Complications of pregnancy are health problems that are related to or arise during
pregnancy
Pregnancy is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins.
Conception (biology), Conception usually occurs ...
. Complications that occur primarily during
childbirth
Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy, where one or more Fetus, fetuses exits the Womb, internal environment of the mother via vaginal delivery or caesarean section and becomes a newborn to ...
are termed
obstetric labor complications, and problems that occur primarily after childbirth are termed
puerperal disorders. While some complications improve or are fully resolved after pregnancy, some may lead to lasting effects, morbidity, or in the most severe cases, maternal or fetal mortality.
Common complications of pregnancy include
anemia
Anemia (also spelt anaemia in British English) is a blood disorder in which the blood has a reduced ability to carry oxygen. This can be due to a lower than normal number of red blood cells, a reduction in the amount of hemoglobin availabl ...
,
gestational diabetes, infections,
gestational hypertension
Gestational hypertension or pregnancy-induced hypertension (PIH) is the development of new hypertension in a pregnant woman after 20 weeks of gestation without the presence of protein in the urine or other signs of pre-eclampsia. Gestational hype ...
, and
pre-eclampsia
Pre-eclampsia is a multi-system disorder specific to pregnancy, characterized by the new onset of hypertension, high blood pressure and often a significant amount of proteinuria, protein in the urine or by the new onset of high blood pressure a ...
.
Presence of these types of complications can have implications on monitoring lab work, imaging, and medical management during pregnancy.
Severe complications of pregnancy, childbirth, and the
puerperium are present in 1.6% of mothers in the US, and in 1.5% of mothers in Canada. In the immediate postpartum period (puerperium), 87% to 94% of women report at least one health problem.
Long-term health problems (persisting after six months postpartum) are reported by 31% of women.
In 2016, complications of pregnancy, childbirth, and the puerperium resulted in 230,600 deaths globally, down from 377,000 deaths in 1990. The most common causes of maternal mortality are
maternal bleeding,
postpartum infections including sepsis,
hypertensive diseases of pregnancy,
obstructed labor
Obstructed labour, also known as labour dystocia, is the baby not exiting the pelvis because it is physically blocked during childbirth although the uterus contracts normally. Complications for the baby include Perinatal asphyxia, not getting e ...
, and unsafe
abortion
Abortion is the early termination of a pregnancy by removal or expulsion of an embryo or fetus. Abortions that occur without intervention are known as miscarriages or "spontaneous abortions", and occur in roughly 30–40% of all pregnan ...
.
Complications of pregnancy can sometimes arise from abnormally severe presentations of
symptoms and discomforts of pregnancy, which usually do not significantly interfere with
activities of daily living
Activities of daily living (ADLs) is a term used in healthcare to refer to an individual's daily self-care activities. Health professionals often use a person's ability or inability to perform ADLs as a measure of their Performance status, functi ...
or pose any significant threat to the health of the birthing person or fetus. For example,
morning sickness is a fairly common mild symptom of pregnancy that generally resolves in the second trimester, but
hyperemesis gravidarum is a severe form of this symptom that sometimes requires medical intervention to prevent
electrolyte imbalance from severe vomiting.
Maternal problems
The following problems originate in the mother, however, they may have serious consequences for the fetus as well.
Gestational diabetes
Gestational diabetes is when a woman, without a previous diagnosis of
diabetes
Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...
, develops
high blood sugar levels during
pregnancy
Pregnancy is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins.
Conception (biology), Conception usually occurs ...
.
There are many non-modifiable and modifiable risk factors that lead to the development of this complication. Non-modifiable risk factors include a family history of diabetes, advanced maternal age, and ethnicity. Modifiable risk factors include maternal obesity.
There is an elevated demand for
insulin
Insulin (, from Latin ''insula'', 'island') is a peptide hormone produced by beta cells of the pancreatic islets encoded in humans by the insulin (''INS)'' gene. It is the main Anabolism, anabolic hormone of the body. It regulates the metabol ...
during pregnancy which leads to increased insulin production from
pancreatic beta cell
Beta cells (β-cells) are specialized endocrine cells located within the pancreatic islets of Langerhans responsible for the production and release of insulin and amylin. Constituting ~50–70% of cells in human islets, beta cells play a vi ...
s. The elevated demand results from increased maternal calorie intake, weight gain, and increased prolactin and growth hormone production. Gestational diabetes increases the risk for further maternal and fetal complications such as the development of pre-eclampsia, the need for cesarean delivery, preterm delivery, polyhydramnios, macrosomia, shoulder dystocia, fetal hypoglycemia, hyperbilirubinemia, and admission into the neonatal intensive care unit. The increased risk is correlated with how well the gestational diabetes is controlled during pregnancy, with poor control associated with worsened outcomes. A multidisciplinary approach is used to treat gestational diabetes. It involves monitoring blood-glucose levels, nutritional and dietary modifications, lifestyle changes such as increasing physical activity, maternal
weight management, and medication such as insulin.
Hyperemesis gravidarum
Hyperemesis gravidarum is the presence of severe and persistent vomiting, causing dehydration and weight loss. It is similar, although more severe than the common
morning sickness.
It is estimated to affect 0.3–3.6% of pregnant women and is the greatest contributor to hospitalizations under 20 weeks of gestation. Most often, nausea and vomiting symptoms during pregnancy are resolved in the first trimester; however, some continue to experience symptoms. Hyperemesis gravidarum is diagnosed by the following criteria: greater than 3 vomiting episodes per day, ketonuria, and weight loss of more than 3 kg or 5% of body weight. Several non-modifiable and modifiable risk factors predispose women to the development of this condition, such as a female fetus, psychiatric illness history, high or low BMI pre-pregnancy, young age, African American or Asian ethnicity, type I diabetes, multiple pregnancies, and a history of pregnancy affected by hyperemesis gravidarum. There are currently no known mechanisms for the cause of this condition. This complication can cause nutritional deficiency, low pregnancy weight gain, dehydration, and vitamin, electrolyte, and acid-based disturbances in the mother. It has been shown to cause low birth weight, small size for gestational age, preterm birth, and poor APGAR scores in the infant. Treatments for this condition focus on preventing harm to the fetus while improving symptoms and commonly include fluid replacement and consumption of small, frequent, bland meals. First-line treatments include ginger and acupuncture. Second-line treatments include vitamin B
6 +/- doxylamine, antihistamines, dopamine antagonists, and serotonin antagonists. Third-line treatments include corticosteroids, transdermal clonidine, and gabapentin. Treatments chosen are dependent on the severity of symptoms and response to therapies.
