Outlooks & Setbacks Saturdays

“You are the closest I will ever come to magic.” ― Suzanne Finnamore

A pregnancy complication is any disease or condition that affects a person’s pregnancy. Getting regular prenatal care, attending all your appointments and tests and sharing your symptoms with your provider is the best thing you can do during pregnancy. Early detection and prompt treatment can help most pregnancy complications.

What is a pregnancy complication?

Pregnancy complications are medical conditions that may affect you or the fetus’s health during pregnancy. Your pregnancy care provider watches for complications during pregnancy. You can help them detect potential problems by attending all your prenatal appointments. Early detection and prompt treatment can help reduce the chance of serious complications.

What causes complications during pregnancy?

Complications during pregnancy can happen for many reasons. Preexisting medical conditions or new ones (caused by being pregnant) can cause pregnancy complications.

What are the most common complications of pregnancy?

Some common early pregnancy complications are:

• Ectopic pregnancy: A condition where the fertilized egg implants outside your uterus (usually in your fallopian tube). The egg can’t develop outside your uterus and you’ll need surgery or medication to remove the ectopic tissue.
• Miscarriage: Miscarriage is the loss of a pregnancy in the first 20 weeks. About 10% to 20% of pregnancies end in miscarriage. More than 80% percent of miscarriages happen in the first trimester.
• Hyperemesis gravidarum (HG): HG is severe and persistent vomiting during pregnancy. It can lead to dehydration or losing too much weight.
• Congenital disorders: If your healthcare provider suspects the fetus has a health issue or congenital disease, you’re at higher risk for complications during pregnancy. This may mean you need additional monitoring or your baby needs special care at birth.

Some of the common complications in the last half of pregnancy include:

• Preeclampsia: Preeclampsia is a blood pressure problem that develops during the second half or pregnancy or up to six weeks after you deliver. About 10% of people will develop this during pregnancy. It’s more common in people with high blood pressure before pregnancy. After your baby is born, the complication will start to go away.
• Gestational diabetes: This happens when your pregnancy hormones make it hard for your metabolism to keep your blood sugar levels stable. You’ll have a glucose screening to detect diabetes during your pregnancy. Most people can keep their blood sugar levels under control with diet and exercise, but some need medication. The condition usually resolves once your baby is born.
• Preterm labor: Preterm (early) labor is when you go into labor before 37 weeks of pregnancy. This can cause your baby to be born at a low birth weight or with underdeveloped organs.
• Infections: Many viral and bacterial infections can complicate a pregnancy. These include urinary tract infections (UTIs), yeast infection, group B strep and bacterial vaginosis. Sexually transmitted infections (STIs) can also cause pregnancy complications. Certain infections can be passed to the fetus during pregnancy (TORCH infections).
• Vaginal bleeding: Heavy or excessive bleeding during pregnancy requires immediate care. Contact your provider if you notice bleeding at any time during pregnancy.
• Placenta previa or placenta accreta: Problems with the placenta can interfere with pregnancy, labor and delivery.
• Low amniotic fluid (oligohydramnios): Low amniotic fluid means the fetus is surrounded by less amniotic fluid than it should have for its age. This increases your risk for premature birth. It’s more common than polyhydramnios (too much amniotic fluid), which can also cause complications.
• Depression and anxiety: Extreme sadness or worry during pregnancy (or postpartum, after the baby’s born) can affect fetal development. Contact your provider right away if you have thoughts of harming the fetus or yourself.
• Anemia: Anemia’s when you don’t have enough red blood cells to carry oxygen throughout your body. It makes you feel tired and weak. It’s common in pregnancy because you need more red blood cells to carry oxygen to the fetus. Iron deficiency is a common cause of anemia. You can prevent iron deficiency by taking supplements or eating more iron-rich foods.

These are some of the more common complications of pregnancy, but there are many others. Talk to your pregnancy care provider about how you’re feeling at your prenatal appointments. Having honest conversations about your symptoms helps them detect potential problems. If you do experience a complication of pregnancy, your pregnancy care provider may recommend a maternal-fetal medicine specialist.

Who is at risk for pregnancy complications?

Anyone can be at risk for a complication during their pregnancy. Your risk is higher if you have a chronic medical condition or illness before pregnancy.

