Complications can arise in
pregnancies for many reasons. Sometimes a woman’s existing health conditions
can contribute to problems, and other times new conditions arise because of
body and hormonal changes that occur during pregnancy.
Always talk to your doctor
if you have any concerns about your risk of complications during your
pregnancy. Some of the most common complications include the following.
Miscarriage is the loss of a pregnancy in the
first 20 weeks of pregnancy. The reasons for miscarriage are not always
known. Most miscarriages occur in the first trimester, which is the first 13
weeks of pregnancy. Chromosomal abnormalities can prevent proper development of
the fertilized egg. Other times physical problems with a woman’s reproductive
system can make it difficult for a healthy fetus to grow.
Miscarriage is sometimes
called spontaneous abortion as the body rids itself of the fetus much like a
procedural abortion. The most common sign of a miscarriage is abnormal vaginal
Other symptoms can include lower
abdominal pain and cramping, and a disappearance of pregnancy symptoms, such as
Most miscarriages don’t require surgical
intervention. When a miscarriage occurs under 12 weeks, the tissue will often
dissolve or pass spontaneously without the need for further intervention. Some
patients will require medicine or a minor procedure in the office to help with
the passage of the tissue.
A fertilized egg implanted outside the uterus is an ectopic pregnancy. The egg
generally settles in one of the fallopian tubes.
Because of the space limitations and the lack of nurturing tissues there, a
fetus cannot properly grow. An ectopic pregnancy can
cause severe pain and damage to a woman’s reproductive system. An ectopic
pregnancy is a potentially life-threatening condition. As the fetus continues
to grow, it can cause the fallopian tube to burst leading to severe internal
The fetus will not survive in
an ectopic pregnancy. Surgery and medication are necessary, as well as careful
monitoring of a woman’s reproductive system by a gynecologist. Causes of
ectopic pregnancies include a condition in which cell tissue like that in the
uterus grows elsewhere in the body (endometriosis) and scarring to the
fallopian tubes from a previous sexually transmitted infection.
Gestational diabetes is
a form of diabetes that is diagnosed during pregnancy. Being diagnosed with
gestational diabetes means that there are additional concerns to be addressed
during your pregnancy and that you are at higher risk for diabetes. Like other
types of diabetes, gestational diabetes is caused by an inability of a woman’s
body to make enough insulin. For most women, gestational diabetes doesn’t cause
any noticeable symptoms.
While most women with
gestational diabetes give birth to healthy babies, the condition can increase
the risk that the baby will have a larger-than-normal body.
Other health risks to the
low levels of minerals in the blood
Gestational diabetes is
treated through changes in diet and close monitoring of the blood sugar levels.
Intake of insulin may also be necessary. The goal is to keep the mother's sugar
levels within a normal range for the remainder of the pregnancy so the mother
and fetus remains healthy.
Cervical Insufficiency (Incompetent Cervix)
A growing baby puts
continual pressure on a pregnant woman’s cervix. In rare cases, the pressure
becomes too much for the cervix to handle. This will cause the cervix to open
before the baby is ready to be born. Women who have previously had a pregnancy
complicated by cervical insufficiency or who have had surgery on their cervix
are most susceptible.
Symptoms are often very vague and
non-specific. Most women who have cervical insufficiency have no idea that
their cervix is thinning or shortening. The hallmark of this condition is that
it’s painless. However, some women do report a feeling of pressure or mild
Cervical insufficiency is diagnosed by measuring
the length of the cervix with ultrasound. The treatment may include bed rest,
vaginal suppositories of the hormone progesterone, or a procedure called
cerclage. A cerclage is a minor surgery in which bands of strong thread
are stitched around the cervix to reinforce it and hold it closed.
The treatment for cervical
insufficiency will depend on many factors including the length of your cervix,
your gestational age, and the outcome in previous pregnancies if you have been
Placental abruption occurs
when the placenta completely or partially separates from the uterus before a
baby is born. This separation means a fetus cannot receive proper nutrients and
oxygen. A placental abruption happens most commonly in the third trimester of a
pregnancy. Common symptoms include vaginal bleeding, contractions, and
There is no definitive
answer as to why abruptions occur. It’s thought that physical trauma can
disrupt the placenta. High blood pressure can also damage the connection
between the placenta and the uterus.
A number of factors can increase your risk
for abruption. Pregnant women with high blood pressure are much more likely to
have an abruption. This is true for blood pressure problems that are unrelated
to pregnancy, like chronic hypertension, and
pregnancy-related problems like toxemia (pre-eclampsia).
The likelihood of abruption
is closely related to the number and nature of your previous pregnancies. The
more babies you’ve had, the greater your risk of abruption. More importantly,
if you’ve had one abruption in the past, you have about a one in 10 chance of
having an abruption with your next pregnancy.
Other factors that
may increase the risk for placental abruption include cigarette
smoking and drug use.
Placenta Previa (Low-Lying Placenta)
Placenta previa is a rare pregnancy complication that
occurs if the placenta attaches to the bottom part of a woman’s uterine wall,
partially or completely covering the cervix. When it occurs, it usually happens
during the second or third trimester.
It’s common, however, for
some women to have a low-lying placenta in early pregnancy. A doctor will
monitor the condition. But often the placenta moves to the appropriate place
without any intervention.
Placenta previa becomes a more
serious condition in the second or third trimesters. It can result in heavy
vaginal bleeding. If left untreated, placenta previa can lead to bleeding heavy
enough to cause maternal shock or even death. Luckily, most cases of the
condition are recognized early on and treated appropriately.
