Healthy Pregnancy - Complications - Symptoms, Diagnosis, and Treatment

Complications Symptoms, Diagnosis, and Treatment

If you have any of the symptoms on this chart, contact your doctor right away to lower your risk of complications.

There are various specific tests done during the first trimester of pregnancy, and a few screenings later in pregnancy to help prevent these problems, or spot them early. Your doctor will give you a schedule for visits, tests, and screenings. It is important to follow your doctor's advice about treatment so you have a safe delivery and a strong, healthy baby.

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:

In this condition, 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:

This is 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:

This is a viral infection that 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.

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 Infection/Sexually Transmitted Diseases :

These infections 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.

Severe constant nausea and/or vomiting several times every day for the first three or four months of pregnancy.

Hyperemesis gravidarum (HG):

This is severe nausea in the first trimester that can cause malnourishment and dehydration in some women. HG keeps pregnant women from drinking enough fluids and eating enough food to stay healthy. Many women with HG lose more than 5 percent of their pre-pregnancy weight, have nutritional problems, and have problems with the balance of electrolytes in their bodies.

If you think you might be vomiting excessively, call your doctor. Your doctor will check you to see if you are dehydrated, which can be dangerous for you and the baby.

Many women with HG have to be hospitalized so they can be fed fluids and nutrients through a tube in their veins. Usually, women with HG begin to feel better by the 20th week of pregnancy. But some women vomit and feel nauseated throughout all three trimesters.

Flu-like illness with fever, muscle aches, chills, and sometimes diarrhea or nausea that can progress to severe headache and stiff neck.

Listeriosis:

This infection is cause by the bacterium listeria monocytogenes. This bacterium 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:

This is a parasitic infection that can be passed on to the baby. The parasite that causes toxoplasmosis is sometimes found in cat feces, soil, and raw or undercooked meat.

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 this infection is left untreated it can spread to the kidneys. This 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, there are no symptoms.

Placenta Previa:

In this condition, the placenta (temporary organ joining mother and fetus) covers part or the entire cervix. Placental previa can cause severe bleeding usually at 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:

This is a condition in which the placenta separates from the uterine wall before delivery. This can deprive 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 doctor right away.

Fetal Problems:

The baby may be having some problems. Fetal distress can increase the 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 doctor 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.

High-blood Pressure/Pre-eclampsia:

This is pregnancy-related high blood pressure. It can also be called toxemia. Pre-eclampsia usually occurs after about 30 weeks of pregnancy.

Blood pressure test; urine test; evaluation by a doctor.

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 doctor 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.

Premature or Pre-term Labor:

This is when a woman goes into labor after 20 weeks, but before 37 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 doctor'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 your doctor. 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:

This is when women become depressed in the first year after giving birth. This serious problem needs medical attention and treatment.

Evaluation by a doctor.

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.

Mastitis:

This is an infection in the breast.

Evaluation by a doctor.

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.

Fifth Disease:

This is a viral infection caused by the human parvovirus B19. Most pregnant women who are infected with this virus do not have serious problems. But, there is a small danger that the virus can infect the fetus. This raises the risk of miscarriage during the first 20 weeks of pregnancy. Fifth Disease can cause severe anemia in women who have red blood cell disorders like sickle-cell disease or immune system problems.

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.

Publications

Diabetes and Pregnancy Frequently Asked Questions - This publication tells why people with diabetes should get proper health care before and during pregnancy to help prevent birth defects and other complications, such as miscarriage or stillbirth.

http://www.cdc.gov/ncbddd/bd/diabetespregnancyfaqs.htm

Group B Streptococcal Disease - This publication provides information on the causes and effects of Group B Strep infections.

http://www.cdc.gov/groupbstrep/

High Blood Pressure in Pregnancy - This publication contains information on high blood pressure in pregnancy. It covers the effects of high blood pressure, what preeclampsia is and how it is detected, and ways to prevent problems from occurring during the pregnancy.

