The majority of pregnancies are free of major complications and result in healthy, full-term babies. This is not meant to scare you, but to provide answers to some what-ifs that have certainly been swirling in your mind. No information provided here should be taken as medical advice--please consult your doctor immediately if you have any concerns.
1. Bleeding
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In the early stages of pregnancy, some bleeding can be totally normal. Hormonal changes, implantation of the fertilized egg into the uterus, sex, or a minor infection can all cause spotting or small amounts of blood. Although bleeding is not always a cause for concern, it can sometimes be a sign of pregnancy complication.
It’s never wrong to call your doctor if you are pregnant and notice any vaginal bleeding. Your doctor will want to run blood tests to check your hormone levels, and will likely order an ultrasound to see what’s happening inside you.
2. Ectopic Pregnancy
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Under normal circumstances, a fertilized egg will attach to the lining of the uterus and develop into a healthy baby. On rare occasions, the egg will get lost on its way and implant somewhere else. Ectopic pregnancies are never viable, and can become an emergency if left untreated.
Signs of a possible ectopic include severe cramping, vaginal bleeding, and pain on one side of your body. If your doctor suspects an ectopic she will order an ultrasound to confirm. Your doctor can give medication to stop the growth of the pregnancy if caught early, or she can perform surgery to remove the pregnancy and repair any damage in severe cases.
3. Subchorionic Hemorrhage
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The most common pregnancy complication found on ultrasound is subchorionic hemorrhage. These bleeds come from between the outer layer of the sac and the placenta. Sometimes these hemorrhages will result in vaginal bleeding, but other times they occur with no symptoms.
The good news is, if your baby has a heartbeat and is developing normally, a subchorionic hemorrhage usually does not put your baby at risk. Your doctor will likely put you on pelvic rest (no sex) and restrict how much you can lift. In more severe cases bed rest may be advised.
4. Hyperemesis Gravidarum
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Nausea is one of the things that almost every pregnant woman has to deal with. If your "morning" sickness never ends and you get to a point that nothing stays down, you might have hyperemesis gravidarum. The biggest concern with hyperemesis is dehydration and malnourishment.
For most cases of hyperemesis your doctor will prescribe anti-nausea medication. If the medication is unable to stop the vomiting, a hospital stay might be necessary so that drugs and fluids can be given intravenously. In only the most severe and inadequately treated cases is there concern for the life of mother or baby.
5. Gestational Diabetes
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Screening for gestational diabetes is part of routine pregnancy care. The screening involves drinking a sickeningly sweet drink and having your blood drawn an hour later to make sure your body is still processing sugar properly. Gestational diabetes frequently has no symptoms, but may include extreme thirst or fatigue.
If you are diagnosed with gestational diabetes, your doctor will put you on a strict diet to control your blood sugar. If diet alone cannot control your blood sugar, insulin shots may become necessary. The main complications from uncontrolled gestational diabetes are early delivery, higher risk of preeclampsia, and the potential of having an extremely large baby.
6. Premature Contractions
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It is completely normal to experience irregular contractions well before your due date. These practice contractions, called Braxton Hicks, are usually just your body’s way of warming up. Dehydration and strain can irritate contractions, so if you are experiencing more than usual, drink plenty of water and lie down on your left side. And of course call your doctor ASAP if you are at all concerned.
If contractions are regular, increase in intensity, or don’t stop after drinking water and lying down, also call your doctor. You will most likely need to be monitored to be sure you are not in premature labor. In the rare chance that you experience pre-term labor, your doctor may put you on bed rest and begin medications to slow contractions and/or speed up your baby’s lung maturity. In some cases you may be admitted to the hospital for constant monitoring.
7. Leaking Fluid
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If you feel as if you are leaking fluid, don’t delay calling your doctor. Since hormones, infections, and a growing uterus putting pressure on your bladder can all cause increased vaginal fluid, your doctor will use a strip of pH paper to determine whether the fluid is amniotic or something else. If it is the former, you will be given an ultrasound to see how much is left and evaluated from there.
If you are leaking amniotic fluid earlier than 37 weeks, you will be admitted to the hospital, put on bed rest, and watched for signs of infection. In some cases, the rupture can heal and the fluid can be replenished, giving the baby more time to grow. In many cases, labor begins within 48 hours of rupture of the amniotic sac. The outcome for a premature baby depends on too many factors to list; however, being in a hospital with a level three NICU is important for monitoring a severely premature baby.
8. Pre-eclampsia
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Pre-eclampsia , the most common of the more severe pregnancy complications, is characterized by elevated blood pressure and increased protein in the urine. If left untreated, pre-eclampsia can result in eclampsia, which can cause fatal seizures in the mother. Your doctor will monitor your blood pressure and test your urine at every prenatal appointment.
The only cure for pre-eclampsia is delivery. If you develop high blood pressure and/or protein in your urine you will be monitored closely to determine if and when you need to deliver. Your doctor will gauge how long it is safe for you to remain pregnant in order to give your baby time to mature--as long as your life is not at risk.
9. PUPPP
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Pruritic urticarial papules and plaques of pregnancy, or PUPPP for short, is an extremely uncomfortable rash that some pregnant women develop. Itchiness from hormonal changes and stretching skin is to be expected, but PUPPPs is a completely different matter. This itchy rash can extend well past your belly to include everything but your face. While PUPPPs is not a threat to the life of baby or mom, the extreme discomfort may cause you to choose induction shortly after 37 weeks of pregnancy.
Steroid creams and lotions may help with the itching, but delivery is the only cure. Your doctor will advise you whether oral steroids could be of any benefit, and will counsel you on choosing if, or when, you should be induced.
10. Placenta Previa
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The placenta is an organ that develops on the lining of the uterus to support your growing baby’s needs. Typically the placenta will attach and grow to the top, front, back, or side of your uterus. In some cases, the placenta attaches to fully or partially cover the cervix, thereby blocking the baby’s way out. If you have developed placenta previa you may have no signs, or you may develop sudden, painless bleeding. If you have been diagnosed with placenta previa it is strongly recommended that you do not insert anything into the vagina as previa can be a potentially serious condition if not monitored properly.
Placenta previa occasionally self-corrects during the course of pregnancy, allowing you to attempt vaginal birth safely. In other cases, your doctor will perform a C-section. In severe cases, preterm delivery is necessary, so monitoring of the placenta and baby is done frequently.