High-Risk Pregnancy Complications

Every family hopes and prays for the expectant mother to have a safe pregnancy and birth of a healthy baby. However, each pregnancy has some risks or difficulties involved, and at times they can be very dangerous to the health of an expecting mother and growing fetus, and can lead to a high-risk pregnancy.

Having a high-risk pregnancy basically, means that a woman has a higher chance of complications during her pregnancy period or at the time of delivery, which can be due to her health conditions, mental status, lifestyle and many other external factors. Though, it is not necessary that every expecting mother would have high-risk pregnancy complications, having some idea about these complications or risks beforehand can help to deal with them and prevent them from occurring.

High-Risk Pregnancy Complications

Anemia: Also termed as anemia of pregnancy, it is a condition wherein the body has very few red blood cells or the cells are unable to carry oxygen to different organs of the body. During pregnancy a woman's blood volume increases nearly by 50% and the concentration of red blood cells get diluted. As the developing fetus is dependent on the mother's blood, if she is suffering anemia, it can lead to poor fetal growth, preterm birth and low birth weight. Deficiency of vitamins and minerals like vitamin B12, folic acid, iron, etc., can cause anemia. However, usually the condition is not considered severe, unless the levels fall too low.

Intrauterine Growth Restriction: Intrauterine Growth Restriction (IUGR) is a condition wherein the fetus is smaller than the expected for a couple of weeks of pregnancy. Also termed as fetal growth restriction, the babies born with IUGR are often called small for gestation age (SGA). A fetus growing under such condition, weights less than 90% of all other fetuses of the same gestational age and there are chances wherein the baby may born prematurely, i.e., before 37 weeks. Deficiency of nutrients and oxygen needed for growth and development of organs is one of the most common cause of IUGR, which prevents cells and tissues for growing or decrease them in size. The condition can be hereditary as well. Newborns often appear weak, pale, and have loose, dry skin and wide eyes. Moreover, their umbilical cord is very thin and dull-looking as compared to the normal shiny and fat cord.

Preterm Labor: Preterm labor is labor that starts before 37 completed weeks of pregnancy and is mainly characterized by premature uterine contractions, rupture of the amniotic sacs or membranes, or cervical dilatation. Though the actual cause of preterm labor is still unknown, premature rupture of membranes is considered to be one of the dominant cause, which may occur as a result of some chronic medical illnesses like heart or kidney disease, high blood pressure, infection, etc. Babies born under such condition are often small, have low birth weight and may need help in breathing, eating, fighting infection, and maintaining stable body temperature.

Premature Rupture of Membranes: Premature Rupture of Membranes (PROM) is basically a rupture of the membranes or amniotic sac before the labor starts. If PROM occurs before 37 completed weeks of pregnancy, it is termed as Preterm Premature Rupture of Membranes (PPROM). The condition usually occurs due to an infection in the uterus, improper prenatal care, sexually transmitted disease, vaginal bleeding, or unhealthy habits like smoking or drinking alcohol. The condition may also lead to complications like placental abruption (early detachment of the placenta from the uterus), compression of the umbilical cord, cesarean birth and postpartum (after delivery) infection.

Gestational Diabetes: Gestational diabetes is another high-risk pregnancy complication wherein the blood glucose level gets elevated and other diabetic symptoms start appearing during pregnancy in a woman who has not been earlier diagnosed with diabetes. Gestation diabetes during pregnancy does not occur due to lack of insulin, but because of blocking effects of other hormones on the insulin generated in the body. Normally, the diabetes symptoms disappear after the delivery.

Pregnancy Induced Hypertension: Pregnancy-induced hypertension (PIH) is a form of high blood pressure during pregnancy which is more common in young woman with a first pregnancy, twin pregnancies, or in a woman suffering other health problems like diabetes, chronic hypertension, etc. In extreme conditions, a woman may suffer eclampsia (a severe form of pregnancy-induced hypertension) which occurs near the end of pregnancy and may cause seizures in the expecting mother.

