed. Some of the more common pregnancy complications encountered include diabetes in pregnancy, hypertensive disorders in pregnancy, preterm labor, premature rupture of membranes and placental pathology.
Diabetes In Pregnancy: Diabetes in pregnancy in called “gestational diabetes”. It is typically classified by whether or not the patient was diabetic before becoming pregnant or after becoming pregnant. It is further classified by whether or not the patient’s diabetes requires treatment with medications or whether or not it can be treated with simple dietary modifications alone. Gestational diabetes is also further classified by the length of time the patient has been diabetic.
When recognized early and when well controlled, gestational diabetes typically causes few pregnancy related complications. When not recognized early however, or when poorly controlled, gestational diabetes can result in fetal nervous system abnormalities, fetal cardiac problems and stillbirth. Additionally poorly controlled or unrecognized gestational diabetes can result in placental malfunction and placental insufficiency. It can also result in excessive fetal growth (macrosomia). Macrosomia is a concern because macrosomic babies are at increase risk for birth injury to their shoulders and/or upper extremities. Babies born to mothers with poorly controlled or unrecognized gestational diabetes are also at ncreased risk for delayed lung development.
So how is gestational diabetes treated? Generally attempts are made to control gestational diabetes firstly with dietary modifications alone. If these dietary modifications fail or prove not to be enough, treatment with medication is then begun. Most times insulin is the medication of choice, though many physicians have also begun to treat gestational diabetes using oral medications like glucophage with a fair amount of success.
Hypertensive Disorders In Pregnancy: Hypertension (high blood pressure) in pregnancy is classified as being either “chronic” hypertension of “gestational” hypertension. Chronic hypertension refers to hypertension diagnosed in a pregnant patient before she has reached 20 weeks of gestation. After 20 weeks of gestation, hypertension diagnosed in a pregnant patient without previously documented hypertension is referred to as “gestational” hypertension. Regardless of the form of hypertension a patient suffers from, it must be recognized early and the elevated blood pressures must be treated medically to prevent pregnancy related complications.
When recognized early and when treated effectively, hypertension in pregnancy typically causes few pregnancy related complications. When not recognized in a timely fashion however, or when not effectively treated, hypertension in pregnancy can result in both maternal and/or fetal complications. Potential maternal complications include stroke, heart attack, seizures and death. Potential fetal complications include growth restriction and still birth.
So how is hypertension in pregnancy treated? The treatment of hypertension in pregnancy depends in part on the form of hypertension one has. In all cases of hypertension in pregnancy the patient’s blood pressure is generally controlled with medications. Additionally if the form of hypertension one suffers from is one in which the patient is at increased risk of seizures, medications are given to lower the risk of seizure activity. Additionally dependent upon the severity of the hypertensive disorder and the gestational age of the pregnancy at the time of diagnosis, delivery of the fetus is considered, as this will lower the likelihood of seizure activity in patients at risk for seizure activity.
Preterm Labor/Premature Rupture of Membranes: Preterm labor is defined as the onset of labor before 37 weeks of gestation. Premature rupture of membranes is defined as rupture of membranes (bag of water breaking) before 37 weeks of gestation. The causes of both preterm labor and premature rupture of membranes oftentimes are not known. When a cause is identified however, preterm labor and/or premature rupture of membranes typically results from a genital tract infection, a malformation in the womb, low prepregnancy maternal weight, maternal age of less than 18 or greater than 40, maternal smoking, maternal drug use or maternal history of preterm labor and/or premature rupture of membranes in previous pregnancies. If preterm rupture of membranes or preterm labor occurs between 32 to 34 weeks of gestational age generally no attempts are taken to prevent delivery. Under some circumstances labor may even be hastened.
If premature rupture of membranes or premature labor occurs before 32 weeks of gestation attempts are generally made to prevent delivery. Additionally two to four steroid injections are generally given to the mother in an attempt to promote maturation of the fetal lungs and brain just in case the baby is born early. Medical science has really made extensive leaps and bounds recently when it comes to the management of preterm labor and/or premature rupture of membranes. When patients of the Women’s Healthcare Partners of Illinois experience preterm labor and/or premature rupture of membranes hospital care is provided for them at the Community Hospital of Ottawa. If they require a higher level of care they are transferred to either The University of Illinois hospital in Peoria, Illinois or to Mt. Sinai Hospital/Medical Center in Chicago, Illinois. Both hospitals have level three Neonatal Intensive Care Units (NICU’s), the highest possible designation for U.S. hospitals. |
