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Serious Complications of Pregnancy

Symptoms
Potential Problem
Diagnosis
Treatment
Slight, irregular vaginal bleeding that often is brownish; pain in the lower abdomen, often on one side, and can be followed by severe pelvic pain; shoulder pain; faintness or dizziness; nausea or vomiting. Ectopic pregnancy (the fertilized egg implants outside of the uterus, usually in the fallopian tube). Blood tests; vaginal or abdominal ultrasound exam (screening that uses high-frequency sound waves to form pictures of the fetus on a computer screen); laparoscopy (surgery to view the abdominal organs directly with a viewing instrument). Because the embryo of an ectopic pregnancy cannot survive, it is removed surgically; or the woman is treated with a cancer drug, methotrexate, which dissolves the pregnancy.
Extreme thirst, hunger, or fatigue (but usually no symptoms). Also, a blood sugar value of 140 mg/DL or greater on a diabetes test. Gestational diabetes (a form of diabetes that usually occurs in the second half of pregnancy). Blood test one hour after drinking a glucose (form of sugar) drink. Most women can control their blood sugar levels with diet and exercise. Some women with gestational diabetes or women who had diabetes before pregnancy need shots of insulin to keep blood sugar levels under control.
Flu-like symptoms like mild fever, headache, muscle aches and tiredness; loss of appetite, nausea, vomiting and diarrhea; dark-colored urine and pale bowel movements; stomach pain; skin and whites of eyes turning yellow (jaundice); liver problems. Also often no symptoms. Hepatitis B (can be passed on to the baby). Blood test. Within 12 hours of birth, your baby will need a shot called HBIG, along with the first Hepatitis B shot.
Often no symptoms, but can include: small blisters or warts in the genital area; fever; fatigue; aches and pains; vaginal discharge (yellowish, bloody, green, gray, or thick and white like cottage cheese, or with a strong odor); burning or pain when urinating; itching around genital area; itching or burning in vagina; pain in legs or buttocks; pain during sex; frequent yeast infections; skin rash HIV or other sexually transmitted diseases (can be passed on to the baby). Blood test. Physical exam to look for symptoms in the throat, anus, or genital area. Visual exam to inspect skin for rashes, growths or sores, especially the area around the genitals. Pelvic exam to look at the inside of the vagina (birth canal) and cervix (opening to the uterus, or womb) and to feel internal organs for any inflammation or growths. Taking a sample of fluid or tissue from the vaginal, anal or genital area to look for the presence of virus. Antiviral drugs; possible cesarean delivery.
Flu-like illness with fever, muscle aches, chills, and sometimes diarrhea or nausea that can progress to severe headache and stiff neck. Listeriosis (infection from the bacterium listeria monocytogenes, which can be found in soft cheeses and ready-to-eat deli meats). Blood test. Antibiotics (often prevent infection in the baby).
Mild flu-like symptoms, or possibly no symptoms. Toxoplasmosis (parasitic infection that can be passed on to the baby, which can be contracted from cat feces or soil, or from eating raw or undercooked meat that contains the parasite). Blood test. If the mother is infected, the fetus can be tested through amniocentesis (a test on the fluid around the baby, to diagnose certain birth defects) and ultrasound. If fetus not yet infected, mother can be given an antibiotic, spiramycin (to help reduce severity of symptoms in the newborn). If the fetus is suspected of being infected, the mother can be given two medications, pyrimethamine and sulfadiazine. Infected babies are treated at birth and through the first year of life with these medications.
Pain or burning when urinating; pain in lower pelvis, lower back, stomach or side; shaking, chills; fever; sweats; nausea, vomiting; frequent or uncontrollable urge to urinate; strong-smelling urine; change in amount of urine; blood or pus in urine; pain during sex Urinary tract infection (if left untreated, can travel to kidneys, which can cause premature, or early, labor). Urine test. Antibiotics, usually 3 to 7 day course of amoxicillin, nitrofurantoin, or cephalosporin.
Painless vaginal bleeding during the second or third trimester. In many cases, no symptoms. Placenta previa (the placenta, or the temporary organ joining the mother and fetus, covers part or all of the cervix and can cause severe bleeding usually toward the end of the second trimester or later). An ultrasound exam. If diagnosed after the 20th week of pregnancy, but with no bleeding, requires to cut back on activity level and increase bed rest. If bleeding is heavy, requires hospitalization until mother and baby are stable. If the bleeding stops or is light, requires continued bed rest until baby is ready for delivery. If bleeding doesn't stop or if pre-term labor starts, baby will be delivered by cesarean.
Vaginal bleeding during the second half of pregnancy; cramping, abdominal pain, and uterine tenderness. Placental abruption (a condition in which the placenta separates from the uterine wall before delivery, depriving the fetus of oxygen). An ultrasound exam. When the separation is minor, bed rest for a few days usually stops the bleeding. Moderate cases may require complete bed rest. Severe cases (when more than half of the placenta separates) can require immediate medical attention and delivery of the baby.
