Complications in pregnancy

Pregnancy and birth
Pregnancy and birth 

Most pregnancies will progress safely, happily and without any major problems or emergencies, but for some there may be complications. To be on the safe side and for your own peace of mind, you should be aware of any potential complications and the corresponding danger signs so that you can seek medical care if necessary.

If you experience any unusual symptoms, or if you have concerns about any of your pregnancy symptoms contact your doctor as soon as possible to arrange a check-up.

Some of the more serious complications include:

  • Ectopic Pregnancy
  • Incompetent Cervix
  • Miscarriage
  • Placenta Praevia
  • Placental Insufficiency
  • Placental Separation
  • Pre-Eclampsia & Eclampsia

Ectopic pregnancy
In normal pregnancy the fertilised ovum implants itself in the uterus, however in an ectopic pregnancy it implants in another area, almost always the fallopian tube. As the embryo grows, it pushes against the fallopian tube and gradually weakens the walls, resulting in bleeding and ultimately a burst fallopian tube. Thankfully there are warning signs for an ectopic pregnancy and along with any other unusual symptoms, these must be reported to your doctor immediately to enable quick treatment. You may be alerted to an ectopic pregnancy by abdominal pain (usually felt on one side), possible bleeding, feeling faint or fainting and shoulder pain in the same side of the body as the abdominal pain. If detected early, the fallopian tube can be saved before rupture occurs, however the embryo cannot be saved. An acute ectopic pregnancy will result in a burst fallopian tube. In this case the pregnancy is removed by surgery and depending on the damage to the tube, it may also need to be removed. After experiencing an ectopic pregnancy you can successfully become pregnant again, depending on your individual circumstances. Read our article on Ectopic Pregnancy.

Incompetent Cervix
In normal pregnancy, the cervix is sealed closed with a plug of mucus, which holds the foetus in the uterus. In an incompetent cervix, the cervix may begin to open before the term of the pregnancy (usually in the third of fourth month). This leads to rupture of the amniotic sac and miscarriage follows. This condition is rare, but may occur if the cervix has been damaged during previous pregnancies or surgery. This condition is not usually diagnosed until a first miscarriage has occurred. If a previous miscarriage is thought to have been caused by an incompetent cervix, preventative measures can be taken for your next pregnancy. Rest is recommended.

The loss of a baby before 28 weeks is termed a miscarriage while after 28 weeks, loss of the foetus is called a stillbirth. There are many known causes of miscarriage, and some unknown causes. Miscarriages usually occur in the first trimester, sometimes before the pregnancy has even been suspected or diagnosed. In the first few weeks of pregnancy approximately 30% of all pregnancies end in miscarriage. In some cases a period may be late and heavy and the conception and miscarriage may not even have been realised. When a couple experiences a miscarriage, they are still likely to conceive again, however miscarriages can increase in frequency with age and with the number of previous pregnancies. Small numbers of women can experience up to three or more miscarriages in a row and approximately 50% of these women may still go on to have a successful pregnancy, even though they will have suffered emotional pain, frustration and disappointment on previous occasions. If bleeding occurs at any stage in your pregnancy you must see your doctor. Bleeding is the most common symptom of miscarriage.

Miscarriage can be caused by many factors including:

  • Genetic problems due to chromosomal defects
  • Environmental factors such as smoking, alcohol and other recreational drugs
  • Hormonal abnormalities
  • Pre-existing disease or illness, uterine abnormalities or other medical conditions in the womb 
  • Bacterial and viral infections

While most people generally understand the need to grieve for the loss of a stillborn baby (after 28 weeks), often others do not understand that a miscarriage can also cause grief and depression. If you have experienced miscarriage, talk to others who have been through the same experience in our miscarriage, stillbirth and the loss of a child forums. You can also read our article on Women's Experience of Miscarriage and Coping with a Miscarriage.

Placenta Praevia
In a normal pregnancy the placenta implants itself in the top part of the uterus. In placenta praevia the placenta implants itself in the lower part or on the side of the uterus and can get in the way of the baby's passage at birth. The cause of placenta praevia is unknown, but it is more common in women who have had several children. Symptoms are bleeding after the 20th week of pregnancy (possibly after sex) and haemorrhage in the last two months of pregnancy. Placenta praevia can be diagnosed by ultrasound and treatment involves bed rest.

Placental insufficiency
A healthy placenta is vital for maintaining a healthy baby. An insufficient placenta can prevent your baby from gaining essential nourishment. Symptoms for placental insufficiency may include below average weight gain, below average fetal development, or slow growth of the uterus. An ultrasound examination will determine if growth of the fetus is adequate. Another useful sign is the activity of the baby in the last few months of pregnancy.

Placental separation
Sometimes the placenta can separate from the uterus, either partially or completely. This is more common in women who have had more than two children, but the cause is unknown. In mild cases, slight blood loss occurs and the condition is treated with bed rest and monitored by ultrasound, however labour may be induced if the pregnancy is close to term. The condition is acute when more blood is lost and a large amount of the placenta separates from the wall. As usual, if you notice any unusual symptoms, such as bleeding or pain, advise your doctor or specialist straight away.

Pre-Eclampsia & Eclampsia
Pre-eclampsia is a form of high blood pressure induced by pregnancy and occurs in approximately 15% of pregnancies. The condition relates to the health of the placenta and is more likely to occur in first time pregnancies, women over 35, multiple pregnancies, severely obese women or women who have suffered from pre-eclampsia in a previous pregnancy. Symptoms can include increasing blood pressure, protein in the urine, disturbances in kidney and liver function, fluid retention, swelling of face, hands and feet and possibly headaches, dizziness and nausea. If you have any of these symptoms you should report them to your doctor straight away! Your regular visits to the doctor include blood pressure and urine checks which doctors perform to help identify pre-eclampsia. In rare cases, pre-eclampsia is not picked up by doctors and develops into the much more serious condition - Eclampsia.

Further information on complications
The above information is only designed to provide you with brief descriptions of some of the symptoms and warning signs of a number of the more serious complications that can be experienced during pregnancy. If you require further information on any of the conditions outlined above, please seek further information from your doctor.

Discuss Pregnancy with other EB members.