Common pregnancy health conditions

Some pregnancies require an extra bit of TLC. Our midwife explains the medical problems you need to keep an eye out for…

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For most mums to be, the biggest challenges during pregnancy will, thankfully, be morning sickness and aches and pains. But for some there could be other conditions that might need monitoring throughout the nine months. Don’t worry though, the main purpose of your antenatal appointments is to keep an eye on your pregnancy and make sure that problems don’t occur.

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Your midwife is constantly looking out for these conditions, and will be able to help if she spots one. Read on to find out what she’ll be watching for and how it could be treated.

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Pregnancy Diabetes

Gestational diabetes

This is when high levels of glucose are present your blood. It’s diagnosed by a blood test and your doctor, or midwife, will send you for a test they think you’re at risk. Lots of women are checked for diabetes during pregnancy, including women with a family history of diabetes, raised BMI (Body Mass Index – a sign of being overweight), and certain ethnic groups (these are all factors that can increase the chance of getting it). Uncontrolled diabetes can cause babies to grow very large and may cause heart problems.

Who gets it? 

Between 2 and 5 per cent of women in this country will have diabetes during pregnancy. Though the majority will no longer have the condition after the birth, there’s an increased risk of getting diabetes in later life.

What’s the treatment? 

The majority of women who develop gestational diabetes successfully control it with exercise and a healthy diet, although a few will need injections of insulin in order to help the body break down the glucose. With close care from the diabetic and obstetric team, it shouldn’t be a problem.

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Pre-eclampsia

This can occur anytime from around 20 weeks of pregnancy until a few days after the birth and is caused by a defect in the placenta. The placenta is the link between mum and baby, providing her baby with oxygen and nutrients. If undetected and allowed to develop, pre-eclampsia can potentially be life-threatening to the mum and baby, causing eclampsia which may result in seizures.

Pre-eclampsia can cause a rise in blood pressure, and protein in the urine. In extreme cases it can mean premature delivery. Some women will get symptoms of headaches, visual disturbances and general swelling (oedema), suggesting high blood pressure, though others will have no symptoms at all.

Who gets it? 

Pre-eclampsia affects one in 10 pregnancies in some form, but severely affects one in a 100 first pregnancies, and can affect both the mother and her unborn baby.

What’s the treatment? 

There is no treatment for pre eclampsia, other than the birth of the baby, but if it is suspected you’ll be monitored closely with frequent checks on blood pressure, urine and blood. If the condition is mild, the doctors will aim for you to continue with your pregnancy for as long as possible though induction may be advised if the tests show that the pre eclampsia is becoming more significant. Severe pre eclampsia will need immediate admission to hospital.

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Bleeding in pregnancy

Placenta praevia

This is when the placenta covers some, or all, of your cervix. It’s usually picked up at the anomaly scan at around 20 weeks of pregnancy. As the pregnancy progresses and the womb stretches, the placenta should rise up the wall of the uterus. When it doesn’t do that, you’re diagnosed with a placenta praevia. You’ll be closely monitored during the remainder of the pregnancy, and a c-section could be advised. Any fresh, painless bleeding should be reported immediately, as you might need to go to hospital.

Who gets it? 

Placenta praevia occurs in a very small percentage, around 0.5 per cent of pregnancies. It’s more common in women who’ve had a previous caesarean section, subsequent pregnancies, twin pregnancy, and those who smoke.

What’s the treatment? 

In more than 90 per cent of women who’ve been diagnosed with placenta praevia in the second trimester, the placenta will correct itself by the end of the pregnancy. The placenta itself doesn’t actually move, but as the uterus stretches it’s not as close to the cervix as it was earlier in pregnancy. Clever, eh!

If the condition is diagnosed after the 20th week, but you’re not bleeding, you’ll probably be advised to refrain from any vigorous exercise and to take life easy. If you’re bleeding heavily, you’ll be admitted to hospital so that the bleeding can be monitored, but even when it stops, you might well be asked to stay in hospital until your baby is ready to be born.

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High blood pressure

This is also known as gestational hypertension. It can affect the blood flow through the placenta, potentially affecting the growth of your baby, or cause a placental abruption (see next slide) so it’s important to keep it under control. Many women will have no symptoms at all, but some will experience a headache or visual disturbances.

Who gets it? 

About one in 10 pregnant women has problems with high blood pressure.

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What’s the treatment? 

If you develop high blood pressure during pregnancy, your midwife will first check for protein in your urine, to eliminate the risk of pre-eclampsia. High blood pressure can be controlled by medication but it will still need close monitoring to make sure that it stays within a normal range

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