Fetus stops moving around and kicking. If, after 26 weeks of pregnancy, you count fewer than 10 kicks in a day, or if the baby is moving a lot less than usual, see your health care provider right away. Baby possibly in distress, potential risk of stillbirth. A nonstress test (NST) (measures the response of the baby's heart rate to each movement the baby makes as reported by mother or seen by a health care provider on an ultrasound screen); contraction stress test (usually ordered if the nonstress test shows a problem - stimulates the uterus to contract with the drug pitocin to look at the effect of contractions on the baby's heart rate); biophysical profile (BPP) (a combination of the NST and an exam of the baby's breathing, body movement, muscle tone, and amount of amniotic fluid). Treatment depends on results of tests. If a test suggests a problem, this does not always mean the baby is in trouble. It may only mean that the mother needs special care until the baby is delivered. This can include a wide variety of things (such as bed rest and further monitoring) depending on the mother's condition.
High blood pressure (usually around 140/90); protein in the urine; swelling of the hands and face; sudden weight gain (1 pound a day or more); blurred vision; severe headaches, dizziness; intense stomach pain Pregnancy-related high blood pressure (preeclampsia, also called toxemia). Usually occurs after about 30 weeks of pregnancy. Blood pressure test; urine test; evaluation by a health care provider. The only cure is delivery, which may not be best for the baby. Labor will probably be induced if condition is mild and woman is near term (37 to 40 weeks of pregnancy). If a woman is not yet ready for labor, her provider may monitor her and her baby closely. May require bed rest at home or in hospital, until blood pressure stabilizes or until delivery.
Contractions, either painful or painless, anytime during pregnancy, that occur more than four times an hour, or are less than 15 minutes apart; menstrual like cramps that come and go; abdominal cramps with or without diarrhea; dull backache that may radiate around to the abdomen; increase in or change in color in vaginal discharge; constant or intermittent pelvic pressure Early or pre-term labor (labor occurring after 20 weeks, but before 37 completed weeks of pregnancy). Monitoring of uterine contractions by wearing an elastic belt around waist that holds a transducer or small pressure-sensitive recorder. Can be worn at the health care provider's office, hospital, or home. Lie down with feet elevated; drink 2 or 3 glasses of water or juice. If symptoms do not subside within one hour, contact health care provider. May require medications called tocolytics or magnesium sulfate to stop contractions.
Intense feelings of sadness, guilt, despair, helplessness, anxiety, irritability, which may disrupt your ability to function; appetite changes; thoughts of self-harm or harming your baby; "baby blues" haven't gone away after 2 weeks. Post-partum depression (a serious kind of depression that needs medical attention and treatment). Evaluation by a health care provider. Can be successfully treated in most cases with antidepressant medication, psychotherapy, participation in a support group, or a combination of these treatments.
Soreness or a lump in the breast accompanied by a fever and/or flu-like symptoms; possibly nausea and vomiting; yellowish discharge from the nipple; breasts feel warm or hot to the touch; pus or blood in the milk; red streaks near the area; symptoms could come on severely and suddenly. Breast infection (mastitis). Evaluation by a health care provider. If symptoms are not relieved within 24 hours of the following steps, see a health care provider (you may need an antibiotic). Relieve soreness by applying heat (heating pad or small hot-water bottle) to the sore area. Massage the area, starting behind the sore spot. Use your fingers in a circular motion and massage toward the nipple. Breastfeed often on the affected side. Rest. Wear a well-fitting supportive bra that is not too tight.
A low-grade fever and tiredness followed by a facial rash that looks like "slapped cheeks." The rash also can look lace-like and be on the trunk, legs, and arms. Some adults do not have the rash, but may have painful and swollen joints. A viral infection called fifth disease, caused by the human parvovirus B19. Many women of childbearing age are immune to this virus, and most women who are infected during pregnancy will not have serious problems as a result. But, there is a small danger that the virus can infect the fetus in some women. This raises the risk of miscarriage within the first 20 weeks of pregnancy. In women who have problems with their immune systems or with red blood cell disorders, such as sickle-cell disease, infection can cause severe anemia. Based on appearance of the rash. A specific blood test can be done to confirm it. No specific treatment, except for blood transfusions that might be needed for people who have problems with their immune systems or with red blood cell disorders. There is no vaccine to help prevent infection with this virus.

 

 


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