Most pregnancies are without complications but this is not the norm. Complication can risk the health of mother, foetus or both. This is the reason why antenatal checkups are always recommended by obstetricians everywhere so that the complication is diagnosed early and managed appropriately.
Blood pressure above systolic > 140mmHg and / or diastolic > 90mmHg diagnosed any time during pregnancy. This is associated with higher risk of many other complications such as premature birth, low birth weight (IUGR), antepartum haemorrhage, still birth.
Patient with high blood pressure must observe for warning signs blurring of vision, severe headache not even releaved by paracetamol, right side upper abdominal / epigastric pain, abnormal body movements.
It is therefore very important to control blood pressure in pregnancy through medications.
Anemia is a condition in which number of red blood cells or haemoglobin concentration with in the body is lower than normal WHO anemia classification in pregnancy
mild anemia 9-10.9g/dl
moderate anemia 7-8.9g/dl
severe anemia <7gm
Having anemia in pregnancy can make you feel tired, weak and pale all the time. National Iron Plus Initiative recommends iron folic acid (IFA) supplimentation of 100mg elemental iron and 500mcg of folic acid every day for at least 100 days starting after the first trimester at 14-16 weeks of gestation for all non-anemic pregnant women followed by same dose for 100days post partum.
Hormonal changes from pregnancy can cause the body to not make enough insulin, or if it does then it is not used efficiently with the lack of insulin the glucose builds up in the blood which cause diabetes or high blood sugar.
On 75gm OGTT test value of 140-199mg is diagnosed as gestational diabetes and value > 200mg is diagnosed as overt diabetes.
Controlling gestational diabetes is important as it can lead to high blood pressure, IUGR, large infant which increases the risk for caesarean delivery.
ICP is the most common liver disease of pregnancy. It is a reversible cholestatic disease presenting typically in the second and third trimester of pregnancy and is characterized by itching of the palms and soles, elevated serum aminotransferases and / or elevated serum bile acid levels (>=10micromol/l) with spontaneous relief of laboratory abnormalities and symptoms promptly after delivery but no later than one month post partum.
ICP is relatively benign to women, but it is reported to have important fetal implications.
ICP has been found to be associated with increased risk of preterm delivery, meconium staining of amniotic fluid, fetal bradycardia, respiratory distress and fetal demise.
So the itching of hand and palm or sudden onset of itching all over the body any time in second and third trimester should not be ignored and must be reported to your obstetrician at the earliest.
Many infections such as bacterial, viral, parasitic and sexually transmitted infection can occur during pregnancy and may lead to complications. These infection can pass from mother to infant during delivery or from the mother to the foetus during pregnancy. It can contribute to miscarriage, low birth weight, birth defects, still birth, and maternal health complication, if not treated in time.
When labour begins before 37 weeks of pregnancy, it is called preterm labour. It can lead to complications as brain and lungs, might not be fully developed .
Miscarriage is loss of pregnancy during the first 20 weeks of pregnancy. Approximately 10% of all pregnancy ends up in miscarriage and 90% of miscarriage occur before 16 weeks. Sign if miscarriage include vaginal bleeding, fluid or tissue passing per vaginum and cramping.
Still birth is the loss of pregnancy after 20 week of pregnancy. Infections, maternal health issues, problems with placenta and chromosomal abnormalities can contribute to still birth.
Placenta previa:- Placenta is an organ that develops in the uterus during pregnancy and provides oxygen and nutrients to the growing baby along with removing waste from its blood.
Placenta previa is a condition in which placenta partially or wholly covers the opening between the uterus and vagina (cervix). The main symptom of placenta previa is vaginal bleeding without any pain or cramp. Visiting your doctor immediately is strongly recommended in such a condition.
Placental abruption:- A serious pregnancy complication in which the placenta detaches from the womb (uterus). The condition can deprive the baby of oxygen and nutrients. symptoms include vaginal bleeding, abdominal pain and back pain mainly in the last 12 weeks of pregnancy Patient must contact the treating doctor immediately.
Although complications can not be prevented, regular health check ups and prenatal care can help in strengthening the health of both the mother and the child.
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MBBS, MS (Obstetrics & Gynaecology)