Pelvic girdle pain
Pelvic girdle pain (PGP) disorder is
pain
Pain is a distressing feeling often caused by intense or damaging Stimulus (physiology), stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sense, sensory and emotional experience associated with, or res ...
in the area between the posterior iliac crest and gluteal fold, beginning
peri or postpartum caused by instability and limitation of mobility. It is associated with
pubic symphysis pain and sometimes radiation of pain down the hips and thighs. For most pregnant individuals, PGP resolves within three months following delivery, but for some, it can last for years, resulting in a reduced tolerance for weight-bearing activities. PGP affects around 45% of individuals during pregnancy: 25% report serious pain, and 8% are severely disabled.
Risk factors for complication development include multiparity, increased BMI, physically strenuous work, smoking, distress, history of back and pelvic trauma, and previous history of pelvic and lower back pain. This syndrome results from a growing uterus during pregnancy that causes increased stress on the lumbar and pelvic regions of the mother, thereby resulting in postural changes and reduced lumbopelvic muscle strength, leading to pelvic instability and pain. It is unclear whether specific hormones in pregnancy are associated with complication development. PGP can result in poor quality of life, predisposition to chronic pain syndrome, extended leave from work, and
psychosocial distress. Many treatment options are available based on symptom severity. Non-invasive treatment options include activity modification, pelvic support garments, analgesia with or without short periods of bed rest, and physiotherapy to increase the strength of gluteal and adductor muscles, reducing stress on the lumbar spine. Invasive surgical management is considered a last-line treatment if all other treatment modalities have failed and symptoms are severe.
High blood pressure
Potential severe hypertensive states of pregnancy are mainly:
*
Pre-eclampsia
Pre-eclampsia is a multi-system disorder specific to pregnancy, characterized by the new onset of hypertension, high blood pressure and often a significant amount of proteinuria, protein in the urine or by the new onset of high blood pressure a ...
– gestational hypertension,
proteinuria
Proteinuria is the presence of excess proteins in the urine. In healthy persons, urine contains very little protein, less than 150 mg/day; an excess is suggestive of illness. Excess protein in the urine often causes the urine to become fo ...
(>300 mg), and
edema
Edema (American English), also spelled oedema (British English), and also known as fluid retention, swelling, dropsy and hydropsy, is the build-up of fluid in the body's tissue (biology), tissue. Most commonly, the legs or arms are affected. S ...
. Severe pre-eclampsia involves a BP over 160/110 (with additional signs). It affects 5–8% of pregnancies.
*
Eclampsia
Eclampsia is the onset of seizures (convulsions) in a pregnant woman with pre-eclampsia. Pre-eclampsia is a hypertensive disorder of pregnancy that presents with three main features: new onset of high blood pressure, large amounts of proteinuria ...
– seizures in a pre-eclamptic patient, affecting around 1.4% of pregnancies.
*
Gestational hypertension
Gestational hypertension or pregnancy-induced hypertension (PIH) is the development of new hypertension in a pregnant woman after 20 weeks of gestation without the presence of protein in the urine or other signs of pre-eclampsia. Gestational hype ...
can develop after 20 weeks but has no other symptoms and may resolve itself, but it can develop into pre-eclampsia.
*
HELLP syndrome –
Hemolytic anemia, elevated
liver enzymes and a
low platelet count. Incidence is reported as 0.5–0.9% of all pregnancies.
*
Acute fatty liver of pregnancy is sometimes included in the pre-eclamptic spectrum. It occurs in approximately one in 7,000 to one in 15,000 pregnancies.
Women who have chronic hypertension before their pregnancy are at increased risk of complications such as
premature birth
Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is betwee ...
,
low birthweight, or
stillbirth
Stillbirth is typically defined as fetus, fetal death at or after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without vital signs, signs of life. A stillbirth can often result in the feeling of guilt (emotio ...
. Women who have high blood pressure and had complications in their pregnancy have three times the risk of developing
cardiovascular disease
Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina, heart attack), heart failure, hypertensive heart disease, rheumati ...
compared to women with normal blood pressure who had no complications in pregnancy. Monitoring pregnant women's blood pressure can help prevent both complications and future cardiovascular diseases.
Venous thromboembolism
Venous thromboembolism
Venous thrombosis is the blockage of a vein caused by a thrombus (blood clot). A common form of venous thrombosis is deep vein thrombosis (DVT), when a blood clot forms in the deep veins. If a thrombus breaks off ( embolizes) and flows to the lun ...
, consisting of
deep vein thrombosis
Deep vein thrombosis (DVT) is a type of venous thrombosis involving the formation of a blood clot in a deep vein, most commonly in the legs or pelvis. A minority of DVTs occur in the arms. Symptoms can include pain, swelling, redness, and enl ...
and
pulmonary embolism
Pulmonary embolism (PE) is a blockage of an pulmonary artery, artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream (embolism). Symptoms of a PE may include dyspnea, shortness of breath, chest pain ...
, is a major risk factor for postpartum morbidity and mortality, especially in highly developed countries. A combination of pregnancy-exacerbated hypercoagulability and additional risk factors such as obesity and thrombophilias makes pregnant women vulnerable to thrombotic events The prophylactic measures that include the usage of low molecular weight heparin can significantly reduce risks associated with surgery, particularly in high-risk patients. Awareness among healthcare givers and prompt response in early identification and management of venous thromboembolism during pregnancy and the postpartum period are both crucial for prompt response. Deep vein thrombosis, a form of venous thromboembolism, has an incidence of 0.5 to 7 per 1,000 pregnancies, and is the second most common cause of
maternal death in developed countries after bleeding.
[Venös tromboembolism (VTE) – Guidelines for treatment in C counties. Bengt Wahlström, Emergency department, Uppsala Academic Hospital. January 2008]
* ''Caused by'':
Pregnancy-induced hypercoagulability as a physiological response in preparation for the potential bleeding during
childbirth
Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy, where one or more Fetus, fetuses exits the Womb, internal environment of the mother via vaginal delivery or caesarean section and becomes a newborn to ...
.
[
* ''Treatment'': Prophylactic treatment, e.g., with ]low molecular weight heparin
Low-molecular-weight heparin (LMWH) is a class of anticoagulant medications. They are used in the prevention of Thrombosis prevention, blood clots and, in the treatment of venous thromboembolism (deep vein thrombosis and pulmonary embolism), and ...
may be indicated when additional risk factors for deep vein thrombosis are present.[
]
Anemia
Anemia is a globally recognized pregnancy complication and is a condition with a low hemoglobin level in one of the trimesters. Such physiological modifications are more pronounced among individuals who suffer from undernutrition as well as chronic diseases associated with hemoglobin rehoming, like sickle cell anemia. Prevention of anemia during pregnancy is complicated and is often treated by a team effort of dietary supplementation, iron therapy, and continuous assessment of mother and fetal indices in a multidisciplinary approach. As an additional measure, emphasis is placed on the astute determination of the respective triggering points, and the application of optimal prenatal care to better maternal and fetal outcome.