Low or Excess Amniotic Fluid
Amniotic fluid cushions the
womb to keep a fetus safe from trauma. It also helps maintain the temperature
inside the womb. Having too little amniotic fluid (oligohydramnios) or too much
amniotic fluid (polyhydramnios) interferes with some of the normal functions of
Low amniotic fluid can prevent a baby from
properly developing muscles, limbs, lungs, and affect the digestive system.
Most cases of excess
amniotic fluid are mild and don’t cause problems. In some rare cases, too much
amniotic fluid can cause:
- premature rupture of amniotic membranes
- placental abruption
- preterm labor and delivery
- postpartum hemorrhage
An absence or excess of
fluids is usually detected during the second trimester when the fetus begins to
practice breathing and sucks in amniotic fluid. For those with too little
amniotic fluid, saline solution may be pumped into the amniotic sac to help
reduce the risk of compression or injury to the child’s organs during delivery.
For those with too much
amniotic fluid, medication can be used to reduce fluid production. In some
cases a procedure to drain excess fluids (amnioreduction) may be required. In
either case, if these treatments prove ineffective, an induced pregnancy or
cesarean section may be required.
Preeclampsia is a condition marked by high blood
pressure and high protein count in a woman’s urine. Doctors are not sure what
causes preeclampsia. Preeclampsia can range from mild to severe. In
serious cases, symptoms may include:
or temporary loss of vision
in the face and hands
You should call your doctor
or go to the emergency room immediately if you have severe headaches, blurred
vision, or severe pain in your abdomen.
For most women, preeclampsia
will not affect the health of the baby. However, some cases of preeclampsia can
prevent the placenta from getting enough blood. Preeclampsia can cause serious
complications in both mother and baby. Some complications include:
- breathing difficulties for
The only cure for preeclampsia is delivery.
However, the symptoms of preeclampsia can be treated with medication and bed
rest. Bed rest can help lower blood pressure and increase blood flow to the
placenta. Anti-seizure medication is taken in many cases. Seizures can be a common and serious complications for
both mother and child.
Medications for hypertension (antihypertensives)
are sometimes taken to lower blood pressure, and corticosteroids can be used to
help mature a baby’s lungs to prepare them for an early delivery.
Labor is considered preterm when it occurs
after 20 weeks and before the 37th week
of pregnancy. Traditionally, the diagnosis is made when regular uterine
contractions are associated with either opening (dilation) or thinning out (effacement)
of the cervix.
The majority of premature labor and births occur spontaneously. However,
up to one-fourth of the cases of preterm birth is a result of an intentional
decision to deliver the baby early. These cases are generally due to
complications in either the mother or the baby. These are best treated by
proceeding with delivery, despite the fact that the mother is not yet at her
Preterm labor requires
prompt medical attention, which can try to halt or postpone labor and delivery.
A woman who experiences symptoms of premature labor may be put on bed rest or
be given medication to stop contractions. A large number of these patients
actually go on to deliver at term.
There are a host of risk
factors associated with premature labor and delivery, including:
history of multiple abortions
history of preterm births
tract and other infections
Venous thrombosis is a blood clot that
normally develops in a vein in a leg.
Women are susceptible to clots throughout pregnancy and delivery, and
particularly postpartum. The body increases the blood’s clotting ability during
childbirth, and sometimes the enlarged uterus makes it difficult for blood in
the lower body to return to the heart. Clots near the surface are more common.
Deep vein thrombosis is much more dangerous and far less common.
A greater risk of
developing clots in women includes:
family history of thrombosis
had three or more previous deliveries
been confined to a bed
undergone a cesarean delivery in the past
Other less common
complications include the following.
A molar pregnancy is an abnormality of the
placenta. It’s when an abnormal mass, instead of a normal embryo, forms inside
the uterus after fertilization. Also called gestational trophoblastic disease (GTD), molar pregnancies are rare.
There are two types of molar pregnancies:
complete and partial. Complete
molar pregnancies occur when the sperm fertilizes an empty egg. The
placenta grows and produces the pregnancy hormone hCG, but there is no fetus
inside. A partial molar pregnancy occurs
when a mass forms which contains both the abnormal cells and an embryo that has
severe defects. In this case, the fetus will quickly be overcome by the growing
A molar pregnancy requires an immediate dilation
and curettage (D&C), and a careful follow up as the molar issue can start growing again and even
develop into a cancer.
Fetal Alcohol Syndrome
Fetal alcohol syndrome occurs
when there are mental and physical defects that develop in a fetus when a
mother drinks alcohol during pregnancy. Alcohol crosses the placenta and has
been linked to stunted growth and damaged brain development.
HELLP Syndrome (Hemolysis, Elevated
Liver enzymes and Low Platelet count)
is a condition characterized by liver and blood abnormalities. HELLP syndrome
can occur on its own or in association with preeclampsia. Symptoms often
Treatment of HELLP usually requires
immediate delivery, as there is increased risk of serious health complications
for the mother. Complications can include permanent damage to her nervous system,
lungs, and kidneys.
Eclampsia occurs when
preeclampsia progresses and attacks the central nervous system, causing seizures.
It’s a very serious condition. If left untreated it can be fatal for both
mother and baby. However, with proper prenatal care, it’s very rare for the
more manageable preeclampsia to progress into eclampsia.