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Pregnancy and postnatal complications

A pregnant woman has her blood pressure checked by her doctorSometimes, a pregnancy doesn’t go a smoothly as planned and complications arise.

When this happens, your healthcare provider will be there to provide you with additional care, information and support.

However, it is always helpful to have some additional resources to hand and so we’ve detailed some pregnancy complications below. Some of these are very rare, but we feel it is important to arm yourself with knowledge so that you may know when things are not as they should be. It is also important to attend all the appointments with your healthcare provider and have all the antenatal screening tests done – that way potential problems can be identified and treated as early as possible.

As always, if you have any questions relating to your pregnancy you should consult your health care professional.

Anaemia

During pregnancy, the volume of blood in a woman’s body increases and she will have more red blood cells than when not pregnant. The red blood cells need iron as part of the process used to carry oxygen around the body. If you have insufficient iron in the body, anaemia results.

Symptoms include:

  • fatigue
  • pale complexion
  • pale under fingernails
  • dark rings under the eyes
  • dizzy spells
  • feeling anxious

Your iron levels will be tested as part of routine blood tests during your pregnancy.

Being anaemic can lead to a greater blood loss than usual during birth and a reduced ability to fight infection, which is particularly important if you need to have a c-section.

Anaemia can be treated by eating a diet rich in iron – red meat (not liver), sardines, dried apricots, baked beans, spinach and other leafy green vegetables, wholemeal bread and iron-fortified cereals to name a few. The absorption of iron is enhanced if taken with vitamin c – so a tomato sauce with your steak or a glass of orange juice with your beans-on-toast. Your healthcare provider may also prescribe supplements. Beware, however, as an excess of iron (usually from tablets rather than from dietary iron) can lead to constipation (characterised by a darkening and hardening of stools) and you should only take iron tablets on the advice of your healthcare provider.

Gestational Diabetes

Diabetes is a condition where the body can’t control blood sugar effectively because of incorrect insulin production.

Gestational Diabetes is a specific form of diabetes that occurs during pregnancy and usually disappears once the baby is born. It is most common in women with a family history of Type 2 Diabetes, older or overweight women and some ethnic groups. If you have gestational diabetes for one pregnancy, you are more likely to have it in subsequent pregnancies.

Gestational Diabetes is usually detected by a ‘Glucose Test’ at approximately 26 weeks. During the test you will be asked to drink a glucose drink; your blood is taken an hour after that and the sugar levels analysed. If your sugar levels are in the ‘danger zone’, you will be asked back for further, more conclusive tests.

Most people manage gestational diabetes through a low GI diet and exercise – your healthcare providers will give you much more information in this regard. A small percentage of women will require insulin injections. The baby isn’t unduly affected, although the higher levels of blood sugar being pumped to the baby can result in larger babies, who are often born a week or two before due dates. The baby’s blood sugar levels will be tested after birth to check for any abnormalities, but this is rare.

To reduce your risk of gestational diabetes, keep fit and healthy during your pregnancy by regular pregnancy exercise and a healthy diet.

READ: Find out more about gestational diabetes and how it can be managed

Hashimoto Hypothyroid Postpartum

Hashimoto Hypothyriod Postpartum (HHP) is a condition of the thyroid that can occur after pregnancy.

In HHP, the white blood cells (which are part of the immune system and usually fight infections and ‘foreign’ bodies), start to attack the thyroid. Once the baby has been born, the woman can become hyperthyroid (have an overactive thyroid) and loose weight quickly, the thyroid then becomes hypothyroid (underactive), resulting in symptoms such as tiredness, sleepy in the mornings, hair loss, brittle nails, depression, anxiety and difficulty losing weight, amongst others. As you can see, these are symptoms that many, non HHP new-mums suffer from, and so the diagnosis can be missed. However, a simple blood test can confirm the condition. If it is not picked up, complications can occur in subsequent pregnancies.

Treatment is available through medicines and some women’s thyroid returns to normal.

HELLP

HELLP syndrome is the medical name given to a serious (and rare) complication of pre-eclampsia involving a combination of liver and blood disorders.