Levels of hemoglobin
Hemoglobin (haemoglobin, Hb or Hgb) is a protein containing iron that facilitates the transportation of oxygen in red blood cells. Almost all vertebrates contain hemoglobin, with the sole exception of the fish family Channichthyidae. Hemoglobin ...
are lower in the third trimester. According to the United Nations
The United Nations (UN) is the Earth, global intergovernmental organization established by the signing of the Charter of the United Nations, UN Charter on 26 June 1945 with the stated purpose of maintaining international peace and internationa ...
(UN) estimates, approximately half of pregnant individuals develop anemia worldwide. Approximately half of pregnant women experience iron deficiency with or without anemia. Anemia prevalence during pregnancy differed from 18% in developed countries to 75% in South Asia; culminating to a global rate of 38% of pregnancies worldwide.
Treatment varies due to the severity of the anaemia, and can be used by increasing iron-containing foods, oral iron tablets, or by the use of parenteral iron.
Infection
Pregnancy is a critical period for the expectant mom to experience additional dangers associated with infections. Moreover, a mother and baby's health is exposed to danger when she is in this condition. The prenatal physiology complexity and immunity modulation inherently increase the risk of influenza
Influenza, commonly known as the flu, is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue. These sympto ...
, hepatitis E, and cytomegalovirus transmission. Avoidance actions like vaccines and strict infectious control protocols can be given priority in the policies aimed at limiting the risk of transmission among high-risk populations. In addition, early diagnosis and management of maternal infections are among the main methods to prevent vertical transmission and fetal aberrations.
A pregnant woman is more susceptible to certain infection
An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...
s. This increased risk is caused by an increased immune tolerance in pregnancy to prevent an immune reaction against the fetus, as well as secondary to maternal physiological changes including a decrease in respiratory volumes and urinary stasis due to an enlarging uterus. Pregnant individuals are more severely affected by, for example, influenza
Influenza, commonly known as the flu, is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue. These sympto ...
, hepatitis E, herpes simplex
Herpes simplex, often known simply as herpes, is a viral disease, viral infection caused by the herpes simplex virus. Herpes infections are categorized by the area of the body that is infected. The two major types of herpes are Cold sore, ora ...
and malaria
Malaria is a Mosquito-borne disease, mosquito-borne infectious disease that affects vertebrates and ''Anopheles'' mosquitoes. Human malaria causes Signs and symptoms, symptoms that typically include fever, Fatigue (medical), fatigue, vomitin ...
. The evidence is more limited for coccidioidomycosis
Coccidioidomycosis (, ) is a mammalian mycosis, fungal disease caused by ''Coccidioides immitis'' or ''Coccidioides posadasii''. It is commonly known as cocci, Valley fever, California fever, desert rheumatism, or San Joaquin Valley fever. Cocci ...
, measles
Measles (probably from Middle Dutch or Middle High German ''masel(e)'', meaning "blemish, blood blister") is a highly contagious, Vaccine-preventable diseases, vaccine-preventable infectious disease caused by Measles morbillivirus, measles v ...
, smallpox
Smallpox was an infectious disease caused by Variola virus (often called Smallpox virus), which belongs to the genus '' Orthopoxvirus''. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (W ...
, and varicella. Mastitis
Mastitis is inflammation of the breast or udder, usually associated with breastfeeding. Symptoms typically include local pain and redness. There is often an associated fever and general soreness. Onset is typically fairly rapid and usually occ ...
, or inflammation of the breast, occurs in 20% of lactating individuals.
Some infections are vertically transmissible, meaning that they can affect the child as well.
Peripartum cardiomyopathy
Peripartum cardiomyopathy is a heart failure caused by a decrease in left ventricular ejection fraction (LVEF) to <45%, which occurs towards the end of pregnancy or a few months postpartum. Symptoms include shortness of breath in various positions and/or with exertion, fatigue, pedal edema, and chest tightness. Risk factors associated with the development of this complication include maternal age over 30 years, multi-gestational pregnancy, family history of cardiomyopathy, previous diagnosis of cardiomyopathy, pre-eclampsia
Pre-eclampsia is a multi-system disorder specific to pregnancy, characterized by the new onset of hypertension, high blood pressure and often a significant amount of proteinuria, protein in the urine or by the new onset of high blood pressure a ...
, hypertension
Hypertension, also known as high blood pressure, is a Chronic condition, long-term Disease, medical condition in which the blood pressure in the artery, arteries is persistently elevated. High blood pressure usually does not cause symptoms i ...
, and African ancestry. The pathogenesis of peripartum cardiomyopathy is not yet known, however, it is suggested that multifactorial potential causes could include autoimmune processes, viral myocarditis, nutritional deficiencies, and maximal cardiovascular changes, which increase cardiac preload. Peripartum cardiomyopathy can lead to many complications such as cardiopulmonary arrest, pulmonary edema
Pulmonary edema (British English: oedema), also known as pulmonary congestion, is excessive fluid accumulation in the tissue or air spaces (usually alveoli) of the lungs. This leads to impaired gas exchange, most often leading to shortness ...
, thromboembolisms, brain injury, and death. Treatment of this condition is very similar to treatment of non-gravid heart failure patients, however, the safety of the fetus must be prioritized. For example, for anticoagulation due to increased risk for thromboembolism, low molecular weight heparin, which is safe for use during pregnancy, is used instead of warfarin, which crosses the placenta.
Hypothyroidism
Hypothyroidism
Hypothyroidism is an endocrine disease in which the thyroid gland does not produce enough thyroid hormones. It can cause a number of symptoms, such as cold intolerance, poor ability to tolerate cold, fatigue, extreme fatigue, muscle aches, co ...
(commonly caused by Hashimoto's disease) is an autoimmune disease that affects the thyroid by causing low thyroid hormone levels. Symptoms of hypothyroidism can include low energy, cold intolerance, muscle cramps, constipation, and memory and concentration problems. It is diagnosed by the presence of elevated levels of thyroid stimulation hormone or TSH. Patients with elevated TSH and decreased levels of free thyroxine or T4 are considered to have overt hypothyroidism. Those with elevated TSH and normal levels of free T4 are considered to have subclinical hypothyroidism. Risk factors for developing hypothyroidism during pregnancy include iodine deficiency, history of thyroid disease, visible goiter, hypothyroidism symptoms, family history of thyroid disease, history of type 1 diabetes or autoimmune conditions, and history of infertility or fetal loss. Various hormones during pregnancy affect the thyroid and increase thyroid hormone demand. For example, during pregnancy, there is increased urinary iodine excretion as well as increased thyroxine binding globulin and thyroid hormone degradation, which all increase thyroid hormone demands. This condition can have a profound effect on the mother and fetus during pregnancy. The infant may be seriously affected and have a variety of birth defects. Complications in the mother and fetus can include pre-eclampsia, anemia, miscarriage, low birth weight, stillbirth, congestive heart failure
Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome caused by an impairment in the heart's ability to fill with and pump blood.
Although symptoms vary based on which side of the heart is affected, HF typically pr ...
