Potential Complications of Pregnancy

A majority of pregnancies considered low risk and require very little interventions. These types of pregnancies are able to be safely managed by the assistance of midwifery care. There are times where complications can and do arise during pregnancy. When complications occur during pregnancy, it is encouraged to seek the care of a physician to safely manage the pregnancy.

There are a variety of complications that can arise that may require the assistance of a physician and they can be broken down into obstetrical and medical complications. In today's article, we will discuss some potential complications that can arise during pregnancy that might require a physician to become part of your care team for pregnancy and childbirth.

Obstetrical Complications:

An obstetrical complication is a complication experienced during pregnancy that is triggered by the pregnancy. These types of complications can have negative effects on the pregnancy if not treated appropriately.

First Trimester Bleeding: First trimester bleeding can be caused by a variety of reasons but one very important reason to rule out is spontaneous abortion, otherwise known as miscarriage. Spontaneous abortion is "the natural termination of pregnancy by expulsion of the products of conception prior to the ability of the fetus to survive if born" (King et al., 2015, p. 725).

Pregnancy Outside of the Uterus: One rare occasions, a fertilized egg can end up implanting on parts of the body that are not appropriate for sustaining pregnancy (ectopic pregnancy, ovarian pregnancy, molar pregnancy).

Hyperemesis Gravidarum: Nausea and vomiting during pregnancy is a common discomfort. It is triggered by the massive fluctuation of hormones experienced in order to support pregnancy. These hormones for some individuals can cause severe vomiting in a small percentage of individuals. When vomiting becomes this severe, medical intervention may become necessary in order to assist in the massive fluid loss experienced by consistent vomiting.

Cervical Insufficiency: In some individuals, the cervix dilates and effaces too early in the gestational period. It is the cervix's job to hold the baby and placenta inside the uterus where they continue to gestate until full-term (37 - 42 weeks). If the cervix dilates and effaces too early in the pregnancy, this might lead to a ruptured membranes and/or contractions before the baby is full-term.

Pre-Term Labor: Pre-term labor is when the body enters into labor before the 37 - 42 week mark.

This can happen for a variety of reasons: cervical insufficiency, infection, inflammation, hormone changes, etc.

Fetal Growth Restriction: FGR is when some factor of the pregnancy is not allowing the baby to grow at a typical rate.

Some potential reasons for this are: high blood pressure, diabetes, too few red blood cells (anemia), long-term lung or kidney conditions, autoimmune conditions such as lupus, low weight, a large amount of excess weight (obese), poor nutrition or weight gain.

Oligohydramnios: This is a condition where there is not a sufficient amount of amniotic fluid surrounding the baby inside of the uterus.

Medical Complications:

As opposed to obstetrical complications, medical complications during pregnancy are not necessarily triggered by pregnancy but can cause negative effects on the pregnancy if experienced during the gestational period.

Hematologic Disorders in Pregnancy: These are conditions that effect blood production and composition.

Examples: Anemia, sickle cell disease, thalassemias, thrombocytopenia.

Clotting Disorders: Similar to hematologic disorders, clotting disorders effect the blood and its ability to clot when bleeding occurs.

Examples: Antiphospholipid syndrome, inherited thrombophilias, venous thromboembolism.

Cardiovascular Conditions: These are conditions that effect the heart and the way that it functions.

Examples: Gestational hypertension, preeclampsia-eclampsia, chronic hypertension, and preexisting hypertension with superimposed preeclampsia.

Respiratory Conditions: These are conditions that effect the lungs and the way that they function.

Examples: Influenza, the common cold, COVID, pneumonia, asthma.

Gastrointestinal Conditions: These types of conditions effect the digestive system and its functions.

Examples: Gastroesophageal reflux, cholelithiasis (gall stones), pancreatitis, viral gastroenteritis.

Endocrine Conditions: The endocrine system is in charge of hormone production. These types of conditions effect the way that the body produces hormones to allow for properly bodily function.

Examples: Pre-gestational diabetes, thyroid disease.

Neurologic Conditions: Neurological function is what sends signals from the brain and out towards the body. Neurological conditions effect the way that these signals are transmitted.

Examples: Carpal tunnel syndrome, bell's palsy, sciatica and meralgia paresthetica, migraine headache, epilepsy, multiple sclerosis.

Dermatoses of Pregnancy: Dermatoses refers to a disruption in skin production within the body both externally and internally.

Examples: Pruritic urticarial papules and plaques of pregnancy (PUPPPS), pemphigoid gestationis, intrahepatic cholestasis of pregnancy.

Infectious Diseases: Infectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites.

Examples: Toxoplasmosis, varicella, listeriosis, parvovirus B19, rubella, cytomegalovirus.

Sources:

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King, Tekoa L., Brucker, Mary C., Kriebs, Jan M., Fahey, Jenifer O., Gegor, Carolyn L. & Varney, Helen (eds.) , (2015) Varney's Midwifery. 5th Edition. Retrieved from: Books@Ovid database.