HELLP stands for:

  • H (haemolysis – red blood cell damage);
  • EL (elevated liver enzymes – indicating liver damage);
  • LP (low platelets in the blood leading to a bleeding tendency)

HELLP syndrome may be associated with other signs of pre eclampsia, such as high blood pressure, protein in the urine and swelling of the hands, feet or face. However, this is not always the case, and this may make its diagnosis more difficult. Women with HELLP syndrome often complain of a pain in the upper abdomen below the ribs, which is indicative of a tender liver. There may also be heartburn, vomiting and headache. The upper abdominal pain of the HELLP syndrome can be very severe, and is not relieved by simple remedies such as antacids (which would be the case if heartburn was the cause of the pain). HELLP syndrome symptoms can often be confused with other problems.

HELLP syndrome can arise at any stage during the second half of pregnancy. Diagnosis is by blood tests which examine liver enzymes, red blood cells and platelets. The condition is cured when the baby is born, however, this may mean that the baby has to be born earlier than intended. Read more about HELLP Syndrome – causes, signs and treatment.

Placenta Previa

In pregnancy, the placenta implants itself into the uterus wall and it is through the uterus that the baby gets all it’s nourishment for growth. The placenta usually implants in the upper part of the uterus, but can sometimes implant in the lower part of the uterus and grow over (or partly over) the cervix (the opening from the uterus to the vagina). This is known as placenta previa.

Placenta previa is usually diagnosed during ultrasounds. A low-lying placenta may move-up during the pregnancy as the uterus grows larger and ultrasounds during the course of the pregnancy will confirm if this is happening. If the placenta remains low-lying and covering, or partially covering the cervix, some painless bleeding can also occur during pregnancy – particularly in the third trimester and you will be advised to avoid intercourse and internal examinations during appointments as these can trigger bleeding. You may also be advised to get plenty of bed rest.

As the cervix dilates during labour, the placenta can begin to separate from the uterine wall and heavy blood loss can occur. The placenta can also block the cervix, preventing the baby from making it’s way down the birth canal. If placenta previa arises, a caesarean-section is usually recommended.

FORUM: Find support in the Pregnancy Health Issues forum section

Faintness

Feeling faint is a sign of a lack of blood flow to the head. When you are pregnant, your body has to work harder than usual to pump increased blood around the body. If you stand for too long, stand up too quickly or over-exert yourself, your blood may not keep up with you resulting in a loss of blood flow to the head and you feeling faint.

Sit or lie down quietly until the feeling passes and take it easy. If symptoms persist and occur often, ensure that you advise your healthcare provider as this may be a sign of other conditions.

Pre-eclampsia

Pre-eclampsia is a serious pregnancy condition that can affect both the mother and foetus.

Pre eclampsia can develop at any time in the second half of the pregnancy, although it is more usual for it to occur in the last few weeks. Symptoms include the following, which are usually detected during routine tests carried out at your ante-natal visits:

  • rising blood pressure
  • protein in the urine
  • swelling of the hands, feet and face

The unborn baby may grow more slowly than normal or suffer potentially dangerous oxygen deficiency.

Women with pre eclampsia may still feel perfectly well, however, pre-eclampsia can develop very quickly and if you experience any of these symptoms you should notify your healthcare provider immediately. Other symptoms may include upper abdominal pain and vomiting, severe headache and visual disturbances. These symptoms can indicate the disease has reached an advanced stage (also see HELLP above).

Occurence of pre-eclampsia may result in your baby having to be born before the planned due date. The condition usually disappears once the baby is born, although the new mum’s blood pressure may take a little longer to return to normal and you should expect to be monitored by your healthcare provider.

Pelvic Instability / Symphysis Pubis Dysfunction (SPD)

Pelvic Instability is a condition which causes pain and mobility problems during pregnancy. In normal pregnancy a hormone called Relaxin softens the ligaments around the joints of the pelvis. This natural process allows the pelvis to open slightly during childbirth for delivery and usually does not cause lasting discomfort. However, in some cases, the process is overactive causing the pelvic joints to move too much, causing pain (sometimes severe) and discomfort.

Pain usually occurs around the pelvic region and is worse when walking. Sometimes the joints click.

Pelvic instability can be treated and the symptoms managed and lessened. Speak to your healthcare provider or a specialist physiotherapist who has experience managing this condition.

Image credit:nyul/123RF Stock Photo

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  1. Tragically fertility rates are decreased in women who have PCOS or Hypothyroidism! But there’s little evidence that any particular diet helps increases a woman’s chances of getting pregnant quickly. However, there’s still hope for you and many other women in facing this challenge.

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