, impaired neurointellectual development, and, if severe, congenital iodine deficiency syndrome. This complication is treated by iodine supplementation, levothyroxine, which is a form of thyroid hormone replacement, and close monitoring of thyroid function.
Acute fatty liver of pregnancy
Acute fatty liver of pregnancy (ALFP) is a rare but serious complication of pregnancy that can result in extensive morbidity or mortality to the mother and fetus. AFLP happens when fat builds up inside the liver. It is thought to be caused by build up of fat cells within the micro vesicular of live cells due to mitochondrial dysfunction in fat break down (fatty acid β-oxidation). This can prevent the liver from working functioning normally, however its exact mechanism is not clearly understood. Diagnosis is supported by abnormal ultrasound findings of the liver or microvascular fatty infiltration of biopsy of the liver. AFLP may cause symptoms of excessive fatigue, vomiting, stomach pain, or jaundice. Individuals may also have low blood sugar, trouble thinking clearly, or bleeding problems.
Summary of signs and symptoms
* Vomiting
* Abdominal pain
* Excessive thirst/urination
* Encephalopathy
AFLP is a medical emergency and requires urgent delivery. Children of mothers with ALFP be at risk of low blood sugar, dilated cardiomyopathy, neuromyopathy and sudden infant death syndrome.
Swansea Criteria for the diagnosis of AFLP. The presence of ≥6 abnormal variables had positive predictive value of 85% and negative predictive value of 100 percent for finding microvascular steatosis:
AFLP can lead to acute liver failure. Acute liver failure is a medical emergency and prompt recognition and treatment with dialysis, delivery and other supportive measures have showed to decrease risk of both maternal and fetal complications.
Fetal and placental problems
The following problems occur in the fetus or placenta
The placenta (: placentas or placentae) is a temporary embryonic and later fetal organ that begins developing from the blastocyst shortly after implantation. It plays critical roles in facilitating nutrient, gas, and waste exchange between ...
, but may have serious consequences on the mother as well.
Ectopic pregnancy
Ectopic pregnancy is implantation of the embryo outside the uterus. This form of complicated pregnancy, which is an implantation of a normally fertilized egg at any spot other than the uterus, involves operation failure, which can cause life-threatening conditions. However, the underlying reasons for this are not exactly known. This phenomenon is often accompanied by Pelvic inflammatory disease (PID), or salpingectomy
Salpingectomy refers to the surgical removal of a fallopian tube. This may be done to treat an ectopic pregnancy or cancer, to prevent cancer, or as a form of contraception.
This procedure is now sometimes preferred over its ovarian tube-sparin ...
(surgery).
* ''Caused by'': Unknown, but risk factors include smoking
Smoking is a practice in which a substance is combusted, and the resulting smoke is typically inhaled to be tasted and absorbed into the bloodstream of a person. Most commonly, the substance used is the dried leaves of the tobacco plant, whi ...
, advanced maternal age, and prior surgery or trauma to the fallopian tube
The fallopian tubes, also known as uterine tubes, oviducts or salpinges (: salpinx), are paired tubular sex organs in the human female body that stretch from the Ovary, ovaries to the uterus. The fallopian tubes are part of the female reproduct ...
s.
* Risk factors include untreated pelvic inflammatory disease, likely due to fallopian tube scarring.
* ''Treatment:'' In most cases, keyhole surgery must be carried out to remove the fetus, along with the fallopian tube. If the pregnancy is very early, it may resolve on its own, or it can be treated with methotrexate
Methotrexate, formerly known as amethopterin, is a chemotherapy agent and immunosuppressive drug, immune-system suppressant. It is used to treat cancer, autoimmune diseases, and ectopic pregnancy, ectopic pregnancies. Types of cancers it is u ...
, an abortifacient
An abortifacient ("that which will cause a miscarriage" from Latin: '' abortus'' "miscarriage" and '' faciens'' "making") is a substance that induces abortion. This is a nonspecific term which may refer to any number of substances or medications, ...
.
Miscarriage
Miscarriage
Miscarriage, also known in medical terms as a spontaneous abortion, is an end to pregnancy resulting in the loss and expulsion of an embryo or fetus from the womb before it can fetal viability, survive independently. Miscarriage before 6 weeks ...
is the loss of a pregnancy before 20 weeks. In the UK, miscarriage is defined as the loss of a pregnancy during the first 23 weeks. Comprehensive support, consists of the consultation of the genomics as well as the provision of the medical or surgical operations required. The psychological relevance of family members, relatives, and friends to the bereaved ones is also crucial. The most effective tools that can be used to minimize the psychological implications of the mourners include autopsy and bereavement counseling.
Approximately 80% of pregnancy loss occurs in the first trimester, with a decrease in risk after 12 weeks of gestation. Some variables, such as the mother's being older or chromosomal abnormalities, possess a higher likelihood of causing multiple miscarriages. Spontaneous abortions can be further categorized into complete, inevitable, missed, and threatened abortions:
* Complete: Vaginal bleeding occurs followed by the complete passing of conception products through the cervix.
* Inevitable: Vaginal bleeding occurs; the cervical os is closed indicating that conception products will pass soon.
* Missed: Vaginal bleeding occurs and some products of conception may have passed through the cervix; the cervical os is closed and ultrasound shows a nonviable fetus and remaining products of conception.
* Threatened: Vaginal bleeding occurs; the cervical os is closed and ultrasound shows a viable fetus.
Stillbirth
Stillbirth
Stillbirth is typically defined as fetus, fetal death at or after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without vital signs, signs of life. A stillbirth can often result in the feeling of guilt (emotio ...
is defined as fetal loss or death after 20 weeks of gestation. Early stillbirth is between 20 and 27 weeks gestation, while late stillbirth is between 28 and 36 weeks of gestation. A term stillbirth is when the fetus dies 37 weeks and above. This phenomenon can go beyond grief and can lead to worries about strange maternal feelings or postpartum treatment regarding complications of childbirth. Such parents would require more than empathy; generally, adequate medical programs should be considered for parents having such unbearable grief. Along with psychiatric help, counseling
Counseling is the professional guidance of the individual by utilizing psychological methods especially in collecting case history data, using various techniques of the personal interview, and testing interests and aptitudes.
This is a list of c ...
, and peer support
Peer support occurs when people provide knowledge, experience, emotional, social or practical help to each other. It commonly refers to an initiative consisting of trained supporters (although it can be provided by peers without training), and can ...
, which should be useful in the process of assisting parents who have lost their children.
* Epidemiology: There are over 2 million stillbirths a year and there are about 6 stillbirths per 1000 births (0.6%)
* Clinical presentation: Fetal behavioral changes like decreased movements or a loss in fetal sensation may indicate stillbirth, but the presentation can vary greatly.
