Watch for these warning signs
Call your physician right away if you experience any of the following symptoms during pregnancy.
- Severe headache
- Blurred vision or “seeing spots”
- Severe stomach pain or menstrual-like cramps, with or without nausea or diarrhea
- Significant swelling in your face, hands or ankles
- Sudden weight gain (more than three pounds a week in the second trimester or two pounds a week in the third)
- Vaginal bleeding or change in vaginal discharge
- A flow of liquid from the vagina (anything from a gush to a trickle)
- Regular contractions
- Noticeable decrease or cessation of fetal movement (after the fifth month)
Pregnancy is a joyful time, full of expectations, wishes and excitement. But if complications arise, pregnancy can be an anxious time as well. In this short article, we’ll tell you about some potentially serious conditions that can develop during pregnancy. Knowing more about them will help you be a partner in your obstetric care.
During pregnancy, hormones produced by the placenta can affect the body’s ability to use insulin, leading to high blood-sugar levels. This form of diabetes usually goes away after the baby is born.
Any pregnant woman can get gestational diabetes. Symptoms include unusual thirst and frequent voiding of large amounts of urine. A blood test for diabetes is routinely done between 26 and 28 weeks of pregnancy.
What happens if gestational diabetes does occur? The condition makes it more likely that other complications, such as preeclampsia and preterm labor (see below), will also develop. And because excess blood sugar crosses the placenta and reaches the fetus, it’s more likely the fetus will grow very large, making delivery difficult or even dangerous. The risk of birth defects also rises.
Fortunately, gestational diabetes can usually be well controlled with the mother’s help. Often all that’s needed is regular exercise and a special diet. In more serious cases, insulin may be needed. More tests may be needed than in the average pregnancy, including home monitoring of blood sugar levels. After it’s born, the baby may need extra time in the hospital to be watched for temporary problems.
Like diabetes, hypertension—high blood pressure—sometimes occurs as a result of pregnancy, in which case it usually clears up after the baby is born. And like gestational diabetes, hypertension related to pregnancy varies from mild to severe.
Your blood pressure will be checked at each prenatal visit, but you should be on the lookout for these signs of a significant rise in blood pressure: severe swelling of the hands, face or ankles and sudden weight gain—more than three pounds a week in the second trimester or two pounds a week in the third.
When blood pressure rises significantly during pregnancy, the condition is called pre-eclampsia. If it were to go untreated, the risks would be grave. They include growth problems, mental retardation or even death for the fetus and organ damage for the mother. In rare, severe cases, preeclampsia progresses to eclampsia, causing seizures and threatening the lives of both mother and fetus. But preeclampsia can generally be well controlled if it’s detected early—which shows the importance of not missing prenatal visits. Bed rest and medication may be needed.
Premature rupture of the membranes
Called PROM for short, this condition occurs in one out of 10 pregnancies. The membranes that hold the amniotic fluid break before labor begins, causing fluid to leak or gush from the vagina. Amniotic fluid continues to be produced, but without the protection of the membranes, the fetus is at risk for infection. To minimize that risk, the woman with PROM needs to be watched carefully. Often this is best done in the hospital. Eighty-five percent of mothers with PROM go into labor within a week.
When the membranes break before the 37th week of pregnancy, the condition is called preterm PROM. Every effort is made to keep the pregnancy going if the fetus isn’t mature enough to survive outside the womb. If the fetal lungs are tested and found to be mature enough, then delivery is often best.
Pregnancy normally lasts 40 weeks. When a woman’s labor begins before the start of the 37th week, it’s called premature labor. It can happen to anyone, although women with one or more recognized factors are at increased risk. These factors include being a smoker, having a low-lying placenta, being younger than 17 or older than 35 and carrying twins. In women at high risk, labor can sometimes be postponed by bed rest, restricted physical activity and careful monitoring.
Symptoms of preterm labor include vaginal discharge (change in type or amount), pressure or tightening in the pelvis or abdomen, dull ache in the lower back, cramps and regular contractions. If you have these symptoms, call your doctor right away. Labor can be stopped only if it’s diagnosed early, before the cervix has dilated and thinned out. Hospitalization may be needed, along with tocolytic drugs, which halt uterine contractions.
The longer a baby can be kept in the uterus prior to 37 weeks’ gestation, the better for its health. Every day counts. If labor can’t be halted and a baby is born early, the chances of its ending up healthy are still excellent in most cases. But the baby may have to spend an extended time in the hospital before going home.
Review the warning signs of pregnancy complications listed on the page at left, and don’t hesitate to call your doctor if you have concerns.