Some examples of health conditions or diseases that may cause complications during pregnancy are:

• Diabetes.
• Cancer.
• High blood pressure. Some people have high blood pressure (hypertension) before pregnancy, while other people develop it during pregnancy. High blood pressure during pregnancy can keep the placenta from getting enough blood.
• Sexually transmitted infections (STIs).
• Kidney problems.
• Epilepsy.
• Anemia.

Many medications used to treat chronic health conditions can safely be used in pregnancy. Some medications may need more frequent monitoring during pregnancy or changes in the dose. Please check with your healthcare provider before you stop or change any of your current medications.

Other factors that may increase your risk for pregnancy complications include:

• Being older than 35.
• Being younger than 20.
• Smoking cigarettes and drinking alcohol-containing beverages.
• Being pregnant with twins, triplets or more.
• Having a history of miscarriage.
• Having obesity.
• Having anorexia.

Can uterine fibroids cause pregnancy complications?

Uterine fibroids don’t usually cause problems during pregnancy. However, they can cause early labor or for the fetus to be in a breech position. A C-section may be safer if a fibroid is blocking your baby’s exit from your vagina during delivery.

Can birth control pills causes pregnancy complications?

There isn’t solid evidence that taking birth control pills during early pregnancy causes harm to the fetus. However, you should stop using all hormonal contraception as soon as you know you’re pregnant. If you suspect you’re pregnant, you should take a pregnancy test right away.

The reason data on this topic is limited is that medical researchers don’t typically conduct testing on pregnant people or fetuses. Testing how a pregnant person reacts to using hormonal birth control throughout the pregnancy puts the fetus at risk.

How do I prevent pregnancy complications?

While some pregnancy complications are out of your control, there are some things you can do to lower your risk for pregnancy complications. These include:

• Being healthy before pregnancy. This could involve better management of preexisting conditions, reaching a healthier weight, quitting smoking and more.
• Attending all your prenatal appointments, ultrasounds and tests.
• Reporting any troubling or unusual symptoms to your pregnancy care provider.
• Maintaining a healthy lifestyle throughout pregnancy by eating nutritious foods, getting regular exercise and not drinking alcohol or smoking cigarettes.
• Trying to reduce your stress levels and getting plenty of rest during pregnancy.
• Taking a prenatal vitamin. Don’t take any medications unless your pregnancy care provider gives you the OK.

What percentage of pregnancies have complications?

Most people don’t experience pregnancy complications. Studies suggest about 8% of pregnancies have complications that, if untreated, could harm you or the fetus.

What’s the most common complication with teen pregnancy?

Some conditions are more common in people who are pregnant before age 15. These include:

• Premature birth.
• Anemia.
• Pregnancy-induced hypertension (PIH) or toxemia.
• Cephalopelvic disproportion (your baby’s head is wider than the opening in your pelvis).

Research also suggests that infant mortality (death) is higher in teenage parents.

How many people die from pregnancy complications?

About 700 people die each year in the United States from complications of pregnancy. Many of these deaths are considered preventable if the complications are recognized and treated early.

The most common causes of pregnancy-related death are:

• Heart and cardiovascular conditions (including high blood pressure).
• Infection or sepsis.
• Excessive bleeding.
• Pulmonary embolism (PE).

Studies show that an increasing number of pregnant people in the U.S. have a chronic health condition like hypertension and diabetes before pregnancy. These conditions put you at higher risk of complications during pregnancy and in the first year postpartum. If you have a chronic health condition and are considering pregnancy, please schedule a pre-pregnancy visit to determine what steps you should take before conception.

When should I call my doctor?

It’s important to discuss all your symptoms with your provider during pregnancy. This is the only way they can diagnose and treat potential complications. Call your pregnancy care provider right away if you:

• Are bleeding heavily or leaking fluid from your vagina.
• Have a chronic and painful headache.
• Have sudden or severe swelling.
• Feel dizzy or have blurred vision.
• Have pain and cramping in your abdomen.
• Have fever, chills or vomiting.
• Feel the fetus move less than usual.

A note from Cleveland Clinic

Hearing you have a pregnancy complication can be scary. It’s normal to feel worried for the fetus’s health and your own health. Most pregnancy complications are treatable, especially when your pregnancy care provider detects them early. The best thing you can do is to attend all your prenatal appointments, ultrasounds and tests. Don’t be afraid to ask your provider questions about your diagnosis; they can put your mind at ease. Share your symptoms with them so they can give you the right care as soon as possible.

Dangerous Situations

What is the most dangerous pregnancy situation you have encountered?