* Risk factors: Maternal weight, age, and smoking, as well as pre-existing maternal diabetes or hypertension
* Treatment: If fetal passing occurs before labor, treatment options include induced labor or cesarean section. Otherwise, stillbirths can pass with a natural birth.
Placental abruption
Placental abruption defined as the separation of the placenta from the uterus before delivery, is a major cause of third trimester vaginal bleeding and complicates about 1% of pregnancies. Symptomatic presentations are variable: Some women can entirely ignore the symptoms, while others have mild bleeding or abdominal discomfort and pain. Hence, though symptom severity variance and precipitous placental separation are not relevant, they can still cause the diagnosis and clinical management to be complicated.
Several contributors may result in placental abruption. This includes: pre-existing maternal factors (e.g., smoking
Smoking is a practice in which a substance is combusted, and the resulting smoke is typically inhaled to be tasted and absorbed into the bloodstream of a person. Most commonly, the substance used is the dried leaves of the tobacco plant, whi ...
, hypertension
Hypertension, also known as high blood pressure, is a Chronic condition, long-term Disease, medical condition in which the blood pressure in the artery, arteries is persistently elevated. High blood pressure usually does not cause symptoms i ...
, advanced age), as well as pregnancy-related factors such a
multiple pregnancies
or the presence of in-utero infections. Identifying risk factors beforehand to take steps and make quick reactions to minimize the likelihood of unfavorable outcomes for the mother or the fetus is essential. The therapy techniques for placental rupture are based on the fetal gestation age and the status of both the mother and the baby. Instant delivery should be medically warranted for full-term babies (36 weeks or more) and in case of distress. Milder cases with immature embryos are monitored closely, and any necessary intervention is done in time after careful observation.
Preventive measures, which include pre-conception counseling to deal with the modifiable risk factors, can significantly reduce incidents of placental abruption. Knowing the long-term impacts on the mother and the baby after giving birth is essential. Continuous research and evidence-based approaches help in providing management that works. Collaboration between healthcare providers and patients is the core of the outcomes of placenta abruption.
* Clinical Presentation: Varies widely from asymptomatic to vaginal bleeding and abdominal pain.
* Risk factors: Prior abruption, smoking, trauma, cocaine use, multifetal gestation, hypertension, preeclampsia, thrombophilias, advanced maternal age, preterm premature rupture of membranes, intrauterine infections, and hydramnios.
* Treatment: Immediate delivery
Delivery may refer to:
Biology and medicine
*Childbirth
*Drug delivery
*Gene delivery
Business and law
*Delivery (commerce), of goods, e.g.:
**Pizza delivery
** Milk delivery
** Food delivery
** Online grocer
*Deed ("delivery" in contract law), a ...
if the fetus is mature (36 weeks or older), or if a younger fetus or the mother is in distress. In less severe cases with immature fetuses, the situation may be monitored in the hospital, with treatment if necessary.
Placenta previa
Placenta previa is a condition that occurs when the placenta fully or partially covers the cervix. Placenta previa can be further categorized into complete previa, partial previa, marginal previa, and low-lying placenta, depending on the degree to which the placenta covers the internal cervical os. Placenta previa is primarily diagnosed by ultrasound, either during a routine examination or following an episode of abnormal vaginal bleeding, often in the second trimester of pregnancy. Most placenta previa cases are diagnosed during the second trimester.
Treatments are adapted according to their severity and the mother's state of health, from strict monitoring to cesarean section.
* Risk Factors: prior cesarean delivery, pregnancy termination, intrauterine surgery, smoking, multifetal gestation, increasing parity, maternal age.
Placenta Accreta
Placenta accreta is an abnormal adherence of the placenta to the uterine wall. Specifically, placenta accreta involves abnormal adherence of the placental trophoblast to the uterine myometrium.
Placenta accreta risk factors include placenta previa, abnormally elevated second-trimester AFP and free β-hCG levels, and advanced gestational parent age, specifically over the age of 35. Furthermore, prior cesarean delivery is one of the most common risk factors for placenta accreta due to the presence of a uterine scar leading to abnormal decidualization of the placenta.
Due to abnormal adherence of the placenta to the uterine wall, cesarean delivery is often indicated, as well as cesarean hysterectomy.
Umbilical Cord Prolapse
Umbilical cord prolapses is a rare and dangerous pregnancy complication that can result in significant adverse outcomes for the mother and fetus. Umbilical cord prolapse is defined by the displacement of the umbilical cord beyond the cervical os before the fetus during labor or delivery. The can lead to compression of the umbilical cord and result in low levels of oxygen being delivered to the fetus which can result in fetal morbidity and mortality.
Several risk factors for umbilical cord prolapse have been identified include maternal age greater than 35 years, multiple prior pregnancies, fetal presentations in which the fetal head is no oriented towards the mother's pelvis during delivery, pre0term labor (<37 weeks gestation), low birth weight, excess amniotic fluid, multiple gestation pregnancy and male sex of the newborn.
Umbilical cord prolapse may result in either severe or complete sudden oxygen deprivation, or a gradual lack of oxygen, each causing distinct effects on the newborn. Umbilical cord prolapse is an obstetrical emergency that requires prompt delivery of the fetus. Caesarean section is the most common method, however a vaginal or assisted delivery may be considered if it can be performed more rapidly.
Several approaches can be used help relieve umbilical cord compression until a cesarean section is performed. These include administering short-acting tocolytic agents, placing the patient in the Trendelenburg or knee-chest position, elevating the buttocks, and filling the maternal bladder.
Multiple pregnancies
Multiple birth
A multiple birth is the culmination of a multiple pregnancy, wherein the mother gives birth to two or more babies. A term most applicable to vertebrate species, multiple births occur in most kinds of mammals, with varying frequencies. Such births ...
s may become monochorionic, sharing the same chorion
The chorion is the outermost fetal membrane around the embryo in mammals, birds and reptiles (amniotes). It is also present around the embryo of other animals, like insects and molluscs.
Structure
In humans and other therian mammals, the cho ...
, with resultant risk of twin-to-twin transfusion syndrome. Monochorionic multiples may even become monoamniotic, sharing the same amniotic sac
The amniotic sac, also called the bag of waters or the membranes, is the sac in which the embryo and later fetus develops in amniotes. It is a thin but tough transparent pair of biological membrane, membranes that hold a developing embryo (and l ...
, resulting in risk of umbilical cord compression and entanglement. In very rare cases, there may be conjoined twins
Conjoined twins, popularly referred to as Siamese twins, are twins joined '' in utero''. It is a very rare phenomenon, estimated to occur in anywhere between one in 50,000 births to one in 200,000 births, with a somewhat higher incidence in south ...
, possibly impairing the function of internal organs. Control of multiple pregnancies, such as special prenatal care and birth plans, can help in the control of placenta accreta. Moreover, early detection and response to the health problems arising from multiple pregnancies can help both the expectant parents and medical care providers deal with this particular aspect of reproductive health consciously.
