Pregnancy week by week

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Complications during pregnancy

 
 
 
Miscarriage

The loss of a baby can be very distressing. Sadly, as many as 20% of pregnancies end in miscarriage and often miscarriage occurs before a woman even knows she is pregnant. The reasons why are not clearly understood. Most miscarriages take place before 12 weeks of pregnancy; late miscarriages are rare. A miscarriage usually begins with vaginal bleeding, cramping or abdominal pain and severe back ache. Normally, during a pregnancy miscarriage, the body expels all the foetal tissue. However, if this does not happen, there are chances of an infection developing and this could be dangerous. Sometimes, a woman must undergo treatment to remove pregnancy tissue in the uterus.

If it happens to you, don’t blame yourself. It is unlikely that there was anything you did or didn’t do that would have caused it. Pregnancy after miscarriage is possible but it is advisable to start trying to conceive again only after two or three months, after giving the uterus adequate time to heal.

If you have had a miscarriage before it may be a while before you let yourself really enjoy this pregnancy. But most women who have had one or even two miscarriages go on to have a healthy baby next time. Remember, this baby is different and look forward to the future.



Ectopic pregnancy

An ectopic pregnancy is a complication in which the fertilized egg implants outside of the uterus, usually in the fallopian tube. It can occur in about one in every 80 pregnancies. It is important that ectopic pregnancy be diagnosed as soon as possible as it can be life threatening for the pregnant woman. Unfortunately, many women will experience very few symptoms in the early stages and can be mistaken for a period. Symptoms can be mild to severe abdominal pain usually on one side, feeling dizzy or faint, and vaginal bleeding.

In some cases, there may be natural miscarriage but if the embryo continues to grow it will eventually cause rupture of the fallopian tube. This will cause severe and dangerous internal bleeding and you will need urgent hospitalization. Emergency surgery or drug are used for treatment.

Ectopic pregnancy can be caused by an STD (sexually transmitted disease), such as Chlamydia, or an infection, such as pelvic inflammatory disease. Women who have been diagnosed with endometriosis or other female reproductive disorders are also at risk.



Pre-term labour

About 7% of babies are born prematurely. There are some known risk factors for premature babies like smoking, underweight mums, and twin pregnancies. Bleeding in early pregnancy can also be an indicator of the baby being born early. Some mothers go into labour early because of a vaginal infection, and occasionally the waters break early. So, be prepared!

There are several warning signs you should be aware of that include:

  • Persistent and rhythmic cramping in the lower belly.
     
  • Contractions that come more frequently than 4 in an hour.

  • Cramping accompanied by low backache.

  • Watery or bloody discharge or leaking.

If you are experiencing any of these or other uncomfortable or unusual symptoms be sure to contact your doctor immediately. Your doctor can often take steps to prevent delivery if premature labour is threatened. The longer your baby stays inside of you in most cases, the better her chances for survival.

If labour begins before 35 weeks, you may be given drugs to delay the birth while you are transferred to a hospital with a neonatal intensive care unit. You may also be given drugs which let your baby’s lungs reach greater maturity so that they are better prepared for breathing when your baby is born.

If your waters break and there are no contractions, you may be admitted to hospital for observation until your baby is old enough to be born or labour has to be induced. Labour may be induced if you develop a raised temperature, which is usually a sign of infection. If the baby is breech (bottom down) a caesarean section may be carried out.


Depending how premature your baby is, and whether or not he is poorly, he may need help with:

  • Temperature control-he will be put in an incubator
     
  • Fighting off infection- he will be given antibiotics via a drip

  • Breathing – he may be given oxygen via a mask or tube

  • Feeding- he may need to be fed via a tube passed through the nose or mouth into the stomach or a drip until strong enough to go to the breast or take a bottle.

The baby’s heartbeat, blood pressure, temperature and rate of breathing are constantly measured. Medical care staff will encourage you to give as much care to your premature baby as possible and show you what to do. Sick and premature babies need emotional as well as physical care.......and this is best given by parents.

Remember you need support, too! You may need the help of friends and relatives to get to and from hospital, and to sit with your baby while you take a break.



Pre-eclampsia

Pre eclampsia is a condition that some women experience during pregnancy after 20 week of their pregnancy. The initial symptoms are high blood pressure, protein in urine and fluid retention (oedema). There are a number of other symptoms that may be experienced as the condition progresses such as visual disturbances, severe headaches, abdominal pains, excessive weight gain, severe swelling of the hands, face and feet and vomiting.

Pre eclampsia can also cause growth problems for the growing foetus (also known as intra uterine growth retardation). This happens because inadequate supply of oxygen and nutrients to the baby as the blood supply to the placenta is disrupted.

Pre eclampsia is usually noticed by your doctor during regular ante natal appointments. You will have regular urine tests and blood pressure checks throughout your pregnancy to monitor your health. If you experience any of the symptoms that occur as pre eclampsia develop then you should seek immediate medical attention to ensure the well being of both you and your baby.

The only way to treat pre eclampsia is to actually have your baby so you will usually be monitored rather than treated until it is safe for you to give birth. If you reach 37 weeks then you may be induced. Before this then it is likely that you will have a caesarean section. If not diagnosed early, eclampsia may develop which results in seizures and which can be life threatening for both mother and baby.

Most women will make full recovery once they have given birth. If you baby is delivered early, he or she may have to be monitored in a neo natal unit.



