Common Problems During Pregnancy

Common problems during pregnancy include pregnancy bleeding, gestational diabetes, and high blood pressure. We can help prepare you to know some of the signs.

Early Pregnancy Bleeding

If you bleed during early pregnancy, there are two things we worry about:

• Miscarriage which is more common
• Ectopic pregnancy which can be life threatening

However, just because you have bleeding early in pregnancy does not mean you automatically have one of these conditions. To know for sure, you will need to see your OB – usually several times – to receive the correct diagnosis and the care you need. Bleeding during early pregnancy can be just a scary situation and your pregnancy turns out fine. However, sadly, this is not always the case.

Miscarriage

A miscarriage is when a woman loses an early pregnancy. Sometimes a woman does not even know she was pregnant – her period might be a few days late and then she has a heavy flow. Other times she had a positive pregnancy test before miscarrying. Even though miscarrying can be daunting to think about, it’s important to be informed for both yourself and your loved ones.

Miscarriage occurs in about twenty percent or more of pregnancies for a variety of reasons. The reason most women miscarry is because the pregnancy did not develop correctly. This means, usually, there are too few or too many chromosomes. This is fundamental damage that does not allow the pregnancy to continue. If you’re concerned about miscarrying, definitely talk to your doctor and take the appropriate steps to avoid miscarrying such as maintaining a healthy lifestyle, seeking regular prenatal care, and avoiding known miscarriage risk factors (smoking, drinking alcohol, and illicit drug use).

Miscarriage is a relatively common experience but that doesn’t make it any easier. It can have a profound emotional impact, not only on the woman herself, but also on her partner, friends, and family. We are sad to give the diagnosis of miscarriage and grieve right along with you and your loved ones. Getting support from loved ones or professional counseling is often necessary in helping with the healing process. There are also many support groups online or at your local hospital.

The following are resources you may find helpful for your recovery process:

• H.E.A.R.T. Strings Support Group – Hope, Empathy, Alliance, Resources, and Teamwork
• Perinatal Bereavement of Palliative Care. Email them atnorthsidepnl@gmail.com or call them at 770.224.1817.

Ectopic Pregnancy

An ectopic pregnancy is when a pregnancy has not developed inside the uterus or womb but instead is located outside of the uterus. Ectopic pregnancy occurs in less than one percent of all pregnancies and is a serious diagnosis. The uterus or womb is the only place a pregnancy can grow into a healthy baby, and it can be life threatening.

The most common location for an ectopic pregnancy to implant is inside the fallopian tube. If the pregnancy implants anywhere other than the uterus, you will likely experience pain and internal bleeding. Heavy bleeding inside the abdomen is why an ectopic pregnancy is so dangerous.

Similar to miscarriage, there are no ways to completely prevent ectopic pregnancies, but it is possible to decrease the risk. This is possible through maintaining a healthy lifestyle, seeking regular prenatal care, and avoiding known risk factors such as smoking, drinking alcohol, and illicit drug use.

Potential Treatments for Miscarriage and Ectopic Pregnancy

Treatments for miscarriage and ectopic pregnancy can include medication, surgery, or simply close observation. Our recommendation will depend upon your symptoms, examinations, and medical history.

Bleeding Later in Pregnancy

The causes of bleeding later in pregnancy, usually after the 20^th week, are more varied than the causes of early pregnancy bleeding. It can be normal and a sign of labor if you are close to your due date. However, if you are not close, this can be dangerous to the health of your unborn baby.

*Overall, if you bleed during your pregnancy, seek immediate medical care.

High Blood Pressure

High blood pressure is another common problem during pregnancy. This condition goes by several names such as toxemia of pregnancy, gestational hypertension, or pre-eclampsia, and it can affect the health of your pregnancy.

There are times your blood pressure is supposed to go up, such as during exercising, but it shouldn’t be high during rest or most of the time. If your blood pressure is high all the time, the increased pressure can damage your organs such as your kidneys, eyes, and heart. High blood pressure during your pregnancy could damage your placenta as well, posing a problem for the pregnancy.

Most importantly, try not to stress. Fewer than ten percent of pregnant women develop high blood pressure, and we will monitor you closely at every visit.