Mother-to-child transmission
Since the embryo and fetus have little or no immune function, they depend on the immune function of their mother. Several pathogen
In biology, a pathogen (, "suffering", "passion" and , "producer of"), in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a Germ theory of d ...
s can cross the placenta
The placenta (: placentas or placentae) is a temporary embryonic and later fetal organ that begins developing from the blastocyst shortly after implantation. It plays critical roles in facilitating nutrient, gas, and waste exchange between ...
and cause (perinatal) infection. Often, microorganism
A microorganism, or microbe, is an organism of microscopic scale, microscopic size, which may exist in its unicellular organism, single-celled form or as a Colony (biology)#Microbial colonies, colony of cells. The possible existence of unseen ...
s that produce minor illness
A disease is a particular abnormal condition that adversely affects the structure or function (biology), function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical condi ...
es in the mother are very dangerous for the developing embryo or fetus. This can result in spontaneous abortion or major developmental disorder
Developmental disorders comprise a group of psychiatric conditions originating in childhood that involve serious impairment in different areas. There are several ways of using this term. The most narrow concept is used in the category "Specific D ...
s. For many infections, the baby is more at risk at particular stages of pregnancy. Problems related to perinatal infection are not always directly noticeable.
The term TORCH complex refers to a set of several different infections that may be caused by transplacental infection:
* T - Toxoplasmosis
Toxoplasmosis is a parasitic disease caused by ''Toxoplasma gondii'', an apicomplexan. Infections with toxoplasmosis are associated with a variety of neuropsychiatric and behavioral conditions. Occasionally, people may have a few weeks or month ...
* O - other infections (i.e., Parvovirus B19, Coxsackievirus
Coxsackieviruses are a few related enteroviruses that belong to the ''Picornaviridae'' family of viral envelope, nonenveloped, linear, positive-sense single-stranded RNA viruses, as well as its genus ''Enterovirus'', which also includes poliovi ...
, Chickenpox
Chickenpox, also known as varicella ( ), is a highly contagious disease caused by varicella zoster virus (VZV), a member of the herpesvirus family. The disease results in a characteristic skin rash that forms small, itchy blisters, which ...
, Chlamydia
Chlamydia, or more specifically a chlamydia infection, is a sexually transmitted infection caused by the bacterium ''Chlamydia trachomatis''. Most people who are infected have no symptoms. When symptoms do appear, they may occur only several w ...
, HIV, HTLV, syphilis
Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms depend on the stage it presents: primary, secondary, latent syphilis, latent or tertiary. The prim ...
, and Zika virus
Zika virus (ZIKV; pronounced or ) is a member of the virus family ''Flaviviridae''. It is spread by daytime-active ''Aedes'' mosquitoes, such as '' A. aegypti'' and '' A. albopictus''. Its name comes from the Ziika Forest of Uganda, where ...
)
* R - Rubella
Rubella, also known as German measles or three-day measles, is an infection caused by the rubella virus. This disease is often mild, with half of people not realizing that they are infected. A rash may start around two weeks after exposure and ...
* C - Cytomegalovirus
''Cytomegalovirus'' (CMV) (from ''cyto-'' 'cell' via Greek - 'container' + 'big, megalo-' + -''virus'' via Latin 'poison') is a genus of viruses in the order '' Herpesvirales'', in the family '' Herpesviridae'', in the subfamily '' Betaherp ...
* H - Herpes Simplex Virus (HSV)
Babies can also become infected by their mother during birth
Birth is the act or process of bearing or bringing forth offspring, also referred to in technical contexts as parturition. In mammals, the process is initiated by hormones which cause the muscular walls of the uterus to contract, expelling the f ...
. During birth, babies are exposed to maternal blood
Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells.
Blood is com ...
and body fluid
Body fluids, bodily fluids, or biofluids, sometimes body liquids, are liquids within the Body (biology), body of an organism. In lean healthy adult men, the total body water is about 60% (60–67%) of the total Human body weight, body weight; it ...
s without the placental barrier intervening and to the maternal genital tract. Because of this, blood-borne microorganisms (hepatitis B
Hepatitis B is an infectious disease caused by the '' hepatitis B virus'' (HBV) that affects the liver; it is a type of viral hepatitis. It can cause both acute and chronic infection.
Many people have no symptoms during an initial infection. ...
, HIV), organisms associated with sexually transmitted disease
A sexually transmitted infection (STI), also referred to as a sexually transmitted disease (STD) and the older term venereal disease (VD), is an infection that is spread by sexual activity, especially vaginal intercourse, anal sex, or ...
(e.g., gonorrhoea and chlamydia
Chlamydia, or more specifically a chlamydia infection, is a sexually transmitted infection caused by the bacterium ''Chlamydia trachomatis''. Most people who are infected have no symptoms. When symptoms do appear, they may occur only several w ...
), and normal fauna
Fauna (: faunae or faunas) is all of the animal life present in a particular region or time. The corresponding terms for plants and fungi are ''flora'' and '' funga'', respectively. Flora, fauna, funga and other forms of life are collectively ...
of the genito-urinary tract (e.g., ''Candida'') are among those commonly seen in infection of newborns. Furthermore, vaccination, commitment to safe birth practices, and prenatal screening and treatment of infections are also strategic measures that can help reduce the risk of newborn infections.
General risk factors
Factors increasing the risk (to either the pregnant individual, the fetus/es, or both) of pregnancy complications beyond the normal level of risk may be present in the pregnant individual's medical profile either before they become pregnant or during the pregnancy. These pre-existing factors may related to the individual's genetics, physical or mental health, their environment and social issues, or a combination of those.
Biological
Some common biological risk factors include:
* Age of either parent
** Adolescent parents: Young mothers are at an increased risk of developing certain complications, including preterm birth and low infant birth weight.
** Older parents: As they age, both mothers
A mother is the female parent of a child. A woman may be considered a mother by virtue of having given birth, by raising a child who may or may not be her biological offspring, or by supplying her ovum for fertilisation in the case of gestat ...
and fathers
A father is the male parent of a child. Besides the paternal bonds of a father to his children, the father may have a parental, legal, and social relationship with the child that carries with it certain rights and obligations. A biological fathe ...
are at an increased risk for complications in the fetus and during pregnancy and childbirth. Complications for those 45 or older include increased risk of primary Caesarean delivery (i.e. C-section).
* Height
Height is measure of vertical distance, either vertical extent (how "tall" something or someone is) or vertical position (how "high" a point is). For an example of vertical extent, "This basketball player is 7 foot 1 inches in height." For an e ...
: Pregnancy in individuals whose height is less than 1.5 meters (5 feet) correlates with a higher incidence of preterm birth
Preterm birth, also known as premature birth, is the Childbirth, birth of a baby at fewer than 37 weeks Gestational age (obstetrics), gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 ...
and underweight babies. Also, these individuals are more likely to have a small pelvis
The pelvis (: pelves or pelvises) is the lower part of an Anatomy, anatomical Trunk (anatomy), trunk, between the human abdomen, abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also c ...