Placenta Previa: Placenta previa is a common high-risk pregnancy complication wherein the placenta is attached close to or covers the cervix (opening of the uterus). The condition may result in excessive bleeding or hemorrhage at the lower part of the uterus or the area of the placenta that covers the cervix. Other risk factors involved are abnormal implantation of the placenta, slow fetal growth, preterm birth, birth defects and infection during pregnancy.

Hydramnios: Hydramnios is a condition in which there is excess of amniotic fluid around the fetus. The condition may lead to birth defects, premature rupture of membranes or amniotic sac, placenta abruption and umbilical cord prolapse. Diabetes, gastrointestinal abnormalities, heart failure, congenital failure, twin to twin transfusion syndrome, etc. are some factors that may contribute to hydramnios during pregnancy.

Rh Disease: Rh disease is a rare condition that occurs when there is an incompatibility between the blood types of the mother and baby. Every individual has a blood type, (O, A, B, or AB) and an Rh factor, either positive or negative, defining certain specific characteristics. Now, if an Rh negative mother has a baby who is Rh positive, complications may occur if the baby's red blood cells cross to the Rh negative mother, especially at the time of delivery when the placenta detaches or during miscarriage or abortion.

Basically, in this disorder (Rh disease) the mother's immune system considers the baby's Rh positive red blood cells as foreign bodies and responds by generating antibiotics to fight and destroy these foreign cells. Generally, during a first pregnancy, Rh sensitization is not likely, but it only becomes a problem in future pregnancies with another Rh positive baby. As the mother's antibodies cross the placenta to fight the Rh positive cells or destroy red blood cells in the baby's body, the newborn can become anemic or have other complications like jaundice or organ enlargement.

Post-Term Pregnancy: Post term pregnancy is a pregnancy that lasts more than 42 weeks, often due to miscalculation of pregnancy conception dates. Basically, near the end of pregnancy, the placenta begins to age and is not able to function properly. Moreover, the amniotic fluid volume also starts decreasing, as a result the fetus may get poor oxygen supply and will stop gaining weight.

Multiple Pregnancy: Multiple pregnancy is a pregnancy with two or more fetuses, which occurs when more than one egg fertilizes and implants in the uterus. A family history of multiple pregnancies, older age, high parity (one or more previous pregnancies), certain ovulation stimulating medications, etc. can contribute to multiple pregnancy in a woman. Though it's not a severe high-risk pregnancy complication, preterm labor and birth, pregnancy induced hypertension, anemia, birth defects, miscarriage, cesarean delivery, postpartum hemorrhage, etc. are some difficulties that can be associated with it.

Ectopic Pregnancy: Ectopic pregnancy is a pregnancy that develops outside the uterus, near the fallopian tube where there is not enough blood flow to keep the fetus alive and so it dies. The condition is more common in women having infertility problems, endometriosis, sexually transmitted disease, tubal surgery and intrauterine conception device (IUD).

Miscarriage: Also termed as spontaneous abortion, miscarriage is defined as early pregnancy loss, which can be categorized in to following types: threatened (spotting and bleeding in the first trimester), complete (the fetus, placenta and other tissues are passed with bleeding), incomplete (some parts of the tissues remain in the uterus), missed abortion (the fetus dies but doesn't passes out of the uterus), septic (infected miscarriage) and recurrent (more than three miscarriages).

Stillbirth: Also termed as intrauterine fetal death or demise, it's an extremely unfortunate condition where in the baby dies in the uterus. Diabetes, high blood pressure, congenital abnormalities, Rh disease, placenta problems, etc. are certain causes of stillbirth.

Postpartum Hemorrhage: Postpartum hemorrhage is another high-risk pregnancy complication, in which there is excessive bleeding after the delivery. The condition is more common after cesarean birth wherein the uterus continues to contract and expels the placenta. As a result, these contractions compress the bleeding vessels in the area where the placenta was connected, leading to intense postpartum bleeding and hemorrhage.

To overcome the aforementioned high-risk pregnancy complications, a pre-pregnancy visit to a health care provider (regarding high-risk pregnancy questions and doubts) is very important especially, if a woman has a prior medical problem. Regular visits to health care providers, high-risk pregnancy test and proper consumption of recommended medications can enable any woman with medical problems to enjoy a healthy and successful pregnancy. Take care!