Pregnancy complications — alarm signs revealed

During pregnancy one may experience discomfort in varying degrees. It is important to differentiate between normal discomfort, and alarm signs of pregnancy complications.

Normal discomfort includes fatigue, excessive salivation, cravings and pica (urge to eat nonfood items). Others are vomiting early in the morning, heartburn, a need to urinate frequently, and backache. But there are additional discomforts that may be warning signs for you or your baby.

Most women have no pregnancy complications. It is important, however, that you recognise alarm signs during pregnancy because in such events you must seek help immediately. During your antenatal clinics, your doctor will routinely screen for potential problems. Some of these routine checks include checking your blood pressure and testing urine. These examinations help ascertain whether you are in the high-risk category.

A pregnancy is considered high risk when the health of the mother or baby is at risk, for instance- where the mother may be having chronic conditions like diabetes and cancer.

The following symptoms indicate possible presence of pregnancy complications. If you experience any of them, inform your health care provider immediately. Your health care provider will advise you on the necessary action to take, or rule out any complications. A delay in seeking medical care, can make the situation more serious than it would have been had advice been sought when you first noticed the symptoms. In some cases neglecting these symptoms could prove fatal.

Excessive vomiting

Extremely severe nausea and vomiting that causes weight loss and dehydration, is called Hyperemesis gravidum. This type of vomiting is continuous, and can lead to starvation and other serious medical problems for the mother. Dehydration can lead to early labour. Increased blood pressure during vomiting can also cause bleeding into your eyes. High blood pressure can damage the vessels supplying blood to your retina. If damaged extensively the blood vessels can leak, or become blocked resulting in retinopathy, a condition that can lead to bleeding in the eye.

Flow of fluid

A gush of fluid from the vagina may indicate preterm labour, pre-term rapture of foetal membranes (layers of tissue enclosing the foetus in the uterus) and, potentially, a miscarriage.

Bleeding when pregnant – miscarriage

Vaginal bleeding during pregnancy is classified into two categories; early pregnancy bleeding (before 28 weeks of gestation), and late pregnancy bleeding (after 28 weeks). Early pregnancy bleeding may indicate a miscarriage. This is abortion (expulsion of the foetus) at any stage before the foetus has developed enough to survive outside the uterus, typically before 24 weeks. Early-pregnancy bleeding can also be caused by hormonal imbalance (deficiency of some hormones,) or implantation bleeding, which occurs when a fertilised egg attaches to the uterus, causing the surrounding tissue to bleed. Implantation bleeding is lighter than menstrual bleeding, and consists of pink or brown coloured blood. Because it roughly coincides with the first missed menstrual period, many pregnant women mistake it to be a real period, leading to erroneous notion that one is not pregnant, and miscalculation of expected due date.

Bleeding when pregnant – ectopic pregnancy

An ectopic pregnancy (an abnormal type of pregnancy that occurs outside the uterus such as in the fallopian tube, cervix, pelvis or abdomen), may also cause bleeding as it may rapture the walls of the tube, as the foetus grows. This might cause massive bleeding, which can lead to death. You may become weak or feel dizzy and faint. Ectopic pregnancies require immediate medical attention.

Bleeding when pregnant – placenta disorders

The most common causes of late-pregnancy bleeding, include placenta previa and placenta abruption. Placenta previa is an abnormally placed placenta. This occurs when the placenta attaches in the lower uterine segment—over or near the opening of the cervix—instead of on the smooth side of the upper wall of the uterus. Heavy, bright red, painless vaginal bleeding that begins suddenly in the second trimester or the beginning of the third trimester may be a sign of placenta previa. If the placenta breaks away from the wall of the uterus before delivery, this can be very serious for both the mother and the baby.

Placenta abruption is a condition most common in the third trimester. The placenta separates from the wall of the uterus before the baby is born. This condition increases the risk of bleeding not only during pregnancy but also after delivery. The condition is characterised by vaginal bleeding, uterine pain and abdominal pain.

Abdominal pain

Another sign of possible pregnancy complications is pelvic or abdominal pain. This could indicate a miscarriage or an ectopic pregnancy. Cysts (tumours), uterine growths and pains in ligaments (tough tissue that connects bones or supports organs, for instance the uterus) also cause pelvic and abdominal pain.

Abdominal pain that radiates to the back, and is regular, and increasing in frequency and intensity, could be a sign of labour. If this is accompanied by regular contractions before 37 weeks it could signal preterm labour. Pelvic or abdominal pain that is severe and persistent may be a sign of an ectopic pregnancy, preterm labour or urinary tract infection, all of which can pose danger to your life.

Persistent back pain requires medical attention because it could indicate either a miscarriage or preterm labour. Other possible causes of back pain are kidney or bladder infection, cysts or normal pregnancy pain. It could also be the result of poor sitting or sleeping posture.

High body temperature

Normal body temperature ranges from 36-37°C. Fever with a temperature of more than 38.1°C indicates a possible infection. This may be due to presence of bacteria, or virus in your blood. Malaria, for example, causes fever.

Swelling of the hands and face

During pregnancy swelling of the hands and feet may indicate oedema, which is excess fluid in the body. About 50 percent of pregnant women develop mild oedema in the third trimester. This is normal but if the swelling is accompanied by other symptoms and signs, for instance high blood pressure (hypertension) and protein in urine, you could be suffering from pre eclampsia (also known as pregnancy-induced hypertension). Pre-eclampsia can occur between week 20 and the week after delivery. Medical examination is the only way to confirm occurence of pre-eclampsia. Bed rest may be recommended in mild cases; severe ones require hospitalisation.

Eclampsia is the final and most severe complication that arises out of untreated pre-eclampsia and is characterised by convulsions, restlessness and blurred vision.

Severe headaches

Severe headaches accompanied by blurring of vision may be a sign of severe pre-eclampsia or impending eclampsia. Eclampsia is the more severe of the two and is accompanied by seizures and possibly coma if not treated immediately. Severe pre-eclampsia and eclampsia are common obstetric emergencies.

END: PG 05/10-11