, which can result in such complications during childbirth as shoulder dystocia.
* Weight
In science and engineering, the weight of an object is a quantity associated with the gravitational force exerted on the object by other objects in its environment, although there is some variation and debate as to the exact definition.
Some sta ...
** Low weight: Individuals whose pre-pregnancy weight is less than 45.5 kilograms (100 pounds) are more likely to have underweight babies.
** High weight: Obese individuals are more likely to have very large babies, potentially increasing difficulties in childbirth
Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy, where one or more Fetus, fetuses exits the Womb, internal environment of the mother via vaginal delivery or caesarean section and becomes a newborn to ...
. Obesity also increases the chances of developing gestational diabetes, high blood pressure
Hypertension, also known as high blood pressure, is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms itself. It is, however, a major ri ...
, preeclampsia, experiencing postterm pregnancy
Postterm pregnancy is when a woman has not yet delivered her baby after 42 weeks of gestation, two weeks beyond the typical 40-week duration of pregnancy. Postmature births carry risks for both the mother and the baby, including fetal malnutrition, ...
and requiring a cesarean delivery.
* Pre-existing disease in pregnancy, or an acquired disease: A disease and condition not necessarily directly caused by the pregnancy.
** Diabetes mellitus in pregnancy
** Lupus in pregnancy
** Thyroid disease in pregnancy
* Risks arising from previous pregnancies: Complications experienced during a previous pregnancy are more likely to recur.
** Multiple pregnancies: Individuals who have had more than five previous pregnancies face increased risks of rapid labor and excessive bleeding after delivery.
** Multiple gestation (having more than one fetus in a single pregnancy): These individuals have an increased risk of mislocated placenta.
Environmental
Some common environmental risk factors during pregnancy include:
* Exposure to environmental toxins
** Ionizing radiation
Ionizing (ionising) radiation, including Radioactive decay, nuclear radiation, consists of subatomic particles or electromagnetic waves that have enough energy per individual photon or particle to ionization, ionize atoms or molecules by detaching ...
* Exposure to recreational drugs
Recreation is an activity of leisure, leisure being discretionary time. The "need to do something for recreation" is an essential element of human biology and psychology. Recreational activities are often done for enjoyment, amusement, or plea ...
** Alcohol: Use during pregnancy can cause fetal alcohol syndrome and fetal alcohol spectrum disorder
Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person who is exposed to alcohol during gestation. FASD affects 1 in 20 Americans, but is highly misdiagnosed and underdiagnosed.
The several forms of the ...
.
** Tobacco use: During pregnancy, causes twice the risk of premature rupture of membranes, placental abruption and placenta previa. Also, it increases the odds of the baby being born prematurely by 30%.
** Prenatal cocaine exposure: Associated with premature birth
Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is betwee ...
, birth defect
A birth defect is an abnormal condition that is present at birth, regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can range from mild to severe. Birth de ...
s and attention deficit disorder
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by symptoms of inattention, hyperactivity, impulsivity, and emotional dysregulation that are excessive and pervasive, impairing in multiple con ...
.
** Prenatal methamphetamine exposure: Can cause premature birth
Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is betwee ...
and congenital abnormalities
A birth defect is an abnormal condition that is present at birth, regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can range from mild to severe. Birth de ...
. Other investigations have revealed short-term neonatal outcomes to include small deficits in infant neurobehavioral function and growth restriction when compared to control infants. Also, prenatal methamphetamine use is believed to have long-term effects in terms of brain development, which may last for many years.
** Cannabis
''Cannabis'' () is a genus of flowering plants in the family Cannabaceae that is widely accepted as being indigenous to and originating from the continent of Asia. However, the number of species is disputed, with as many as three species be ...
: Possibly associated with adverse effects on the child later in life.
* Social and socioeconomic
Economics () is a behavioral science that studies the Production (economics), production, distribution (economics), distribution, and Consumption (economics), consumption of goods and services.
Economics focuses on the behaviour and interac ...
factors: Generally speaking, unmarried individuals and those in lower socioeconomic groups experience an increased level of risk in pregnancy, due at least in part to lack of access to appropriate prenatal care
Prenatal care, also known as antenatal care, is a type of preventive healthcare for pregnant individuals. It is provided in the form of medical checkups and healthy lifestyle recommendations for the pregnant person. Antenatal care also consists of ...
.
* Unintended pregnancy
Unintended pregnancies are pregnancies that are mistimed or unwanted at the time of conception, also known as unplanned pregnancies.
Sexual activity without the use of effective contraception through choice or coercion is the predominant caus ...
: Unintended pregnancies preclude preconception care and delay prenatal care. They preclude other preventive care, may disrupt life plans, and, on average, have worse health and psychological outcomes for the mother and, if birth occurs, the child.
* Exposure to pharmaceutical drugs: Certain anti-depressants
Antidepressants are a class of medications used to treat major depressive disorder, anxiety disorders, chronic pain, and addiction.
Common side effects of antidepressants include dry mouth, weight gain, dizziness, headaches, akathisia, sex ...
may increase risks of preterm delivery.
* Stress
** An elevated level of stress during pregnancy leads to notorious pregnancy outcomes, including preterm birth
Preterm birth, also known as premature birth, is the Childbirth, birth of a baby at fewer than 37 weeks Gestational age (obstetrics), gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 ...
, low birth weight, and mental health problems for the mother.
** Prolonged effects of chronic stressors such as discrimination, intimate partner violence, housing issues, and poverty lead to widespread maternal health issues and adverse pregnancy outcomes.
*Culture
Culture ( ) is a concept that encompasses the social behavior, institutions, and Social norm, norms found in human societies, as well as the knowledge, beliefs, arts, laws, Social norm, customs, capabilities, Attitude (psychology), attitudes ...
**Cultural norms, convictions, and traditions connected to pregnancy and childbirth lead people to establish perceptions, habits, and treatment-seeking. Cultural determinants affect the assessment of prenatal care utilization, childbirth practice, dietary habits, and reproductive health beliefs, which are direct outcomes of pregnancy and health situations.
High-risk pregnancy
Some disorders and conditions can mean that pregnancy is considered high-risk (about 6-8% of pregnancies in the USA) and, in extreme cases, may be contraindicated
In medicine, a contraindication is a condition (a situation or factor) that serves as a reason not to take a certain medical treatment due to the harm that it would cause the patient. Contraindication is the opposite of indication, which is a rea ...
. High-risk pregnancies are the main focus of doctors specialising in maternal-fetal medicine. Serious pre-existing disorders which can reduce a woman's physical ability to survive pregnancy include a range of congenital defects (that is, conditions with which the woman herself was born, for example, those of the heart
The heart is a muscular Organ (biology), organ found in humans and other animals. This organ pumps blood through the blood vessels. The heart and blood vessels together make the circulatory system. The pumped blood carries oxygen and nutrie ...
or reproductive organs, some of which are listed above) and diseases acquired at any time during the woman's life.