Risk Factors of High Blood Pressure

Those most at risk for high blood pressure include:

• Teenagers
• Women over 35 years old
• Twin pregnancy
• Prior history of gestational hypertension
• Diabetes
• Hypertensives
• Obesity
• Kidney disease

Symptoms of High Blood Pressure During Pregnancy

If you experience the following symptoms, your blood pressure could be elevated:

• Swelling of the hands and face
• Headaches
• Changes in your vision, such as seeing spots
• Abdominal pain
• Sudden weight gain of more than two pounds a week

These warning signs can commonly occur during normal pregnancy too, so you’ll be evaluated on a regular basis at your appointments.

Management of High Blood Pressure During Pregnancy

There are several tests used to determine how to manage high blood pressure during pregnancy.

• Blood work will be used to evaluate your liver, kidney, and bone marrow
• Ultrasounds may be performed to evaluate your baby and your placenta
• A urine collection may be done over the span of 24 hours.

The only real cure for hypertension during pregnancy is the delivery of your baby. Our timing of when to recommend this will depend upon the severity of your symptoms and the gestational age of your baby. We are always weighing one against the other, trying to determine the best time to act.

In more serious cases, we may admit you to the hospital for closer observation.

Gestational Diabetes

Gestational diabetes is a type of diabetes that only occurs when blood sugar levels remain elevated in pregnant women. The condition usually subsides after pregnancy, but women who have had gestational diabetes are more likely to develop permanent diabetes later in life. It is a serious condition because it can lead to the birth of a large baby, which may mean a difficult vaginal birth or cesarean birth. Babies born to gestational diabetics are also prone to having low blood sugar levels and jaundice after birth, which can lead to permanent neurological problems.

Risk Factors of Gestational Diabetes

Some women are more likely to develop gestational diabetes, including those who:

• Have previously given birth to a large infant weighing nine pounds or more
• Are obese
• Have had stillborn babies
• Have a family history of diabetes

When and How is Gestational Diabetes Diagnosed?

Between the 24th and 28th week of pregnancy, you will come in for a glucose screening and glucose tolerance test. You will drink a beverage mixed with glucose, then we will test your sugar level an hour later. If you have elevated sugar levels, you will require further testing to determine if gestational diabetes exists.

Further testing involves drinking a beverage mixed with more glucose then taking more blood tests over three hours. If your blood sugar levels are elevated two out of four times in those three hours, you are diagnosed with gestational diabetes.

What Causes Gestational Diabetes?

Gestational diabetes occurs because of hormonal changes during pregnancy. Increased levels of certain hormones interfere with the body’s ability to manage blood sugar. This condition is known as insulin resistance, and as the placenta grows larger during pregnancy, it produces more hormones, thus increasing the resistance to insulin. If a pregnant woman’s pancreas is unable to produce more insulin to overcome the effects of additional hormones in the body, blood sugar levels will rise, resulting in gestational diabetes.

Treatments for Gestational Diabetes

For women who test positive for gestational diabetes, there are extra doctor visits and treatments required. The goal with treatments are to make sure your blood glucose levels remain at a normal level. The first treatment will be diet and exercise and checking your blood sugar levels daily.

Diet, Exercise and Checking Your Blood Sugar

Diet – A registered dietician will be able to help you limit the amount of carbohydrates you eat to control blood sugar, as well as outline a healthy eating regimen. On average, a healthy weight gain during pregnancy is between 25 and 35 pounds, and your obstetrician or midwife will work with your dietician to recommend ways to monitor your overall weight gain.

Exercise – Aim for two hours a week (or 30 minutes 5 times a week) of moderate exercise to help your body use insulin better and help control your blood sugar level. Low impact exercises, such as walking and swimming, are great options for pregnant women.

Checking blood sugar – Checking your blood sugar at home daily will help to make sure your level is within target range. Some women may require testing more than once a day, so it’s important to talk to your doctor about frequency during your routine prenatal visits.

Other Treatments

Insulin Shots – If your blood sugar levels are still too high after making changes in your diet and exercise routine, you may need insulin shots, which can lower your blood sugar without harming your baby. You can also ask your doctor about medications such as glyburide or metformin that help regulate blood sugar.

We’re Here to Help You During Your Pregnancy

We know there is a lot to monitor and keep track of during pregnancy. The best thing you can do to ease your stress is to seek routine prenatal medical care. We’re here to help and keep you and your baby healthy.

Request an appointment online or call us at 770.720.7733 to schedule an appointment in either our Woodstock or Canton location.