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Complications of Pregnancy: High Blood Pressure to

Gestational Diabetes and More

Gestational Diabetes (GD):

Gestational diabetes (GD) is high blood sugar or glucose levels during pregnancy. About 4% of pregnant
women will suffer from gestational diabetes. Not every mother will need to be screened using blood work, there
are guidelines as to who needs to be screened with blood work. This is typically screened for in the 28th week
of pregnancy, if you need additional screening with a glucose tolerance test (GTT) it will be done at this point.
If you have GD, your labor may be induced.
• Glucose Tolerance Test (GTT)
• Guidelines for GTT Testing
• Jelly Bean Alternative

Pregnancy Induced Hypertension/High Blood Pressure:

Pregnancy induced hypertension (PIH) is a high blood pressure disorder of pregnancy. It has long been one of
the major problems for mothers in pregnancy, it may also be talked about as ecclampsia or preecclampsia. It
affects 7% of first time mothers. Labor may be induced early if you suffer from severe PIH.

There are three different levels of PIH:

1. High Blood Pressure alone

2. High Blood Pressure and protein in urine and/or swelling
3. High Blood Pressure, protein in urine, swelling and convulsions
• Pregnancy Induced Hypertension
• Swelling in Pregnancy
• False Hypertension

Rh Factor:

In addition to the blood group (A, B, O, AB), the Rh factor is written as either positive (present) or negative
(absent). Most people (85%) are Rh positive. This factor does not effect your health except during pregnancy.

A woman is at risk when she has a negative Rh factor and her partner has a positive Rh factor. This
combination can produce a child who is Rh positive. If the mother and baby's blood mix, this can cause the
mother to create antibodies against the Rh factor, thus treating an Rh positive baby like an intruder in her
body. Rhogam is given to help prevent this sentiszation.

• Rh Factor

Placenta Previa:

Placenta previa is where all or part of the placenta covers the cervix or opening of the uterus. True placenta
previa occurs in about 1 in 200 pregnancies. Many times early ultrasounds may show a placenta previa, but
later as the uterus grows, the condition resolves itself. If it is still present at the end of pregnancy a cesarean
section may be performed to prevent bleeding.
• Placenta Previa

Oligohydramnios (Low Amnitotic Fluid):

When a woman is said to have too little amniotic fluid she has oligohydramnios. This is defined as having less
than 200 ml of amniotic fluid at term or an AFI of less than 5 cm. This means that during an ultrasound the
largest pocket of fluid found did not measure 1 cm or greater at its largest diameter. Though sometimes it is
actually related to maternal hydration, meaning that mom hasn't been well hydrated. There is also some
indication that amniotic fluid levels drop as the time of birth comes near. Many practitioners will have you drink
fluids and rexamine you via ultrasound.
• Oligohydramnios

Polyhydramnios (High Amniotic Fluid):

Polyhydramnios is the opposite end of the scale, being defined as 2000 ml of fluid at term or greater. This
occurs in fewer that 1% of the pregnancies.

While some feel that polyhydramnios is a cause for preterm labor because of uterine distension,
polyhydramnios in and of itself is not a predictor for preterm labor, rather the cause of the increase in fluid is
predictive of whether the pregnancy will go to term.

Polyhydramnios is more likely to occur when:

• There is a multiple gestation.

• There is Maternal diabetes.
• There is a congenital malformation.
• Polyhydramnios

Breech and Other Malpositions:

Breech babies are not in the normal head down position. This happens about 3-4% of all births at the end of
pregnancy. Babies are usually in malpositions for a variety of reasons, including:
• Uterine anomalies
• Fetal issues
• Multiples
• Other conditions

There is also a position known as transverse, meaning that the baby is lying sideways in the uterus. Since it
would be difficult to give birth to a baby in this way, your practitioner may do an external version or do a
cesarean section for your birth. There are also some practitioners who will do vaginal breech births.

• Breech Babies

Preterm Labor:

Premature labor is a very serious complication of pregnancy. Early detection can help prevent premature birth
and possibly enable you to carry your pregnancy to term or to give your baby a better chance of survival.
• Contractions or cramping
• Bright red bleeding
• Swelling or puffiness of the face or hands
• Pain during urination
• Sharp or prolonged pain in your stomach
• Acute or continuous vomiting
• Sudden gush of clear, watery fluid
• Backache
• Intense pelvic pressure

There may be other signs your doctor tells you to look for, be sure to call if you are concerned.

• Preventing Preterm Labor

Incompetent Cervix:

An incompetent cervix is basically a cervix that is too weak to stay closed during a pregnancy. Therefore
resulting in a preterm birth and possibly the loss of the baby, because of the shortened gestational length. It is
believed that cervical incompetence is the cause of 20 - 25 % of all second trimester losses. This incompetence
generally shows up in the early part of the second trimester, but possibly as late as the early third trimester.

It is generally categorized as premature opening of the cervix without labor or contractions. Diagnosis can be
made either manually or with ultrasonography.