List of complications (complete)
Obstetric complications are those complications that develop during pregnancy. A woman may develop an infection, syndrome, or complication that is not unique to pregnancy and that may have existed before pregnancy. Pregnancy often is complicated by preexisting and concurrent conditions. Though these pre-existing and concurrent conditions may have a great impact on pregnancy, they are not included in the following list.
* Chromosome abnormalities
* Ectopic pregnancy
* Mendelian disorders
* Spontaneous abortion
* Nonmedelian disorders
* Oligohydramnios
Oligohydramnios is a medical condition in pregnancy characterized by a deficiency of amniotic fluid, the fluid that surrounds the fetus in the abdomen, in the amniotic sac. The limiting case is anhydramnios, where there is a complete absence of ...
* Hydramnios
* Abnormal labor and delivery
* Chorioamnionitis
* Shoulder dystocia
* Breech delivery
* Prior Cesarean delivery
* Uterine rupture
* Hysterectomy
Hysterectomy is the surgical removal of the uterus and cervix. Supracervical hysterectomy refers to removal of the uterus while the cervix is spared. These procedures may also involve removal of the ovaries (oophorectomy), fallopian tubes ( salpi ...
after delivery
* Postpartum infection
* Postpartum depression
* Septic pelvic thrombosis
* Hypertension
Hypertension, also known as high blood pressure, is a Chronic condition, long-term Disease, medical condition in which the blood pressure in the artery, arteries is persistently elevated. High blood pressure usually does not cause symptoms i ...
* Preeclampsia
* Eclampsia
Eclampsia is the onset of seizures (convulsions) in a pregnant woman with pre-eclampsia. Pre-eclampsia is a hypertensive disorder of pregnancy that presents with three main features: new onset of high blood pressure, large amounts of proteinuria ...
* Placental abruption
* Placenta previa
* Fetal-to-mother hemorrhage
* Rh disease
* Amniotic fluid embolism
An amniotic fluid embolism (AFE) is a life-threatening childbirth ( obstetric) emergency in which amniotic fluid enters the blood stream of the mother, triggering a serious reaction which results in cardiorespiratory (heart and lung) collapse a ...
* Delayed delivery
* Fetal death
* Incontinence
* Preterm birth
Preterm birth, also known as premature birth, is the Childbirth, birth of a baby at fewer than 37 weeks Gestational age (obstetrics), gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 ...
* Neonatal infection
* Low birth-weight infant
* Premature rupture of membranes
* Incompetent cervix
* Posterm infant
* Fetal growth restriction
* Macrosomia
Large for gestational age (LGA) is a term used to describe infants that are born with an abnormally high weight, specifically in the 90th percentile or above, compared to other babies of the same developmental age. Macrosomia is a similar term tha ...
* Twin pregnancy
* Triplets
A multiple birth is the culmination of a multiple pregnancy, wherein the mother gives birth to two or more babies. A term most applicable to vertebrate species, multiple births occur in most kinds of mammals, with varying frequencies. Such births ...
and more
* Seizures
A seizure is a sudden, brief disruption of brain activity caused by abnormal, excessive, or synchronous neuronal firing. Depending on the regions of the brain involved, seizures can lead to changes in movement, sensation, behavior, awareness, o ...
* Gestational trophoblastic disease
* Gestational diabetes
* Hyperemesis gravidarum
* Pelvic girdle pain
* HELLP syndrome
* Acute fatty liver of pregnancy
* Deep vein thrombosis
Deep vein thrombosis (DVT) is a type of venous thrombosis involving the formation of a blood clot in a deep vein, most commonly in the legs or pelvis. A minority of DVTs occur in the arms. Symptoms can include pain, swelling, redness, and enl ...
* Pregnancy-induced hypercoagulability
* Immune tolerance in pregnancy
* Mastitis
Mastitis is inflammation of the breast or udder, usually associated with breastfeeding. Symptoms typically include local pain and redness. There is often an associated fever and general soreness. Onset is typically fairly rapid and usually occ ...
* Peripartum cardiomyopathy
* Vertically transmitted infection
A vertically transmitted infection is an infection caused by pathogenic bacteria or viruses that use mother-to-child transmission, that is, transmission directly from the mother to an embryo, fetus, or baby during pregnancy or childbirth. It ...
* Postpartum bleeding
* Perineal tear
* Fetal alcohol spectrum disorder
Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person who is exposed to alcohol during gestation. FASD affects 1 in 20 Americans, but is highly misdiagnosed and underdiagnosed.
The several forms of the ...
* Thyroid disease in pregnancy
* Pruritic urticarial papules and plaques of pregnancy
* Intrahepatic cholestasis of pregnancy
* Gestational pemphigoid
* Prurigo gestationis
* Lupus
* Cephalopelvic disproportion
* Stillbirth
Stillbirth is typically defined as fetus, fetal death at or after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without vital signs, signs of life. A stillbirth can often result in the feeling of guilt (emotio ...
* Molar pregnancy
* Obstetric fistula
Obstetric fistula is a medical condition in which a hole develops in the birth canal as a result of childbirth. This can be between the vagina and rectum, ureter, or bladder. It can result in incontinence of urine or feces. Complications may ...
* Uterine incarceration
* Twin to Twin transfusion syndrome[
* Gestational trophoblastic disease
* Antiphospholipid antibody syndrome
* Hyperemesis gravidarum
* Acute fatty liver of pregnancy
* Gestational diabetes
* Hemoglobinopathies
* Postpartum thyroiditis
* Postpartum depression
* ]Hyperpigmentation
Hyperpigmentation, also known as the dark spots or circles on the skin, is the darkening of an area of Human skin, skin or nail (anatomy), nails caused by increased melanin.
Causes
Hyperpigmentation can be caused by sun damage, inflammation, or ...
* Hair
Hair is a protein filament that grows from follicles found in the dermis. Hair is one of the defining characteristics of mammals.
The human body, apart from areas of glabrous skin, is covered in follicles which produce thick terminal and ...
growth changes
* Herpes gestationitis
* Pruritic urticarial papaules of pregnancy
* Abnormality of maternal pelvic organs
* Postpartum acute renal failure[
* Postpartum nephritis][
* Haemorrhoids in pregnancy][
* Obstetric embolism][
* Pregnancy-related peripheral neuritis][
* Obstetrical tetanus][
* Unicornuate uterus
* Maternal death][
* Arcuate uterus
]
See also
* List of obstetric topics
* Dermatoses of pregnancy
* Thyroid disease in pregnancy
* Reproductive Health Supplies Coalition
References
Further reading
*
External links
Maternal mortality
World Health Organization.
{{Authority control
*
Women's health
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