http://www.nhlbi.nih.gov/health/public/heart/hbp/hbp_preg.htm

Parvovirus B19 Infection and Pregnancy - This fact sheet provides information about the parvovirus B19 infection and pregnancy. It describes illnesses caused by this infection (including Fifth Disease) the signs and symptoms, the affects it has during pregnancy, and treatment.

http://www.cdc.gov/ncidod/dvrd/revb/respiratory/B19&preg.htm

Breech Babies: What Can I Do if My Baby is Breech? (Copyright © AAFP) - This publication provides information on breech pregnancy: what it is, how a baby can be safely delivered, and what an external cephalic version is.

http://familydoctor.org/online/famdocen/home/women/pregnancy/labor/310.html

Epilepsy and Pregnancy: What You Should Know (Copyright © AAFP) - This fact sheet is for women with epilepsy who become pregnant, including the risks to the mother, the risks for the baby, how to protect you and your baby, and what to expect when you are pregnant.

http://familydoctor.org/online/famdocen/home/women/pregnancy/illness/243.html

http://www.marchofdimes.com/pnhec/188_677.asp

http://www.diabetes.org/gestational-diabetes.jsp

Gestational Diabetes: What It Means for Me and My Baby (Copyright © AAFP) - This fact sheet provides information on gestational diabetes including how it can affect you and your baby, what you can do if you have this disease, what changes you should make to your diet, and what you can do to protect you and your baby.

http://familydoctor.org/online/famdocen/home/women/pregnancy/complications/075.html...

http://www.marchofdimes.com/pnhec/188_679.asp

Hyperemesis Gravidarum (Copyright © APA) - This fact sheet explains what hyperemesis gravidarum is, why it happens, what the symptoms are, how to tell the difference between hyperemesis gravidarum and morning sickness, and what treatments are available.

http://www.americanpregnancy.org/pregnancyhealth/hyperemesisgravidarum.html

Intrauterine Growth Restriction: When Your Baby Stops Growing Before Birth (Copyright © AAFP) - This publication explains what happes when a baby is smaller than normal during pregnancy, what causes intrauterine growth restriction and how to know if your baby is just small or had IUGR.

http://familydoctor.org/313.xml

Miscarriage (Copyright © MOD) - This fact sheet explains some of the reasons why a miscarriage can occur, the tests that can be done following a miscarriage, how to prevent future miscarriages, and the recovery time you should expect before becoming pregnant again.

http://www.marchofdimes.com/pnhec/188_1086.asp

http://familydoctor.org/online/famdocen/home/women/pregnancy/complications/064.html...

Preeclampsia (Copyright © Mayo Foundation for Medical Education and Research) - Preeclampsia is a common problem during pregnancy. The condition — sometimes referred to as pregnancy-induced hypertension — is defined by high blood pressure and excess protein in the urine after 20 weeks of pregnancy. This publication provides general information regarding preeclampsia.

http://www.mayoclinic.com/health/preeclampsia/DS00583

Shortness of Breath During Pregnancy (Copyright © University of Michigan) - This fact sheet explains the shortness of breath you may experience during your third trimester, as the baby's weight presses on your diaphragm and digestive organs.

http://www.med.umich.edu/obgyn/smartmoms/pregnancy/discomforts/shortnessofbreath.htm...

Toxoplasmosis and Pregnancy (Copyright © AAFP) - Toxoplasmosis is an infection that occurs during pregnancy and can affect the unborn child. This fact sheet explains prevention of toxoplasmosis, and treatment methods.

http://familydoctor.org/180.xml

Urinary Tract Infections During Pregnancy (Copyright © AAFP) - This publication contains information on urinary tract infections (UTI): How it can affect your baby, how it can be treated, and what to do to prevent them from reoccurring.

http://familydoctor.org/497.xml

Organizations

= Indicates Federal Resources

Current as of March 2007