Placenta praevia

Placenta praevia is a rare complication that few pregnant women might face during this time. In this condition, the placenta completely or partially blocks the opening of cervix inside of the uterus. It presents as painless vaginal bleeding during second or third trimester. Another uncommon condition is abruptio placenta where placenta separates from the uterine wall before delivery. Immediate abdominal pain, cramping, and vaginal bleeding are signs of the problem. If the separation is minor, bed rest is advised. However, in severe cases immediate hospitalization and early delivery of the baby is warranted.

If placenta previa is diagnosed after the 20th week of pregnancy, but with no bleeding, bed rest is advised. If there is light bleeding or bleeding stops, continued bed rest is resumed until baby is ready for delivery.  If bleeding doesn’t stop or if pre term labour starts, baby will have to be delivered by Caesarean section.

Most low-lying placentas found at the 20 week scan will change position by the time the baby is born. If your placenta covered the cervix at your 20 week scan, you will be offered another scan at 36 weeks to check if the placenta is still covering the neck of the womb, your baby will need to be born by caesarean section to prevent you having a serious bleed. If the placenta is close to the cervix but not covering it, your doctor may offer to check its position using ultrasound scans at 1-2 weekly intervals. If you start to bleed, you will need to go into hospital.



Gestational diabetes

When diabetes, or abnormally high blood sugar, occurs during pregnancy, it is called gestational diabetes. It usually develops during the second trimester. Women with gestational diabetes are at risk for complications, such as a very large babies, difficult labour and delivery, pre term labour,and still birth.

The treatment of gestational diabetes includes special diet and possibly insulin injections. The symptoms of gestational diabetes are extreme thirst, hunger, or fatigue. Many women have no symptoms therefore; checking for gestational diabetes is done as routine at around 24 weeks of pregnancy.



Hyperemesis gravidarum


This condition is an extreme form of morning sickness. There is severe persistent nausea and vomiting. This can result in poor appetite, weight loss, feeling faint and dehydration. Usually women with Hyperemesis gravidarum begin to feel better by the 20th week of pregnancy. But some women vomit and feel nauseated throughout all three trimesters. Dry bland foods and fluids together is the first line of treatment. Sometimes , medicines are prescribed to help nausea.

 

Infections


Here we give you some tips on how to protect yourself from infections during pregnancy.  There are several infections that could cause problems for you and your baby. The earlier in pregnancy you are infected, the more serious the complications can be for the baby.

1) Viral infections

Common viral infections that can affect your baby are Rubella, cytomegalovirus and parvovirus. They cause mild flu-like symptoms but can cause complications in the baby. Rubella can be prevented by immunization before pregnancy but check with your doctor if you come in contact with the illness during pregnancy. A test can be done to find out if you are already immune.

Hepatitis A and E can also complicate your pregnancy, especially hepatitis E which can cause serious complications. It’s best to avoid eating out and preparing fresh fruit juices at home rather than drinking outside.


2) Chickenpox

Most of us are immune to chickenpox as we already had it in our childhood. Chickenpox can be serious during pregnancy as the infection can be passed on to the baby and cause birth defects. If you get infected in the early stage of your pregnancy, there is less likelihood of passing the virus to your baby. However, between 36-40 weeks, the risk is higher of you passing it on to your baby. You may need to take an injection of anti-viral drugs.

If you catch the infection close to the birth or shortly afterwards, it can be very serious and your baby will need an injection of immunoglobulin. Although it may not stop him getting it, it will reduce the risk of more serious complications.  . If your baby is born with chickenpox he will also need an anti-viral injection that will help him get better more quickly.


3) Bacterial infections such as listeriosis, typhoid and salmonella

Listeria bacteria may be found in pre-cooked chilled foods, ready-to-eat chicken. You may only experience mild, flu-like illness, but your baby is more at risk. Salmonella bacteria may be found in raw eggs, raw meat and chicken. You may have loose motions, fever and abdominal cramps, which put your unborn baby at risk.


4) Parasite infection such as toxoplasmosis

The parasite eggs, which cause the infection, can be found in undercooked meat, cat and dog poo and garden soil.

You can follow these guidelines to keep yourself safe:

  • Always wash your hands before preparing food
     
  • Wash fresh fruits and all vegetables thoroughly

  • Wash all salads thoroughly

  • Heat through any ready meals till they are piping hot

  • Avoid eating out

  • Always wash your hands with soap and water after doing the gardening

  • Thoroughly cook meat, chicken and fish

  • Avoid eating raw or half-boiled eggs

  • If you have a medical condition like hypertension, anaemia, diabetes or your previous babies were light in weight, consult your doctor about any supplements or diet you might need.

5) Group B strep

Some women carry Group B Strep (GBS) bacteria in their vagina- you may not even know it, as the bacteria don’t usually cause problems or symptoms. However, if your baby catches the infection, he could become seriously ill. About 0.1% of babies born each year develop the infection and sadly it causes around 100 of them to die. Your baby is more likely to develop a GBS infection if:

  • You have previously had a baby infected with GBS
     
  • You go into labour before 37 weeks of pregnancy

  • Your water breaks before 37 weeks with or without other signs of labour

  • Your water breaks more than 18 to 24 hours before you have your baby

  • You have a raised temperature during labour

  • GBS has been found in your urine during this pregnancy

If GBS is found in your urine, it will be treated. In labour you may be given intravenous antibiotics from the start of your labour until your baby is born, to prevent infections in your baby.

Urine infection can be another common problem during pregnancy. If you experience pain while passing urine or have an unusual discharge from vagina, or are suffering from lower back pain then consult your doctor for advice.
 

 



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